Can health insurance support me with a lung condition? 

If you’re among the 7 million Australians living with a lung condition, such as chronic obstructive pulmonary disease (COPD), lung cancer or bronchiectasis, you’ll be very familiar with hospital and clinic waiting rooms. From medical procedures to lifestyle support, living with a lung condition means supporting your health is vital. Here’s what you need to know about health cover for lung conditions.

How Hospital Cover can help with lung conditions 

Under Hospital Cover, Lung and Chest is the clinical category (group of hospital services) that covers lung conditions. If your policy includes cover for Lung and Chest, you’ll be covered for: 

• open chest surgery to treat lung cancer 

• treatments for: 

• pneumonia 

• trauma to the chest 

• emphysema. 

Some health insurers offer Lung and Chest cover on Basic tier policies, but with restrictions on cover (which means out-of-pocket costs for you). If your policy is Bronze, Silver or Gold your access to Lung and Chest is unrestricted (but you’ll still need to check with your insurer whether a Gap applies).  

What are the different tiers of Hospital Cover?

Curious about how much health cover for lung conditions costs? We found the lowest cost of Combined Hospital and Extras Cover that included Lung and Chest for one adult in Victoria was a Bronze Plus policy for $168.03 per month, with a $750 excess.  

Here are some other different levels of Combined Hospital and Extras Cover for one adult in Victoria: 

How Extras Cover can help with lung conditions  

Lung Foundation Australia says lifestyle changes can help you stay healthy and better manage your energy with a lung condition. Extras Cover can help with some of these lifestyle changes. Remember that some Extras policies have limits, so check your policy conditions. 

Eating well 

If you’re having trouble meeting your nutritional needs, it’s best to work with an accredited practising dietitian to get dietary advice that’s tailored to you. If your Extras policy includes cover for Dietetics/Dietary Advice, you can claim some of the cost of these appointments.   

Staying active 

It may be difficult to exercise if you’re experiencing breathlessness, however Lung Foundation Australia says regular exercise can help improve your wellbeing, especially if you’re living with COPD. It’s recommended that you get a healthcare professional to advise you on the best forms of exercise for you. If you have Extras Cover for Physiotherapy or Exercise Physiology you can get fitness advice for your health needs and claim it on your policy. And if you have cover for Health Management/Healthy Living, you may be able to claim back the cost of your gym membership (a health professional will need to confirm that you have a chronic condition). Check with your insurer first.  

Getting emotional support 

Living with a chronic condition can take a toll emotionally. If you need support, talk to your GP about getting 10 free psychology sessions under Medicare (this is called a Mental Health Treatment Plan. If you don’t qualify, or if you need something ongoing, check whether you have Extras Cover for Psychology, and book in with a psychologist who meets your health insurer’s requirements.  

Quitting smoking 

It can take a number of attempts to quit smoking successfully, and having the right support can make all the difference. If your Extras Cover includes cover for Health Management/Healthy Living, check whether your insurer provides access to a quit smoking program.  

Getting vaccinated 

Lung Foundation Australia recommends being vaccinated against pneumonia and the flu (each year). These vaccines are free under Medicare for people with chronic conditions, so check with your doctor to see whether you’re eligible; if not, and your Extras Cover includes Vaccination cover, you may be able to claim from your health insurer.  

What’s the best health cover for lung conditions? 

If you have a lung condition and your current health insurance policy isn’t meeting your needs, look for a better one using our Calculator. We search every policy on the market and offer you all your options, without any bias. You don’t have to enter any contact details and since we aren’t selling insurance, you won’t be pressured to buy.

Compare your existing policy using our Calculator or look for a new policy.  

Keep in mind, a lung condition is considered a pre-existing condition, so you will have to serve a waiting period on a new policy before you can claim. But if you’re switching insurers to a policy at the same tier and level as your previous policy, waiting periods will be waived. Waiting periods for Hospital Cover are a maximum of 12 months for pre-existing conditions, and can vary on Extras Cover. Talk to your insurer to find out waiting periods, policy conditions, excess, co-payments and limits before you sign up.  

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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