Australia has a universal healthcare system. Medicare is how Australian citizens and permanent residents (PR) access healthcare. Almost 14 million Australians also have private health insurance so how do you find the right health insurance for you?

There are many reasons why some Australians decide to have private health insurance. If you have been considering private health insurance, let me help cover what you need to know before deciding.

Australia’s health care system is ranked within the top ten list of Health Care Indexes by Country in 2021. The reasons that keep Australia at the top of the list are as follows:

– General quality of the health care system
– Health care infrastructure
– Health care professionals (doctors, nursing staff, and other health workers)
– Cost (USD p.a. per capita)
– Quality medicine availability

Here’s why that’s important…

If you don’t have Medicare and you are holding a temporary visa, you must have private insurance. Without health insurance, if you need special healthcare treatment during your temporary visit to Australia it can be costly.

Temporary visa holders must have a health cover for the duration of their stay. If you are entering Australian territory you must have health insurance to cover your expenses in case of an emergency.

It’s advisable to keep essential health insurance from your home country during your temporary stay in Australia. You may be wondering why? The reason is simple – if you need costly treatment that is not covered by your insurance in Australia, it may be cheaper to return to your home country and have treatment there under your home country insurance cover.

Some treatments can only be done if you still have active payment insurance in your country. Of course we all hope you don’t ever have an emergency, but it is better to be prepared incase it happens.

Public health insurance

Medicare is Australia’s health care system and helps Australians cover costs and some or all of the expenses of essential health care. But Medicare doesn’t pay for all medical services. For example, Medicare doesn’t cover some general health care such as dental treatment or optometry. Read more about what’s covered.

With public health, you’ll need to pay for your medical appointment if your GP doesn’t bulk bill (bulk bill means the GP covers the cost of the whole appointment under Medicare). If your GP does bilk bill, Medicare will refund the cost directly to the doctor. It means you won’t have to pay anything or at worst only a small amount.  

Medicare also helps to make some medicines more affordable. If you have high medical costs, there are some ways to keep your costs under control. Read more about help with medical expenses.

The Australian Government pays for the cost of running Medicare through the Medicare levy. Working people in Australia pay the Medicare levy as part of their income tax.

If your income is above the Medicare Levy Surcharge threshold, and you don’t hold adequate private health insurance, you’ll pay the Medicare levy and the surcharge.

Migrants, refugees and visitors

You may be eligible for returns and assistance if you’ve either:

– Arrived in Australia on a refugee or humanitarian grant

– Been granted a permanent protection visa.

If you need more information, check the Refugee Servicing Network. It can help you settle into life in Australia.

New arrivals to Australia may have to wait before expecting the first payments or services. Check the newly arrived resident’s waiting period.

International students

All international students should have OSHC (Overseas Student Health Cover) as set by the Australian Government. You aren’t forced to use the OSHC provider your college or institution recommends, but you will need OSHC to meet your temporary visa health insurance conditions.

International students get similar medical cover to Australian residents as set by the policies of their OSHC. Check OSHC Australia to compare Australian Government providers. 

People with a temporary visa, student visa, work or business visa should pay for private health insurance. It is strongly recommended that all visitors take out private health insurance.

Private health insurance

By now you must be wondering: if the public healthcare system is so wonderful then why do so many people choose to use private insurance?

Firstly private health care helps alleviate the risks associated with potentially high unexpected health care expenses which may not be covered by Medicare.

Secondly, health insurance helps fund the cost of your procedure. In Australia the private health system often shares the same hospital facilities as the public health system. Private health insurance helps to pay for the cost of running these facilities meaning less costs for Medicare and the Government.

Furthermore, private health insurance means you may be able to avoid the public waiting lists for some procedures. Public hospitals are busy, and they prioritise treatment order by level of urgency. The urgency of your situation will decide the waiting list time frame. Private health insurance can mean you may treated faster the system has capacity.

Finally, private health cover can reduce the amount of income tax you may have to pay. There are incentives in the Australian tax system where having private health insurance can reduce the level of income tax you pay or the amount of the Medicare levy.

When selecting your insurance cover, you should choose the proper coverage appropriate for you or you may end up paying extra medical bills if your health insurance doesn’t cover enough.

Let me break this down for you…

If you earn above $90,000 as a single or over $180,000 as a couple, you will have to pay the Medicare Levy Surcharge (MLS) that’s between 1% to 1.5%. It’s designed to incentivise higher salary earners to take up private health insurance. Having private health coverage may help to reduce your income tax.

How to Find the Right Health Insurance?

There’s no one single health insurance policy that’s suitable for everyone as all of our needs are different. What’s most useful for you might not be enough for someone else.

Shop around for an insurance company that meets your needs. Depending on the stage of life you are in, you may have different needs. It’s important that you find insurance that fits you and your lifestyle and your future plans.

A single person with no children may be looking for specific coverage that works for them. A couple with plans to have children in the future should look for pregnancy coverage. As the years go by, our needs change and having wide health coverage is essential.

You can use different portals to compare the various policies and choose the most suitable one. Here are some web pages where you can compare: Private Health, Choices, Compare the Market and Compare Club.

How to Find the Right Health Insurance?

I suggest you decide what is important to you and then pick the cover that works best for you and your budget. The good thing is that the policies are very flexible and allow you to select some items. Here is some of the possible coverage:

– Dental treatment

– Chiropractic treatment

– Home nursing

– Podiatry

– Physiotherapy, occupational therapy, speech therapy and eye therapy

– Glasses and contact lenses

– Prostheses (e.g. hearing aids)

Remember to review your policy annually. Changing companies may be a good idea if you have been with the same insurance company for several years.

There are many options, and companies are constantly expanding their benefits and providing additional coverage to new subscribers.

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