Private health insurance myths and facts

When it comes to private health insurance, there’s a lot of confusion and misunderstanding out there. We dispel some of the more popular myths and misconceptions.

Myth: “We don’t need private health insurance in Australia – we have Medicare”

FACT: Private health insurance means you get greater choice over your hospital experience. This means access to a private room in a private hospital and greater choice over your doctor, and when and where you are treated. While the Australian Government covers most medical services through the Medicare system, it doesn't cover you for accommodation in a private hospital.

Without private health insurance, you may also have to wait – an average of 73 days for a hip replacement in a public hospital or an average of 38 days for general surgery in a public hospital.[1]

Myth: “I’m fit and healthy so I don’t need health insurance”

FACT: Being fit and healthy doesn’t mean you won’t get injured, suffer an accident or medical emergency. Private health insurance can help you financially in all types of situations – from having your tonsils removed, breaking your arm or leg, or sporting injuries.

Private health insurance, through extras, also means you can access a range of non-hospital treatments such as dental, optical, physio, chiro and remedial massage.

Myth: “The costs of private health insurance outweigh the benefits”

FACT: Some providers offer more than just insurance. Medibank’s GymBetter is a prime example, providing members with access to a nationwide network of gyms at discounted single-visit rates. There’s also the 24/7 access to health advice from a Medibank nurse. So it pays to shop around to find value for money beyond just health insurance.

Myth: “Private health insurance is just too expensive”

FACT: Consider the cost of not having private health insurance – or the wrong kind of health insurance for your needs. Unfortunately, no matter how healthy you are, accidents can happen. This could leave you with considerable out-of-pocket expenses.

In addition, without an appropriate level of private health insurance cover singles who earn over $90,000 a year and couples and families who earn over $180,000 a year may be required to pay a Medicare Levy Surcharge.

Myth: “Choosing the right private health insurance policy is just too confusing”

FACT: If you do your research and talk to the experts, you can choose a fund that best suits your health needs.

Start your search with trusted independent sources, such as the Australian Government’s Private Health Insurance Ombudsman or Canstar and compare the policies based on your needs. Then talk to individual funds for detailed information about any policy you are interested in, and to understand what you are actually covered for.

Before signing up:

• Read the policy details and talk to experts to make sure there are no restrictions for common procedures.
• Check you have a broad range of coverage with a wide range of services available for you to access.

Myth: “Once I’ve found a health insurer, I don’t need to update my policy”

FACT: As our lives change, so do our health needs. Whether you're single, married, have children, are enjoying your retirement or planning a stint overseas – it's worth reviewing your cover regularly. And if your situation changes, it’s a good idea to contact your fund to discuss your options to ensure you are always covered. If you’ve just added a dog or a cat to the family, your fund might also have other insurance products, like pet or travel insurance that you can access, often at a discounted rate.