Western Australia Health Insurance

Published: August 29, 2017

If you live in Western Australia, then you are privileged to experience the best health standards in the world. A state that also boasts of having one of the longest life expectancies. That said, 66% of Western Australians are obese and overweight, the drinking behaviour is considered risky, and the healthcare system is under pressure from an ageing and expanding population.

While Medicare does cover more comprehensive services like health management programs, weight-related surgery, rehabilitation, joint surgery, and osteoporosis treatment, private health insurers do.

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Use this guide to find out which health insurance fund in Western Australia might offer you the cheapest premium. While price shouldn’t be your only consideration, we’ll also compare the features and benefits of some of the top health insurance funds available to you.

Who offers cheap health insurance in WA?

Western Australians can expect to pay higher Extras premiums than the rest of the country, with families paying around $1,898.00 in yearly premiums. Hospital cover will cost families around $4,112.85 per year, while combined packages for families are generally cheaper compared to other states, with annual premiums of around $6,145.54.

While premiums are largely dependent on your personal needs and circumstances, generally they are influenced by the cost of running a health fund, the level of competition between health funds, the cost of living, health trends in your area, and the demographics in your state. Because of all these variables, you’ll only find the cheapest health cover in WA by comparing different policies from different companies.

Compare private health insurance in WA

We’ve compared health insurers in Western Australia to give you a good idea of how much you could pay for private health insurance. The below table shows you the average monthly premium for a combined hospital and extras package for a single adult with no dependents.

Health Fund Policy Option Excess Average Monthly Premium What Stands Out
HBF Young Singles Saver Twin Pack $100 $112 Biggest health fund in WA, covering 82% of medical treatments in hospitals. You can avoid or reduce outstanding costs by choosing their GapSaver.
Teachers Health Fund StarterPak $0 $97.20 Exclusively for teachers. Health & fitness discounts, quality health management programs, and access to 17 dental centres.
Medibank Everyday Essentials $250 $114.85 Access their 24/7 Health Advice Line in times of emergencies, and claim 100% back on your annual dental check-up and optical items.
Nurses and Midwives Starterpak $0 $97.20 Exclusive policies for nurses & midwives. One of the few funds to offer a 9-month waiting period for pregnancy and birth-related services instead of the usual 12 months.
AHM Health Insurance black+white starter flexi $500 $112.28 Backed by a trusted national brand (Medibank), AHM offers a range of policies with no individual limits on included Extras, so you can claim more and spend less.
Police Health Platinum Health $0 $283.72 A simple range of policies, designed specifically for policing communities, with a 99% customer satisfaction score.

WA health insurance levies and rebates

Private health insurance is not only a means of effectively covering the cost of quality healthcare but also helps you avoid certain levies.

Get money back through rebates

The Australian Government encourages you to get private health insurance to alleviate demand on the public health care system (Medicare), by giving you a rebate. This is paid to you in the form of a percentage of the cost of your premiums, up to a maximum of 34.579%.

Your rebate percentage is based on your taxable income, your age, and how many dependents you have. You can either claim your rebate directly from your fund through reduced premiums or back on your annual income tax return from the Australian Taxation Office (ATO).

Save money by avoiding levies

When you buy private health cover, you can save up to 1.5% in tax by avoiding the Medicare Levy Surcharge (MLS). MLS is an additional tax amount that you pay if you earn over a certain amount and you don’t have private health insurance.

The Government also charges a 2% additional tax through the Lifetime Health Cover (LHC) loading if you don’t get private cover before the 1st of July following your 31st birthday. LHC is charged incrementally for every year that you have not had private cover for since you turned 30 (up to a maximum of 70%).

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Exclusions and waiting periods

Private health insurance is considered an effective way of covering the cost of a wide range of medical treatments and services. However, it is important that you know the terms and conditions of your policy before buying, especially the exclusions and waiting periods.

Exclusions

Exclusions refer to the conditions and services your health insurer does not cover, and while these are mostly standard throughout the industry, each insurer can decide on their own set of exclusions.

Read your product disclosure carefully. Some general exclusions your policy might have, include:

  • Claims made 2 years after treatment was received.
  • Elective cosmetic surgery.
  • Prostheses used for cosmetic reasons and where no Medicare benefit applies.
  • Any treatments and services provided by a family member, business partner, or a provider that isn’t recognised by your health fund.
  • Any treatments and services you received from outside of Australia.
  • Any treatments and services you received while your policy is in arrears, suspended, or within a waiting period.

Waiting periods

To prevent people from taking advantage and only purchasing or upgrading their cover when they need treatment, health funds are allowed to impose waiting periods. A waiting period is a length of time that must pass before you can access any services and treatments included with your policy.

While the maximum for Hospital waiting periods is set by the Government, waiting periods for Extras are set by individual health insurers.

General waiting periods for Hospital treatments:

  • 12 months for pre-existing conditions, pregnancy and birth-related services (like delivery costs, hospital accommodation, IVF, Obstetricians’ fees, etc.).
  • 2 months for psychiatric care, rehabilitation, and palliative care (even if these are pre-existing conditions), like eating disorders, alcohol rehabilitation, and post-natal depression.

General waiting periods for Extras treatments:

  • 1, 2, or 3 years for more expensive procedures, like orthodontics.
  • 12 months for major dental procedures, like bridges.
  • 6 months for optometry, including the cost of glasses and contact lenses.
  • 2 months for physiotherapy and general dental services.

Frequently asked questions

How much does ambulance cover cost for people living in WA?

The cost of ambulance cover in WA varies according to your specific location and what services the ambulance provides. For example, residents of the Perth metro area are encouraged to take out private health cover to help pay for specific ambulance fees. Life-threatening and urgent trips cost $932, non-urgent trips cost $500, and patient transfer costs $458 in metro areas.

Take note that aged pensioners receive free ambulance services, and senior citizens over 65 need only pay half the cost of normal ambulance expenses.

Can I get free dental when living in Western Australia?

If you live in Western Australia and are between the ages 5-16, and a student at a school recognised by the Department of Education you’ll get free dental services from the School Dental Service, up until the end of year 11.

If you have a Pensioner Concession Card or Health Care Card, you are eligible to receive subsidised emergency and general dental care. The rate of subsidy is currently at 50% of the cost of treatment.

We can help you compare health insurance in WA, so you can find the policy to suit your specific requirements and budget; providing you maximum value for the type cover you want.  

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4 Comments

  • Nicole |

    I am currently with nib and have top hospital cover, including maternity. My next payment is due on the 15th of July and I am thinking of lowering my cover, as I will not be using private maternity.

    I have been with nib for over 3 years now and am getting extremely frustrated that they can’t provide me with a list of nib affiliated providers, as HBF can (I was previously with HBF). It seems so difficult to find out which provider nib covers.

    I am thinking of going back to HBF, but am due to have a baby in January 2019, and was thinking that I should just stay with nib (lower cover) until then and then take out a single parent cover, once the baby is born.

    Any advice would be greatly appreciated.
    Kind Regards
    Nicole

    • SPECIALIST
      Anneke Van Aswegen |

      Hello Nicole. It’s wonderful that you’re planning ahead.

      Generally, if you switch health funds, most health insurers will not require you to reserve your 12 month waiting period. So, seeing as you’ve had cover with nib for over 3 years now, you probably already served the waiting period for pregnancy benefits and can thus change to HBF, or whichever health fund you choose.

      However, loyalty limits and accrued benefits don’t necessarily transfer between insurers. This is something that you must check with your new insurer.

  • Nicci |

    Is it legal for a private health care provider to downgrade your policy and take away some of the services that were covered but keep your premium at the same cost?

    • SPECIALIST
      Anneke Van Aswegen |

      Great Question Nicci!

      Generally, you as the insured person can choose to downgrade your policy when you’d like to keep premiums more affordable. Private health insurance companies can’t typically downgrade your policy, but they can remove certain services previously offered. However, whether this is really within the regulatory framework for private health insurer’s remains to be seen.