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Everything you need to know about reviewing your cover

6 minute read
A couple with their newborn baby

Do you have pregnancy cover, even though your family is now complete? Have you given up rugby, but not the high level of Extras cover you selected when you were seeing your physio throughout the season?

As you approach every new stage of life, it’s important to make sure your health insurance matches your needs and lifestyle. And finding the right policy has now become easier than ever.

Thanks to the Government-initiated reforms, as of 1 April 2019 health funds will be categorising their hospital cover products into easy to understand Gold, Silver, Bronze and Basic tiers that reflect the level of cover they provide.

Each tier has a minimum set of hospital services that must be included, but insurers can choose to include additional services on top of the minimum required to create ‘Plus’ products.

The way treatments are defined will also be made the same across the board, so health funds will be speaking the same language. That means it’s going to be easier than ever to review and compare your options, but it's important to remember it's not all about price – the cheapest policy may not be the right one for your circumstances.

To help you review your options, here are a few things you should consider.

1. What hospital services do I want to be covered for?

Before you start comparing any products, consider your personal circumstances and create a checklist of essential hospital services.

Here are a few questions to consider:

  • Are you looking to start or expand your family?
  • Do you have a family history of any illnesses?
  • What can you afford?

There’s a lot to think about, but once you’ve narrowed down the services that are important to you, you can start finding options that match. And, with the introduction of the new Gold, Silver, Bronze and Basic hospital cover tiers, this process is now easier than ever.

For example, if everything on your checklist falls within a Silver product tier, you’ll be able to compare Silver policies across different health funds knowing that they all meet the same minimum standard in terms of the benefits they provide.

Please note, if you have an existing medical condition, you'll still be able to take out health cover, but you may need to wait longer to have any related treatment covered. Be sure to take note of waiting periods and become familiar with pre-existing conditions, so you don't end up disappointed with your cover selection later on.

A women's AFL team walking out onto a field

2. What Extras cover do I need?

When you start to look at Extras options, shop around and consider the services you want to be covered for. Extras cover can include things like dentist and optometrist visits, as well as physiotherapy or chiropractic treatments.

Once you've checked that the services you want are included in the cover you're looking at, confirm if any waiting periods apply and take note of the annual limits.

As you compare Extras covers, you'll probably notice the "percentage back" varies from cover to cover. This percentage back refers to the amount of the total cost of your service that you'll get back from your health insurer.

Considering Extras-only cover? It’s worth factoring in that hospital cover is what you'll need to avoid the Medicare Levy Surcharge (if your taxable income is above certain thresholds) and Lifetime Health Cover loading (which means you will pay higher premiums if you take out private health insurance after turning 31).

3. What excess level is right for me?

Just like with your car or home insurance, excess (which is sometimes referred to as a front-end deductible) is an amount of money you agree to pay for a hospital stay before health insurance benefits are payable. Generally speaking, choosing a higher excess means you’ll pay less in health insurance premiums.

As of 1 April 2019, nib members now have the option to increase their maximum excess limit from $500 to $750 for singles, and $1,000 to $1,500 for couples or families. So, if you’re with nib, you can opt for a higher level of excess in return for a lower premium. If you’re with another health fund, this might not apply as it’s an optional part of the reforms.

Find out more about your excess options.

4. How easy is it for you to use your cover?

When it comes to using your private health cover, you want to make sure you’re with a fund that makes claiming easy. With nib, you can easily claim by swiping your nib card at your provider (if they have this available) or through your phone (we have photo claiming on our nib app).

At nib, it’s easy to see the provider of your choice. We’ll pay benefits when you visit any recognised provider, as long as you are covered for the service and it you have annual limits remaining. We also have a network of trusted health professionals to make it easier for you to keep your out-of-pocket expenses low. You can search for a local provider online with our First Choice provider search tool.

A young couple discussing their future private health insurance needs while walking down the street

5. Are there any other benefits of my private health insurance?

Excluding peace of mind and protecting yourself against the unexpected, it’s important to take into account some of the other benefits of your private health cover.

At nib, you can access a world of discounts, benefits, and offers from over 2,000 providers across Australia through nib Rewards. With 150+ retailers (think David Jones, JB Hi-Fi, Adairs and Kmart), 500 Good Food Guide and Gourmet Traveller restaurants and serious savings on everything from groceries to gym memberships, nib Rewards is our way of helping you live a fun, healthy and rewarding life. Find out how you can save today.

To keep you at your healthiest all year round, we also offer a range of Health Management Programs at no additional cost to eligible members* that aim to help get you in shape, keep you out of hospital, improve your physical and mental wellbeing and aid a quicker recovery post-hospitalisation.

And, we’re with you when you need us most – when you’re going to hospital. We provide the support you need to navigate the system whether it’s with a cover check, by providing you with the average cost of your procedure, giving you tips on keeping out-of-pockets low or suggesting questions you should ask your specialist.

How often should I review my private health insurance cover?

No one likes paying for things they don’t need, which is why it’s important that you select a level of cover that suits your needs, rather than picking the cheapest option or the first one you see. Health insurance shouldn’t be set and forget, so keep comparing your options as your health needs change.

What are you waiting for? Get comparing today!

If you need help finding the right health insurance policy for you, contact our award-winning member service team on 13 16 42.

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