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South Australia Private Health Insurance

Megan Fraser Fact Checked Updated: 27 November 2023
Types of Health Insurance

One of the wisest decisions you can make is to plan and prepare for your future. One way to achieve this is by making sure you are protected during any emergency situation and have access to all treatments or services needed to improve or maintain your health.

We all want to avoid having to fork out extra money for unforeseen medical bills, which is why having private health insurance could be a good decision for you and your family.

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Why do health premiums differ according to state?

Health insurance premiums vary according to the state you live in. This is due to each state having its own level of taxes and charges that affect health insurance costs. Discrepancies in state property markets also influence health costs. For example, it might cost more to manage a hospital in the eastern suburbs of Sydney than in parts of Adelaide.

Recently, health insurance premiums throughout Australia have risen by close to 5%. This increase means that Hospital Cover for a single adult living in South Australia will come to an annual average of $2 043.57. If you decide to add Extras Cover you can expect to pay an additional $868.24 per annum.

Private health insurance premiums across states vary because of:

Best Private Health Insurance in South Australia

Despite rising costs, private health insurance is necessary for many SA residents, giving them more control over their choice of health care practitioner, helping them avoid out-of-pocket expenses and the Medicare Levy Surcharge.  

If you are one of those SA residents, you should regularly review your health policy to ensure it is still providing you value or if you’re thinking of purchasing a policy for the first time, then compare similar options to see which one best suits your requirements and budget.

The below table provides insight into what a single South Australian adult, without dependents, can expect to pay for a combined hospital and extras policy.

Compare health insurance in South Australia

Health Fund Policy OptionExcess Average Monthly Premium What Stands Out
GMHBA Budget Direct Starter Package $500 $123.71 Covers the removal of tonsils, wisdom teeth and appendix, as well as joint reconstructions and investigations. You’re also covered for physiotherapy and partial ambulance services.
Medibank For Everyday Starter $500 $112.95 Overnight accommodation in a private hospital and a shared room in a public hospital as a private patient. Comprehensive ambulance cover and covers optical, acupuncture and remedial massage.
Bupa Simple Start $500 $116.35 Cover you for accidents, selected dental surgery and minor gynaecological surgery. For everything else, you get public hospital cover.
HCF Young Starter $500 $144.60 Hospital treatments and accommodation as a private patient in a private or public hospital, with comprehensive ambulance cover. You’ll also receive free overseas travel insurance.
nib Kickstarter $500 $108.33 Private hospital cover for accidental injuries only and comprehensive ambulance cover. You’ll also benefit from Non PBS Pharmaceuticals, general dental and chiropractic.

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SA private hospital insurance waiting periods

A waiting period refers to the amount of time you’ll have to wait after joining your private health insurance until when you’re able to claim for services. Waiting periods exist as a form of protection for health insurers against people who might wait until they need treatment before joining a health fund, claiming large amounts, and then immediately cancelling their policy.

You’ll generally be subject to a waiting period when you:

  • Are a new member, never before having a Hospital or Extras policy.
  • Are an existing member, upgrading to a higher level of cover, or if you plan to reduce your payable excess.
  • Transferred from another health fund and have not fully served the required waiting periods for equivalent benefits.

General waiting periods

Health insurance Levy and Rebates

Avoid health insurance levies

As a South Australian resident, you have access to Medicare. However, you are encouraged to take out private health insurance to relieve pressure from this public health care system.

If you decide not to take out private health insurance, you will be expected to pay a Medicare Levy Surcharge of 1.5%, based on your annual income. Additionally, you’ll also be charged another 2% tax via the Lifetime Health Cover (LHC) loading if you don’t get a health fund before the 1st of July following your 31st birthday.

Private health insurance rebates

If the avoiding the above levies weren’t incentive enough, having private health insurance makes you eligible for the private health insurance rebate. This rebate is an amount that the government contributes towards the cost of your insurance premiums, with the amount depending on your income.

If you qualify to receive a rebate, you can claim either in 2 ways:

  • As a premium reduction OR
  • On your annual tax return from the ATO.

Frequently asked questions

  • Are ambulance services in SA free?

    No, ambulance services in SA are not free and non-emergency ambulance fees start at $213.00. However, you can reduce this amount to $21.20 per annum by taking out a private health insurance policy with Ambulance Extras Cover.
  • Are dental services in South Australia free?

    Yes, SA Dental Services provide a range of publicly funded dental services throughout South Australia for eligible children and adults. Adults are eligible for basic dental treatment when they have a current Pensioner Concession Card or Health Care Card or a Department of Veteran’s Affairs Pensioner Concession Card. Dental services for children under the age of 18 is available whether their parents have a current concessions card or not.

When comparing private health funds available in South Australia, make sure you look at more than just the price, terms and conditions of each policy vary greatly.

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