When private health insurance is no assurance at all

May I sound a note of caution to the growing numbers considering private health insurance?

My mother, who is 93, has held her policy with a major UK provider for 60 years. At her age the premium is astronomical — even more than her utility bills — but she retains this luxury so she has the reassurance of having care if she needs it — and she did.

Four months ago she fractured her thighbone in a fall. Paramedics attended swiftly and the subsequent operation and NHS hospital care was superb.

On about the seventh day post-op the hospital was anxious to send her home, so great was the wintertime pressure on beds. She was still unable to stand, so had the idea to transfer to the private ward of the hospital for a few days of rehabilitation.

But her insurance refused to cover this, as she had failed to advise them, as laid down in the small print, that if she was admitted as an emergency on the NHS, she would let them know within five days.

Is it fair that a frail lady, in the throes of a catastrophe, should be expected to gather her wits and contact her insurer?

It makes me wonder if saving a small sum each month, rather than handing over money for an insurance policy tied up in small print, may be a safer option should you ever want to go down the private healthcare route.

© Solo dmg media

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What is private health insurance?

Private health insurance helps with the cost of healthcare not covered by Medicare. Not all policies are created equal, so it’s important to compare health insurance and find the best health cover for you. There are two main types of cover: hospital and extras.

How much does private health insurance cost?

The cost of private health insurance varies, but we crunched the numbers from 30+ Australian funds to see what you’ll have to pay for hospital and extras cover per month, depending on the level of cover you choose.

Tiers Average Treatments included
Basic $86
Bronze $100
  • 18 categories including joint reconstructions and ENT
Silver $150
  • 26 categories including dental and podiatric surgeries
gold $193
  • 38 categories including joint replacements and pregnancy
Extra cover Average Included benefits
Cores $32
  • At least General Dental and Ambulance Cover
Medium $67
  • At least Major Dental, Optical and Physio
Comprehensive $116
  • Treatments like Orthodontics and Hearing aids

Prices quoted are based on a single 30 year-old in Sydney, earning less than $90,000 with a $750 hospital excess from June 2022. Extras categories used the same methodology as the 2022 Finder Health Insurance awards.

Find out how much you could claim back

If you earn under $140,000 (single) or $280,000 (couples), you’re entitled to a rebate on your private health insurance policy.

Pop in a few of your details, including how much you’ve paid or expect to pay in premiums from 1 April 2022 to 31 March 2023. Find out how much you can get back.

Public vs private health insurance comparison

Not sure if private health insurance is worth it? Here are some key differences between the public and private healthcare systems in Australia:

public system Private health insurance
Doctor A public hospital will allocate a doctor for you.
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