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How health insurance can support you through cancer  

By Trudie McConnochie

If you, or someone you love, has been diagnosed with cancer, we hope you have lots of support around you. The word ‘cancer’ is news that no one wants to hear, yet 452 Australians are diagnosed with this illness every day. You might be feeling a bit overwhelmed, so we’re here to give you the facts and explain how Private Health Insurance can support you with cancer treatment and care.  

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Image credit: Shutterstock 

You don’t need health insurance for cancer treatments, as Medicare will cover most, if not all, of your treatments for cancer in a public hospital, and most of your medications will be covered by the Pharmaceutical Benefits Schedule (PBS), unless your form of cancer is very rare. However having health insurance can give you more options.

If you have Hospital Cover, you can choose to be treated in a private hospital, with the doctor of your choice and may also get your own room. And if you have Extras Cover, you can claim a portion of cancer-related treatments such as home nursing and rehabilitation costs, such as physiotherapy. 

Be aware that you may have to pay an excess, co-payment or out-of-pocket charges (also known as a Gap), so it’s important that you get a full breakdown of costs from your doctors and speak to your health insurer in advance. It’s a good idea to ask your doctors for the Medicare Benefits Schedule (MBS) item number for your procedures so you can check your level of cover with your health insurer. 

Under Hospital Cover, depending on your policy tier you may be covered for:  

Type of treatment Hospital Cover tier 
Chemotherapy, Radiotherapy and Immunotherapy Bronze, Silver, Gold 
Breast Surgery (if medically necessary) Bronze, Silver, Gold   
Pain ManagementGold  
Plastic and Reconstructive Surgery (if medically necessary) Gold 
Palliative CareBasic, Bronze, Silver, Gold (but you may have out-of-pocket costs on lower tier policies)  
Throat cancer treatment (under the Ear, Nose and Throat Clinical Category) Bronze, Silver, Gold 
Oesophageal cancer treatment (under the Digestive System Clinical Category) Bronze, Silver, Gold 

Under Extras Cover, depending on your policy, you may be covered for: 

If you are taking out health insurance after being diagnosed with cancer, rest assured you will not pay a higher cost for your policy. Health insurers cannot charge you a higher premium due to any health conditions you may have. With that said, they can impose a 12-month waiting period on pre-existing conditions, so you will not be able to claim for cancer-related treatments right away. You can, however, change to a policy at the same level with a different insurer without having to serve waiting periods again. 

If you do have health insurance but don’t have the level of cover you need, you can upgrade your policy to a higher tier, but waiting periods for pre-existing conditions may apply. Ask your insurer about their waiting periods, and find out what other conditions may apply. 

Looking for health insurance to cover you for cancer treatments? Start calculating your cheapest policy  – the healthslips Calculator is the only health insurance comparison calculator that compares all policies from every insurer and gives you free open access to your results. 

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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