Your Pain-free Guide to Switching Health Insurance in Australia

Published: March 13, 2018

As premiums rise and health fund complaints increase, you’re probably thinking about switching private health insurances or even cancelling. However, you might not want to rely solely on Medicare, especially with patients having to wait up to two years to see a public hospital specialist before they can even be assessed for surgery.

The decision to switch health insurance providers should be dependent on your personal circumstances, changing lifestyle and budget. The switch is a relatively simple process, with most private health companies assisting you with the transition. The hard work comes before when deciding which health insurer you’re going to change to. Compare leading health funds and make sure to consider your current and future needs before you switch.

Breaking up with your private health fund is hard, but if you've decided to switch then our guide will make your transition as painless as possible.

Can I transfer my health insurance to another company?

Yes, you can change your health insurer at any time. You are not bound by a contract and don’t have to remain with a health fund that no longer provides what you need.

In fact, your new health insurer will probably assist you with the switching process. Your job is to make sure you know what you want from a new health insurer and compare quotes from Australia’s top health insurance companies before making a decision.

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12 factors to consider before switching health insurance companies

  1. Waiting periods: Generally, you won't have to reserve a waiting period, unless you're switching to a higher level of cover. If you have not yet completed your waiting period, you will serve the remainder on your new fund.
  2. Whether your needs have changed: Consider the stage of life you're in now. For example, perhaps you've gotten married or divorced, started a family or nearing retirement.
  3. What the plan covers: Make sure your new fund provides coverage for all your list of requirements. For example, outpatient care, ambulance cover, maternity services and orthodontics if you have kids.
  4. The premium: Don't base your decision to switch on cost alone. However, you might want to review the health fund's history of yearly increases to get an indication of their long-term affordability.
  5. Out-of-pocket maximums: Consider the gap payments you'll be responsible for if visiting a medical specialist, not on their list of providers.
  6. Annual limits: Be clear on the benefit and lifetime limits for specific services. covered on the policy. Annual limits are different between health funds and usually also depends on your level of cover: basic, mid or comprehensive.
  7. Loyalty bonuses: Select companies rewards loyal customers with bonuses or discounts. Make sure you're not worse off when transferring to a new company.
  8. Provider networks: Check if your preferred dentist, doctor and specialist are covered under the new fund's network of providers.
  9. List of prescriptions drugs: Are your medications covered under the new fund and if so what amount do you need to contribute?
  10. Customer reviews: Be sure to read what customers have to say about their experience with the health fund. Ideally, you want to find an insurer that is liked by their customers and has a good reputation for paying claims.
  11. Lifetime Health Cover loading: Fortunately, switching health funds will not have any effect on your lifetime health cover (LHC) loading, provided your new fund includes hospital cover.
  12. Clearance certificate: You need a clearance certificate from your previous insurer before you can change health insurance. This certificate provides a record of your current health insurance coverage.

How to switch health insurance providers: Your step-by-step-guide

  • Step1: Get a variety of quotes: Get detailed quotes from leading health insurance companies and compare which is best suited to your requirements.
  • Step 2: Apply for cover from your new fund and ensure premium payments of your old policy are up to date. Make sure to specify that your new membership should start once cover from your old fund has ceased.
  • Step 3: Request a clearance certificate, also known as transfer certificate, from your old fund. This must be completed within 14 days of a request. If your new insurer is handling the transfer, check in after a few days to make sure your old policy details have been sent.
  • Step 4: Check the paperwork from your new health insurer carefully to confirm that your purchase matches what you expect to be covered for.
  • Step 5: Cancel your old cover and check your bank statement to make sure the deductions have stopped.
  • Step 6: Start your new cover: Contact your new fund and permit them to deduct premiums from your bank account.

Example health insurance companies to change to

Once you have decided to switch policies, you need to start comparing coverage from some of Australia’s top health funds, below are some examples:


Switch to Medibank

With over 3,000,000 members, Medibank ranks as one of Australia’s leading private health insurance companies. Moving over to Medibank can be done in three easy steps:

  1. Call them or join Medibank online. The Medibank health cover selector will assist you by recommending a cover based on your personal needs.
  2. Choose the Medibank health cover that’s right for you. Medibank will immediately cover you for services your previous fund covered you for.
  3. Contact your previous fund and cancel your existing health coverage.

Changing to HCF

HCF is Australia's largest not-for-profit health insurance company. All that HCF requires of you is to:

  • Select your choice of cover: Hospital, Extras or Combined.
  • Complete your application
  • HCF will liaise with your previous fund on your behalf.

Switching to nib

nib is one of Australia’s fastest growing health funds. They go out of their way to make switching easy:

  • Join nib online.
  • Choose the nib cover best suited to your needs.
  • nib will contact your previous insurer and request a Transfer Certificate.

Make sure you switch to nib within 59 days of cancelling your previous policy.


Switching to Australian Unity

Australian Unity has provided Australians with health coverage for over 175 years. Changing to Australian Unity requires you to:

  • Choose your new Australian Unity Cover.
  • Sign up online or over the phone.
  • Australian Unity will contact your old health fund, cancel your cover, an
  • Request your details to be forwarded to them.

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Why people leave or move health funds

Whether you decide to switch funds or cancel your policy depends on your specific situation. Decisions are most often based on:

  • Premium increases: Health insurance premiums are revised annually to keep in line with medical costs.
  • Your doctor has stopped accepting your insurance fund, so you switch to a fund that lists them as a provider.
  • Joining your partner’s health fund.
  • Public health insurance is just as good: While Medicare is astounding, it's important to remember you will be placed on a waiting list for elective surgeries and Medicare does not cover emergency ambulance costs unless you are eligible for a concession.
  • Bad experience with private health insurance: There has been a 60% year-on-year increase in complaints to the Private Health Insurance Ombudsman (PHIO).

How can I change my health insurance plan?

If you decide to stay with your current provider, you can always just change your level of cover to better suit your changing circumstances and budget. Go to their online membership portal or call your insurer and ask them to switch your membership to a different policy. If you change to a higher level of cover you may have to serve a waiting period before claiming benefits not previously provided.

Frequently asked questions and answers

When should I change my health insurance plan?

The best time to change your health insurance plan is before the 1st of April, which is when health insurers increase their premiums every year. You might also consider switching when your current health fund no longer provides the benefits you require at your current stage of life.

Do I have to re-serve waiting periods when switching?

No, generally you do not have to reserve a waiting period which you’ve completed on your old health fund when changing to a new fund of the same or lower level of benefit. Your new fund will give you continuity for the waiting periods you have already served. 

However, should your new policy include higher benefits than your old policy, you will have to wait the specified amount of time before you can claim for those benefits.

How do I cancel my health insurance?

If you want to cancel your private health insurance policy, you will need to be up-to-date with your insurance premiums and any other outstanding fees. On the other hand, you must be reimbursed for any insurance payments you made in advance.

To cancel your private health insurance:

  1. Call, email or log onto the online membership portal.
  2. Request a cancellation.
  3. Make sure you receive your clearance certificate within 14 days of cancellation.

Can I suspend my health insurance policy?

Yes, you can usually suspend your health insurance policy. Australians travelling overseas for a specific period do not need to cancel their policy while they're away. Just contact your insurer and find out how long they’ll allow you to suspend your cover.

Do I have to have hospital cover and extras from the same provider?

No, you do not have to take hospital and extras coverage from the same insurer. Just make sure your different health funds knows you have cover with other funds and that you agree to follow their guidelines concerning claims.

What are the implications when switching health insurance when pregnant?

Most health insurance policies have a 12-month waiting period for pregnancy-related claims. This means that you need to arrange private health insurance as soon as you begin planning for a family.

However, if you’ve already served part of your waiting period on one fund and want to switch, you’ll only be required to serve the remainder of your waiting period to be able to claim for the same services you had on your previous fund.

Ready to switch?

Start comparing health funds and going through the 12-point checklist above.

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