Understanding hospital and extras cover

When it comes to buying private health insurance there are two main types – hospital and extras. The level of cover you choose determines the procedures and services you’re covered for – but as a rule of thumb the higher the level of cover the more you’ll be able to claim and the more money you’ll typically get back.

Hospital cover

With a basic hospital cover you may be covered for a ride in an ambulance, accidents and minor surgeries such as removal of appendix or tonsils or some knee and shoulder surgeries. Inclusions differ between providers, so you’ll need to read the product disclosure statement before signing up.

Policies that cover you for just public hospital stays also exist, and from around $9 per week may be sufficient coverage for those wanting to avoid paying the Medicare Levy Surcharge and the Lifetime Health Cover Loading. Ambulance only cover is available from around $40 per year and can be claimed unlimited times throughout the year.

Most public hospital only policies give you choice of which doctor treats you in the public system, but you’ll be likely to stay in a shared ward. For only a few dollars per week more, a basic hospital and extras policy will give you access to private rooms, the chance to jump public hospital queues and access to more services such as dental, optical, physiotherapies and natural therapies.

Extras

For those healthy young things out there, hospital and major illness may not be top of mind. But that doesn’t mean you won’t benefit from private health insurance. Extras cover is for the services you use every day that keep you fit and healthy. So if you need to see a physiotherapist or chiropractor, or want a new pair of Prada frames, then extras cover may be suitable for your lifestyle – some extras covers will even foot part of the bill for fitness centre sign up fees.

With extras, most providers limit how much you can claim, so you may be entitled to receive up to $300 each year on physio bills, or be able to claim up to $450 on basic dental, for example. Claim periods differ between providers – some claim periods commence with your policy, others may back date your claim period in line with the calendar year so it’s worth asking your provider.

Once you’ve done your homework and crunched the numbers to determine which policy is best for your situation, shop around for the best deal. Your hospital and extras cover don’t need to be held with the same provider, so compare each separately to find the best option for you. Revisit your cover annually to ensure you’re still paying for the best cover and that your policy is still relevant to your lifestyle, if you’re not happy then switch over!