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Hospital cover in Australia
Private hospital cover helps pay for treatment in private hospitals, offering more flexibility and shorter surgery waiting lists. Policies start from less than $75 a month and may help cut your tax bill.
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Cheap hospital cover
If you're just looking for the cheapest hospital cover available, here are a few basic tier policies from Finder partners. All of these will exempt you from the Medicare Levy Surcharge (MLS) and the Lifetime Health Cover loading (LHC).
*Quotes are based on a single individual with less than $90,000 income, $500 excess and living in Sydney.
What you should know about cheap hospital cover
Not a lot is covered. The cheapest policies will usually only give you restricted cover for rehabilitation, hospital psychiatric services and palliative care. Some of the policies featured above are 'plus' policies that cover some additional treatments - keep an eye out for these.
There may be high excesses. The cheapest policies may come with a high excess, so you'll have to pay a big lump-sum before you get any help from your insurer. The polices in the table listed above all have a $500 excess, which is lower than many.
You may have waiting periods to serve later. If you get a low level of health insurance now then upgrade later, you'll still have to serve the waiting periods for any benefits that weren't included in your initial policy.
Compare Bronze hospital cover
If you're looking for cheap hospital cover that covers more treatments than a basic policy, here are some options from Finder partners. They're all bronze-tier policies, which cover a reasonable range of treatments.
*Quotes are based on a single individual with less than $90,000 income, $750 excess and living in Sydney.
What is hospital only health insurance?
Hospital only health insurance lets you be treated at private or public hospital as a private patient - usually with your choice of doctor. Hospital cover also pays a share of your medical costs when you're admitted to the hospital, such as accommodation and theatre fees. Hospital cover can give you more flexibility as a patient, including access to shorter surgery waiting lists. It comes in four tiers: basic, bronze, silver and gold.
Hospital only
Hospital cover helps pay for treatment in a private hospital, and may help you save money at tax time.
Extras only
Extras cover will chip in for medical costs outside hospital, like optical, dental, physio and chiro.
Combined
Combined policies have both hospital and extras coverage, offering the most comprehensive coverage available.Pros and cons of hospital health insurance
Pros
- With 4 tiers to choose from, and dozens of health funds, it's possible find cover that's tailored to your individual needs
- With a hospital plan, you can swerve long elective surgery waiting lists at public hospitals
- Basic hospital policies can cost less than what you'd be hit with if the Medicare levy surcharge, a government levy, applies to you. Getting in early can also help you make premium savings due to the Lifetime Health Cover loading
Cons
- Top tier plans offer wide-ranging cover, but they can add more than $200 to your insurance bills each month; more basic plans come with limited perks
- Out-of-pocket costs still apply when the cost of your health service is more than the MBS item fee.
- You can't usually claim for pre-existing medical conditions for the first 12 months of your policy. A pre-existing condition is any ailment you've suffered from within the 6 month period before your insurance starts.
What are the hospital health insurance tiers?
Each of the different health insurance tiers has to cover a standardised set of treatments. Here's a quick summary of each tier.
Gold hospital cover
Gold-tier hospital insurance covers all 38 treatments outline by the Australian government. This includes treatments like joint replacements, pregnancy and insulin pumps, as well as all services covered by Silver-tier policies.
Typical cost: From around $160/month for a single policy.
Silver hospital cover
Silver-tier hospital insurance covers at least 26 treatments outlined by the Australian government. This includes treatments like dental surgery, lung and chest, and podiatric surgery, as well as all services covered by Bronze-tier policies.
Typical cost: From around $115/month for a single policy.
Bronze hospital cover
Bronze-tier hospital insurance covers at least 18 treatments outlined by the Australian government. This includes treatments like joint reconstructions, Ear, nose and throat, and gynaecology, as well as all services covered by Basic-tier policies.
Typical cost: From around $80/month for a single policy.
Basic hospital cover
Basic-tier hospital insurance isn't required to fully cover any treatments outlined by the Australian government, but it does need to have restricted cover for rehabilitation, hospital psychiatric services, and palliative care. Generally, basic cover is primarily used to avoid the Medicare Levy Surcharge and Lifetime Health Cover loading.
Typical cost: From around $75/month for a single policy.
If a policy is described as a 'plus' policy, then it will cover the minimum number of treatments for its tier, plus at least one treatment from the next tier up. For a full list of the treatments covered by gold policies, open the drop-down below.
Hospital health insurance and tax (the MLS and LHC)
There are two different government schemes that, if you do not have hospital cover, may cost you money.
Medicare Levy Surcharge
If you earn over $90,000 and don't have hospital cover, you'll be taxed between 1% and 1.5% of your wage due to the Medicare Levy Surcharge. Get a cheap policy, and you can avoid the tax.
For a lot of people, the cost of a hospital policy can actually be less than what they'd be taxed if they didn't have it. So even if you don't plan on using private health insurance, it can make financial sense to get a policy anyway.
Lifetime Health Cover loading
Lifetime Health Cover loading kicks in on the 1 July, immediately following your 31st birthday. For every year you don't have health insurance from that date, you'll be charged an extra 2% when you eventually do decide to get a policy.
That means if you wait until you're 41, your premiums will be 20% higher than they would have been if you took out a policy before the deadline. Get life insurance before the deadline, and you won't be hit with the penalty.
Gold hospital cover
If you're looking for premium-level hospital cover, a gold-tier policy is the best you can get. It's the only type of policy that has to offer unrestricted access to all 38 categories and covers treatments related to pregnancy, weight-loss surgery and joint replacements.
Quotes are based on a single individual with less than $90,000 income, $500 excess and living in Sydney.
How does hospital cover work?
If you receive an in-hospital service as a private patient, Medicare typically covers 75% of the
Medicare Benefits Schedule (MBS)fee. Your private health cover will pay the remaining 25%.
However, a doctor or specialist won't always stick to the MBS fee (set by the government as a fair fee for a service or treatment). In which case, you'd have to pay an out-of-pocket fee known as 'the gap'.
Some insurers have deals with healthcare providers that mean all or some of the gap is covered by your health fund.
Hospital cover only helps with items that are on the MBS. If the treatment you want isn't on the MBS, you won't get help from private hospital cover.
Waiting periods for hospital cover
The main hospital covers and their waiting periods include:
| Service covered | Typical waiting period |
|---|---|
| Emergency ambulance cover | 1 day |
| Accidental injury benefit | 1 day |
| Acute mental health treatment | 2 months - a one-time waiver may apply |
| Rehabilitation | 2 months |
| Palliative care (for life-limiting illnesses) | 2 months |
| Pregnancy and birth | 12 months |
| Pre-existing conditions | 12 months |
Waiting periods vary depending on your policy. The services listed here do not represent a complete list of services covered under all hospital policies. Depending on your fund and policy, you may find many other cover options to match your needs.
What isn't covered by private hospital insurance?
No matter what level of health insurance you get, there are certain things that won't be covered. They include the following:
- Pre-existing medical conditions within the first 12 months
- Out of pocket costs (that's when your doctor charges more than the MBS item fee)
- Fees for any specialists you see outside of hospital
- Any services you receive outside of hospital
- Any medical treatment that does not have an MBS item number
- Hospital stays that are longer than 35 days
- Cosmetic surgery for non-medical reasons
Health insurance deals from participating funds for September 2021
| Store | Discount | |
|---|---|---|
 ahm Deals
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Get 6 weeks free. PLUS any 2 & 6 month waits on extras waived Offer applies for new joins on hospital and extras after the first 60 days by September 30. T&Cs apply. Last verified |
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Coupon code ends |
 Medibank Health Insurance Deals
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|
Want up to 40,000 Live Better points plus, 2&6 month waits waived on extras? That’s up to $400 worth of gift cards! Available for new members who join eligible hospital and extras and complete a Live Better goal or challenge. Up to 20,000 points for singles / up to 40,000 points for couples/families. T&Cs apply. Last verified |
VERIFIED
Coupon code ends |
 Qantas Health Insurance Deals
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|
Join and earn up to 120,000 Qantas Points. Plus, waive the 2 & 6 month waiting periods on extras with combined Hospital and Extras cover. Issued by nib health funds. Eligibility criteria and T&Cs apply. Last verified |
Get deal
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Deal ends |
 HCF Health Insurance deals
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|
HCF members can get loyalty rewards and discounts across Australian stores Health fund members can claim 8% off Rebel gift cards, 4% off Woolworths e-gift cards & more. Last verified |
Get deal
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|
Frequently asked questions
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Ask an Expert
Need to find health insurance that covers plastic surgery, breast lift and augmentation and lower body lift please.
Hi Julie,
Thank you for getting in touch with Finder.
A top hospital cover will usually include plastic and reconstructive surgery. Please note that you will need to compare using the filter for ‘cosmetic surgery’ in your health insurance policy (part of hospital cover). It is also important to note that it’s only covered if deemed medically necessary, so best to check each specific surgery with the insurer directly. Not all surgeries are covered in full too – so always best to ask for the specifics.
You may seek help from one of our health insurance teams on 1300 594 882 to help you fully understand your options when it comes to health insurance for plastic surgery. Also, consider your cover needs and discuss the policies available with your health fund before deciding on the right policy for you.
I hope this helps.
Please feel free to reach out to us if you have any other enquiries.
Thank you and have a wonderful day!
Cheers,
Jeni
Which hospital cover insurance is best value option for gastric lap band surgery please
Hi Cheryl,
Thank you for reaching out to Finder!
While we can’t recommend specific policies or insurers to our users, you may utilize our page to compare policies from insurers covering weight-loss surgeries such as lap band surgery.
Please ensure that you carefully read through relevant documents such as Product Disclosure Statements/Terms and Conditions when comparing your options before making a decision to make sure it caters to your needs.
Cheers,
Charisse