How Much Does Private Health Insurance Cost
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When you start to review and compare health insurance policies, the price generally becomes a big part of your decision-making process.
The price of health insurance depends on your location, the health fund you choose, and the level and cover amount you want. For example, the average cost of private health insurance for a Basic Hospital plan for a single adult living in NSW is between $96 to $115.15 per month, while Extras only costs between $14.30 and $29.61 per month (February 2020).
Table of contents
- Calculating your private health insurance cost
- How the type and level of coverage affects your price
- Compare Hospital insurance cost
- Compare the cost of Extras cover
- Compare the price of ambulance cover
- Average cost of health insurance per State
- Health insurance and taxes
- How to find affordable health insurance
Will health insurance save you money in the long run?
For many Australians, the peace of mind that private coverage brings is worth the cost. Others prefer to save the money they would have spent on health insurance premiums, only using it for health expenses.
Consider how much money you'll have to save to pay for future medical expenses that are not covered by Medicare. Add that annual amount to the Lifetime Health Cover (LHC) loading and Medicare Levy Surcharge (MLS) you must pay. If these costs are lower than what you'll pay in premiums a year, then the cost of health insurance might not be worth it for you.
Health insurance policies vary from insurer to insurer. Luckily, it's a very competitive market. You can shop around and compare policies from major health funds to find a plan best suited to your requirements and budget.
How is your health insurance cost calculated?
Health insurance premiums usually have a base calculation, and then depends on your chosen provider and personal requirements. For example, the average cost of private health insurance for a combined Basic Hospital and Extras policy with a $750 Excess for a single adult living in NSW is between $110.50 and $142.30 (February 2020).
Other factors influencing your health insurance cost, include your LHC loading (if applicable), the hospital Excess and co-payment you pay and the rebate you can claim at tax time.
How the type and level of coverage affects your premium
Your specific requirements and family dynamic should provide you with an indication of the level and type of coverage you need.
For example, do you want a policy that covers your preferred doctor or specialist? Are you planning to get pregnant and want protection for a broader list of birth-related benefits? Do you have kids that need braces, or are you approaching the age where you need to consider joint replacement surgery and hearing aids?
Generally, Hospital cover costs more than Extras cover. However, if you combine the two options into one policy from the same insurer, you might be able to save.
Private Hospital policies fall into 4 categories; Basic, Bronze, Silver and Gold. Each group includes a minimum number of services it must cover and a list of exclusions and restrictions.
- Gold: Most comprehensive policy, covering 38 clinical categories. Generally, the most expensive hospital plan that includes pregnancy and birth-related services.
- Silver: A mid-level hospital policy that covers 29 clinical categories, including dental surgery and heart-related services.
- Bronze: An affordable policy covering 21 clinical categories. Generally, excludes joint replacements, as well as services for the back, neck and spine.
- Basic: The cheapest hospital plan that covers you for accidents and helps you avoid paying the MLS and LHC loading.
With a Hospital policy, you usually have to pay an Excess amount when admitted to hospital. The higher your Excess, the lower your health insurance premium will generally be. You typically have the choice of a $0, $250, $500 or $750 Excess for a single adult, depending on your insurer. Some insurers' also charge a co-payment, which is the amount you agree to pay each day you're in the hospital.
Take note: Depending on your insurer, Basic Hospital policies might not be available without Extras cover. If your Hospital policy has a 'Plus' it means it provides additional benefits on top of the minimum number of services it must provide.
Compare Hospital insurance cost
Take note: The above information is based on a monthly premium for a Hospital policy with a $750 Excess for a single adult living in Queensland and excludes any LHC loading and rebates.
Find cheap health insurance
Extras insurance pays a benefit for general treatments and services received outside of the hospital. There are 3 broad categories you can choose from; Basic, Mid and Top. However, different insurers might have different names for their Extras options.
- Basic: Generally, the most affordable option covering essential treatments with a lower annual limit. For example, general dental, physio and optical.
- Mid: A medium-level policy with increased annual limits for a long list of treatments.
- Top: The most comprehensive Extras option, covering an extensive list of general treatment and services, generally, provides the highest benefit limits.
Take note: Extras cover cannot help you avoid paying the MLS and LHC loading, you’ll need a Hospital policy for that.
Compare private health insurance cost for Extras cover
Take note: The above information is based on a monthly premium for an Extras policy for a single adult living in Queensland.
Cost of ambulance cover in Australia
If you live somewhere, that requires you to pay for ambulance services, for example, Victoria and ACT, you might need a policy that provides ambulance cover.
Ambulance cover is generally included in Hospital and Extras policies. However, select insurers do offer ambulance only cover options.
Take note: Cover is based on a single adult living in Victoria looking for emergency ambulance cover only.
The price of health insurance in different States of Australia
Heath insurance premiums vary according to where you live. Your location affects the price of your health cover, because of competition between funds, your state rules and the cost of living in your area.
Average cost of health insurance by State
|State||The average monthly premium for a Basic Hospital & Extras policy|
Take note: Cover is based on the average monthly premium for a single adult purchasing a combined Basic Hospital and Extras policy.
Tax and health insurance
There are three financial tax incentives the Australian government uses to persuade you to purchase private health insurance.
Lifetime health cover (LHC) loading
The LHC loading requires you pay an additional 2% on your health insurance premium (up to 70%) for each year you did not have Hospital cover after the 1st of July following your 31st birthday. This loading can only be removed after you've held a Hospital policy for 10 consecutive years.
Medicare Levy Surcharge
Should you decide not to purchase private health insurance, you'll pay an additional 1% to 1.5% MLS fee on your taxable income. The percentage depends on your income threshold. You can avoid the Medicare Levy Surcharge by purchasing a Hospital insurance policy.
The private health insurance rebate
Get up to 33.413% back on premiums when you qualify for a private health insurance tax return. This rebate can generally be claimed as an upfront reduction on your premiums or as a refund through your annual tax return. The deduction percentage you're entitled is calculated on your age and expected taxable income for the financial year.
Take note: Rebate percentages are adjusted yearly on the 1st of April.
Tips for finding cheap health insurance
Generally, the best way to find more affordable health insurance in Australia is to:
- Do your research and know the benefits you want your health plan to cover. If you only wish to avoid the LHC loading and MLS, then a Basic Hospital plan might suffice.
- Shop around and compare costs from some of the major health funds available in your state.
- Consider a higher Excess to reduce your monthly premiums. However, make sure you have that amount of money saved and ready when needed.
- Consider combining plans into one policy purchased from the same insurer; this may result in a discount.
- Pay your annual premium as a lump sum before the 1ste of April to avoid the yearly price increase.
- Check to see if you can join one of the restricted health funds suited to your industry, for example, the Teachers Health and Defence Health Limited.
- Pick the plan most suited to your stage of life and budget.
Frequently asked questions and answers
Generally, you can pay your health insurance weekly, monthly or yearly via direct debit, credit card, the fund’s online membership service, a cheque in the mail or BPay. However, payment arrangements differ from insurer to insurer.
Every year, on the 1ste of April, the price of health insurance rise. The cost of health insurance in Australia generally goes up due to the increasing cost and usage of health services and requests for new technologies.
Sort of. You might be able to claim the private health insurance rebate as a refundable tax offset when lodging your tax return. Alternatively, you can get a reduction on the amount of premiums you pay your insurer.
The average cost of a combined Silver Hospital ($750 Excess) and Extras policy for two adults with children living in NSW is around $390.75 to $485 per month (as at 17 February 2020). However, the price you'll pay depends on the state you live in, the health fund you choose and your specific requirements.
For a single adult, without dependents, living in NSW, you can expect to pay between $110.50 and $142.30 a month for a Basic combined Hospital ($750 Excess) and Extras policy (17 February 2020).
Couples wanting a Bronze Hospital policy ($750 Excess) with minimum Extras generally pay between $292.62 and $312.92 per month (as at 17 February 2020). Start comparing similar policies from major health funds to decide which one offers the best value at an affordable price.
To avoid paying the 1% to 1.5% Medicare Levy Surcharge, you generally need to purchase a Basic Hospital plan, which is usually the cheapest option.
Request & compare private health insurance cost
- Discover why your health insurance premiums are rising. Learn about the factors that influence the rise and what you can do to keep your insurance affordable.
- On 1 April 2020, health insurance costs are rising by an average of 2.92%. Find out how your health fund compares to other health insurers in Australia.
- Pensioners could benefit from private health insurance that includes comprehensive hospital and extras services. Find out if you need it & how much it costs.
- Get the best health insurance promotions &save on premiums or have your Extras waiting periods waived. Find out which health funds offer sign-up incentives.
- If you’re between the ages of 18 and 29 years old, you can save up to 10% on your hospital premiums. Discover which health funds provide youth discounts.
- Learn how Access Gap Cover can help you reduce or eliminate out-of-pocket specialist fees for in-hospital treatments. Compare gap health insurance providers.