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The five key things to consider when comparing Health Funds

It’s important to understand the key areas of a health insurance comparison service before drawing any conclusions, otherwise this can result in a ‘The Devil You Know’ mentality. It’s a phrase we often hear from people that put comparing health insurance into the too-hard basket:

I’ll stay where I am because it’s the Devil I Know

We think everyone deserves a health fund and policy that is not just there for emergencies but is viewed as genuinely helpful and good value and getting to that point shouldn’t be a chore.

So we’ve drawn up some key points that will help you review and compare between funds.

We deem these to be the five key areas to comparing health insurance:


What’s covered or excluded on your Private Hospital Cover.

There’s a lot of confusing terms thrown around like Basic, Mid and Top hospital cover. It can lead to the misconception that, during a private hospital visit, a basic hospital cover doesn’t cover you to the financial degree as a top hospital cover. This is inaccurate. The main difference between levels of cover is not what financial degree you are covered to during your surgery, but rather whether-or-not some procedures are covered at all. For example, both a Basic and Top Hospital cover may cover you for colonoscopies to the exact same degree, but only a Top Hospital cover includes joint replacements and cataract major eye surgery.

Usually, the main difference between differing levels of hospital cover is whether just a handful of high-cost treatments are included. The main offenders are usually pregnancy & IVF, joint replacements, major eye surgery, dialysis, psychiatric, rehabilitation, weight loss & gastric banding, heart & cardiac, and palliative care. It’s important to understand that this is not a definitive list, and exclusions can differ from fund to fund. When you speak to our health insurance advisers, we cover off all these questions to make sure you are always covered for the things you need, while also helping you trim-the services you don’t need.

Most of the time, a basic, mid or top hospital cover will all cover you for the other 2000+ procedures we haven’t mentioned, from cancer to colonoscopies. There are, however, some funds that offer bare-boned hospital covers that don’t cover you for more than a small handful of day procedures, and yet still call it Basic Hospital… confusing right? This is why we insist on helping you one-on-one.

We help you deal in facts.


Your hospital excess.

Although most funds offer similar excess options these days, there can still be a fair amount of disparity between how a health fund structures their excess. You can put two health funds side-by-side, each offering a $500 or $250 excess on paper, but behind the scenes each fund might have a different set of conditions for when, or how often it is payable each year. Choosing which excess is best for you can seem straight forward but also has its nuances. Sometimes it’s a great idea to look at your current bill of health alongside your likelihood of going into hospital in the next 5 years and weighing up the cost difference between having no excess and paying higher premiums or having a higher excess and saving the coin. Obviously, this is something we can help you do.


Your health funds participating private hospitals

All private hospitals need to have a contract with your health fund in order for you to receive treatment there without incurring significant expenses. The reality is, most private hospitals recognize and accept all health funds, but there are some exceptions and it’s an ever-changing environment. This information isn’t always easily available, so speaking to us directly is a simple way to get some visibility on your local or preferred private hospitals. To be frank, sometimes its the Big Health Funds that sometimes renegotiate on private hospital contracts around Australia. Bigger doesn’t always mean better.


The extras benefits and annual limits.

This is one of the more common reasons for comparing health insurance. For extras services such as dental, major dental, optical, physiotherapy, chiropractic, massage, and all the rest, comparing your extras cover is paramount to making sure you are getting great value out of your health insurance. Every fund has different amounts they pay for each service, within different annual limits for where they cap you at for the things you use most.

In short, we can help you review and improve your extras with the view to get you more money back from your fund for the services you like to use each year. Higher benefits mean you hand over less money for these health and lifestyle services.



Of course, the big dollar sign reigns over all. It’s all good and well have to private health insurance that ticks all the boxes, but is it competitively priced compared to the rest of the market? Is another fund doing something equivalent or better for a lower cost? You’ll be very surprised how often we help find our customers a policy with higher benefits and payouts, but at a lower premium too. The big win. On the other hand, it’s not always about lower premiums. As our health needs change, it might be time to upgrade to a higher level of cover, for which we try to help you meet your new needs while mitigating the cost increase.

Other things to consider.

So, we come to the end of our list. Although we highlighted these five key criteria as being the most significant aspects when comparing health insurance, there are some other areas that can be important to consider before switching funds, particularly if you have upcoming surgery or significant health needs. Our very experienced health insurance advisers ask you all the right questions so that no stone is left unturned. We pride ourselves on presenting the facts in a professional and transparent manner, the way it certainly should always be when dealing with your health. Transparency is key.


Comparing your health insurance using an online comparison tool is great to get an idea of what’s out there, but as this article demonstrates, there a lot of factors that go into a comprehensive health insurance comparison. That’s why we often ask for your contact details, for no other reason than to contact you and ask if we can help you compare all aspects of your potential new health fund and policy. We are simply here to help.

Take the time to call us directly or use our online comparison tool, it’s only about 10 minutes of your time and the outcome can be worth hundreds, if not thousands of dollars in health insurance cost reductions or benefit increases for the coming years.