Signs your health insurance policy isn’t right for you 

How much time do you spend thinking about your health insurance? If you’re like most Australians, the answer is probably: not a lot. Health insurance tends to be something we purchase then mostly forget about, until we need to use it. But considering how much of your income goes on health insurance, it’s a good idea to check in and make sure it’s right for you, and that you’re paying the best price compared to every policy available. 

Here are some tell-tale signs that you might not have the right health insurance policy for your needs. 

You’re paying a lot of money but not getting much back 

If you only chose health insurance to avoid the Medicare Levy Surcharge (MLS), you probably opted for the cheapest policy and didn’t think much about it. But as time went by and your health needs changed – perhaps you experienced an injury and needed physio, or started a family – it might be disappointing to find that the policy you’ve been paying for isn’t covering much of what you need.  

Regardless of the reasons you chose your health insurance policy, if you’re not getting much back, it makes sense to change it. Sit down and make a list of your healthcare needs (both now and in the near future), then use our Calculator to find the right health insurance policy that suits your budget, age, family status and health needs.  

Get tips on choosing the best policy.
Try the healthslips.com.au Calculator to find the best policy for you.

You’re covered for lots of services you don’t need

This is a common mistake. There are 38 Clinical Categories that Hospital Cover could cover you for. They vary depending on the tier of Hospital Cover (Basic, Bronze, Silver or Gold) you select. If you’re young, have no chronic health conditions and you’re paying for a Gold policy that covers all 38 categories, you might be paying more money than you need to. For example, if you’re not planning to have children, you don’t need a policy that covers Assisted Reproductive Services or Pregnancy and Birth, so you might consider switching to a lower tier. 

Read more about the Clinical Categories of health insurance.

You might also like to reconsider whether both Hospital Cover and Extras Cover are essential for your healthcare needs. Make sure you understand the difference between the two, and what services and treatments they cover. Of course, your current healthcare needs are likely to change, so it’s important to keep your future needs in mind.  

You have a pre-existing or hereditary condition but low cover 

Make sure your health insurance policy covers your needs in the future, not just your needs in the now. If you’re living with a pre-existing condition such as diabetes, for example, make sure your policy includes Diabetes Management. It might also be a good idea to get cover for areas that your condition might affect down the track, such as Heart and Vascular System cover (according to the Heart Foundation there’s a link between diabetes and heart disease).  

And if there’s a hereditary condition in your family that increases your risk of diagnosis, it could be worth getting appropriate cover before you need it (so that you don’t have to serve waiting periods). For example, if you have a family history of cataracts, the Centre for Eye Research Australia says your risk of developing this eye condition at a younger age may be higher. With that in mind, you might consider getting a policy that includes the Cataracts Clinical Category.

Remember that there’s usually a 12-month waiting period before you can claim on a pre-existing condition for new policies, or after you’ve upgraded to a higher level of cover.

Compare your health insurance policy with one that meets your needs.

Your policy doesn’t match your circumstances 

Getting married, separating or becoming a parent can make a big difference to your health insurance. Here are some factors to consider when your circumstances change: 

• If you’re married or living with a partner, combining your singles Private Health Insurance policies into a couples policy might make it easier to manage. You’ll need to consider your combined income level, which may affect your eligibility for the Private Health Insurance Rebate. And if one, or both, of you has the Lifetime Health Cover Loading (LHCL), that will be averaged across both of you in a joint policy.  
• If you’ve separated, you might be able to pay less on a single or single parent policy. As above, your Private Health Insurance Rebate, Age-based Discount and LHCL all need to be considered. 
  Find out about single parent health cover.
• Started a family? Make sure your policy includes your children, so their healthcare needs are covered.
• Have your kids aged out of your family policy? Changing to a couples policy could save you a lot of money in reduced premiums.
• If you’ve been widowed, talk to your insurer about changing to a single or single parent policy to reduce your premium costs. Compare the price to other similar policies available using our Calculator, to make sure you’re getting the best deal for you. 

You’ve missed out on a better deal 

When you’re comparing health insurance policies, you can only find the best deal for you if you’re comparing against every single policy available. Unfortunately, if you’ve used another insurance comparison site, you won’t have been given all the options, as other sites only show users a selection of what’s available, giving preference to insurers they have commercial partnerships with.  

To make sure you don’t miss out on the best option for you, healthslips.com.au is completely impartial. We’re the only insurance comparison site that allows you to compare with every policy for all Australian health insurers, to make sure you’ve found the best health cover for your needs. So what are you waiting for? Try our Calculator now. 

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

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