Private health insurance and diabetes
Choosing a health insurance company that meets your health and budget needs takes time and research.
Private health insurance consists of two parts: Hospital Cover and Extras Cover. These parts can be purchased separately or packaged together.
Hospital Cover can be used for in-patient hospital expenses with your choice of doctor and hospital from your fund’s approved hospital list. You’ll also receive tax benefits where applicable.
Extras Cover can be used to receive benefits for health services that Medicare doesn’t cover, like dental, optical, physiotherapy and more.
Some tips when choosing private health insurance:
- Make a list of the sorts of services you are likely to want to use
- Talk with your diabetes educator. They know your medical history and have experience across type 1 and type 2 diabetes
- Contact private health insurance providers for a quote
- Only pay for the health insurance features you need
- Check your insurer has formal agreements with your health services provider
- Compare products and ask for written quotes. There are also ‘compare’ websites that compare a range of insurance, energy and personal finance products.
- Ask all consultants if their advice is independent and whether they take commissions
- Check which services are covered by Medicare. You can do this by contacting Medicare on 132 011, by email or checking their website
- Check waiting times and any exclusions for people with your health conditions. Often there is a 12 month waiting period on claims for benefits.
- Review your health insurance needs each year.
All premium changes will apply from 1 April 2024. Each insurer’s average change will be displayed on health.gov.au. It is each insurer’s responsibility to clearly explain to their policy holders any changes to their premiums and their options to make sure they have the right policy for their circumstances.
Comparing private health insurance companies
There are companies who offer independent advice on buying health insurance. Some are managed by the government but some receive commission for selling health insurance. A selection of the companies who offer advice on private health insurance are:
Australian Medical Association (AMA)
Each year the AMA publish a health insurance report card to help people to understand how health insurance works. Read their AMA Private Health Insurance Report card 2023.
Choice
The consumer advocacy group, Choice, have information on their website to help people understand more about buying private health insurance. Read their Health insurance buying guide.
comparethemarket.com.au
Comparethemarket.com.au is a comparison website to help people to choose a private health insurance policy.
Health Insurance Consultants Australia (HICA)
HICA is a health insurance review service. It allows consumers to assess which health insurance is most appropriate for them.
MoneySmart
This section of the MoneySmart website offers free, independent advice on insurance products so you can get the policy that’s right for you.
PrivateHealth.gov.au
PrivateHealth.gov.au a government website which is independent of private health funds and brokers. It aims to answer questions about health insurance by explaining how it works and who and what is covered. You can also compare policies from different health funds to help you choose a private health insurance policy that is right for you.
If you have a complaint about your health fund, you may wish to contact the Private Health Insurance Ombudsman on 1300 362 072 or www.ombudsman.gov.au.