Making the Most of Your Private Health Insurance

Posted on: 8 January 2018

While private health insurance undoubtedly offers choice and security when it comes to your health, it is still a big financial commitment. You want to make sure you're making the most of it. Here are five ways to ensure your private health insurance is working for you.

Check exactly what is covered

If you're 21 you probably don't need to worry about hip replacement surgery. If you're a 73-year-old woman then you're not going to need any pregnancy cover. Make sure you review your health insurance policy regularly to make sure you know what is or isn't covered. If you find that you need more coverage or that you're paying for coverage you don't require then contact your insurer about changing to a different policy.

Use your extras!

If you have extras coverage then make sure you're using them as required. Be aware of any extras services such as optometry that need to be used up before a certain date. If you're entitled to regular dental check-ups then make the time to have them. Not only will you be maximising your use of the extras coverage, but you'll also be taking care of your health and identifying any small problems before they get more difficult (and costly) to manage.

Make use of any preferred provider service

A preferred provider service means your health insurer has arrangements with selected health care providers to reduce your costs.  This means that your health provider (be it a medical specialist or an allied health professional) is aware of exactly what will be funded by your health insurer and has agreed to charge you either no gap or a very small gap.  It means that you can be confident about what is covered, so you're not going to get any unexpected fees at the end of your treatment. Preferred providers sometimes offer extra services or particular treatment plans when you use your private health insurance with them, giving you more bang for your health buck.

Know any waiting periods

Planning a baby or needing new glasses from your new health insurance policy? Make sure you're well aware of any waiting periods you'd need to serve before accessing services such as obstetrics or extras cover. You may need to have held adequate coverage for a period of 1-12 months before receiving care. The best way to make sure of this is to plan ahead and be very clear about any waiting periods.  If something unexpected pops up make sure you discuss it with your health insurer, as they'll be able to give you advice about exactly how to best go ahead before the waiting period is up.

Check your rebate and Medicare surcharge

If you're paying for private health insurance you may as well maximise the tax and rebate benefits. Most Australians can access the Australian Government Private Health Insurance Rebate.  If your individual income is under $140,001 for a single policy or your household income is under $280,001 for a family policy then you'll be able to receive a rebate of up to 34% on your health insurance fees. Your exact rebate will depend on your age and income bracket, but no matter what it will lower your fees.  The rebate is often applied by the health insurer in any quotes or before charging you fees, but make sure the documentation is in place so that you're getting your full rebate. Along the same line make sure that you get your annual coverage statement from your health insurer so that you're covered for any additional Medicare levy at tax time.