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Insure? Not Sure?

Topics in this Section

Introduction

Contents

General Information

Surcharges and Incentives

About Private Health Insurance

Types of Cover

Questions You Should Ask

Common Terms

Insurer Contact Details

Types of Private Health Insurance Cover

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Hospital Cover

You could elect to pay a lower premium and take out a hospital cover policy with one or more of the following features:

  • an exclusion for a particular condition or conditions

If your policy features an exclusion for a particular condition, you are not covered for treatment as a private patient in a public or private hospital for that condition. For example, if you purchase a private health insurance policy that excludes maternity, hip replacements and knee replacements, and you go into hospital as a private patient for one of these conditions, your health insurer will not pay any benefits towards your hospital and medical costs.

If you are unsure which conditions are excluded on your policy you should ask your health insurer.

  • a front-end deductible (also known as an excess)

An excess is an amount of money you agree to pay for a hospital stay before health insurance benefits are payable. For example, if your policy has an excess of $200, you will be required to pay the first $200 of your hospital costs should you go to hospital as a private patient. An excess could apply every time that you go to hospital in a year, or it may be capped at a total amount that you will have to pay in a year. If you are unsure how the excess on your policy works you should ask your health insurer.

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Private Health Insurance Administration Council

Suite 16, Level 1, 71 Leichhardt Street, KINGSTON ACT 2604
Telephone 02 6215 7900 | Facsimile 02 6215 7977 | Email phiac@phiac.gov.au

 

Last modified: 22 July, 2005