How To Choose A Health Insurance Provider
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How To Choose A Health Insurance Provider

Katie Douglass

Katie Douglass

02/09/2021 • 5 minute read

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In Australia, there are many health insurance policies to choose from. In fact, according to the Australian Competition and Consumer Commission (ACCC):

There are over 30 insurers in Australia offering around 3,500 health insurance products.

That’s a lot to choose from! So understandably, finding the right health insurance policy that suits your needs and budget can feel overwhelming.

To help you out, we’ve put together a guide on how to choose a health insurance provider. While there’s no one-size-fits-all answer, there are some factors you can consider to help you make your decision.

Assess your healthcare needs

Whether you’re a young, active person, a couple looking to start a family, or need regular medical treatment, it’s important to understand your health needs when choosing a policy.

There are some questions you can ask yourself to help determine which policy can meet your healthcare needs:

Do you and/or your partner have any pre-existing conditions? e.g. diabetes, lupus, high blood pressure, heart attack If yes, you might want to think about getting a policy that helps cover the costs of treatment associated with a pre-existing condition.
Do you and/or your partner have any hereditary conditions or genetic disorders? e.g. diabetes, heart disease, cancer, osteoporosis If yes, you might want to consider a policy that covers for some or all of these conditions.
Are you planning on having a baby? Most private health insurers set a 12 month waiting period for pregnancy and birth-related services. It’s important to keep this in mind and plan in advance if you’re looking to start a family.
Are there any out-of-hospital services you use? For example, if you’re regularly attending physiotherapy or wear glasses, you might want to consider taking out an extras policy to help cover costs for out-of-hospital treatment.
What stage in life are you at? Generally, health insurers offer policies for different life stages — young, single people, couples, families, and seniors. This can help you find a policy tailored to your specific needs. For example, families can look for a policy that allows them to upgrade services such as orthodontics.
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It can be helpful to consult with your doctor while looking for a suitable health insurance policy. They can give you an idea of what level of coverage and any extras you might need for your situation.

Figure out what type of cover you need

When choosing a health insurance provider, consider the type of cover/s you need for your situation. But first, it’s important to understand the difference between each type of cover to find the right policy for you.

There are three types of private health insurance: ambulance cover, hospital cover, and extras cover. Generally, you can get hospital or extras cover either on its own or combined.

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When you take out private health insurance for the first time or upgrade your policy, there is usually a waiting period you’ll have to complete before you can make a claim. Keep this in mind when choosing health insurance, as some waiting periods can vary between providers.

Below, we give a quick rundown of each type of cover:

Ambulance cover

Except for Queensland and Tasmania, the cost of ambulance services are paid either out-of-pocket or through private health insurance. If your state government doesn’t cover ambulance services, you might want to consider adding ambulance cover to your policy.

Hospital cover

Hospital cover helps pay for the cost of staying as a private patient in a public or private hospital in Australia. Generally, adding hospital cover to your policy allows you to choose your own doctor, get a private room, and avoid public hospital waiting lists.

As mentioned earlier, hospital cover typically comes with waiting periods. This is why it can be a good idea to think carefully about what services you’ll need in the future. For example, if you’re planning on starting a family, adding pregnancy and birth-related coverage to your policy might be worthwhile. This is because there is usually a 12- month waiting period for this type of service.


Extras is a type of private health insurance policy that covers a range of out-of-hospital services such as physiotherapy, podiatry, and general dental. If you find yourself regularly using these services, an extras policy can be good value for you. However, keep in mind the more extras included, the more expensive it is. So, make sure you weigh up the cost of extras cover and whether it’s worth it.

Work out your budget

Private health insurance can be costly so it’s important to work out how much you can afford to pay for it. Fortunately, health insurers offer a variety of policies to suit different budgets.

In Australia, private health insurance is categorised into four tiers — Basic, Bronze, Silver, and Gold. This tier system allows you to better understand what is included and excluded in each hospital policy and choose one that suits your needs and budget. Generally, the Gold and Silver tiers are more expensive and comprehensive than the Basic and Bronze tiers.

A handy way to work out how much you can afford to spend on private health insurance is MoneySmart’s budget planner tool. It allows you to look at where your money goes and how much you have left over for health insurance.

Keep an eye out for sign-up deals

Some health insurers offer sign-up deals and incentives to attract new members. While it shouldn’t be the only factor when choosing a health insurance provider, it can be a handy way to save money.

Compare policies

Now that you know what factors to consider when choosing a health insurance provider, the next step is to compare policies. One of the ways to do this is through the website. They have a helpful comparison tool that allows you to compare all Australian private health insurers and their policies.

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Before you purchase a private health insurance policy, make sure to read through the Product Disclosure Statement (PDS) and understand exactly what services are and aren’t included. Plus, look at the waiting periods to find out how long you’ll have to wait before you can make a claim on services.

Don’t set and forget

After you purchase health insurance, don’t set and forget. It’s always a good idea to reassess your policy regularly and ensure it aligns with your current health needs. Especially given that premiums typically increase each year so you might want to consider switching insurers for a better deal.

Oiyo is a consolidated online resource, we are not financial advisors. We work with a range of industry professionals and compliance check our articles to ensure factual accuracy. However, we do not provide professional financial advice. Consider seeking independent legal, financial, taxation or other advice to check how the information and ideas presented in this article relate to your unique circumstances.

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It’s important to make the right decisions when it comes to your health insurance. Check out our latest articles on all things health insurance.

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Katie Douglass

Written by Katie Douglass

Katie Douglass is the Communications Manager at Oiyo and a writer. In recent years, Katie's work has appeared in publications such as Marie Claire, InStyle, and THE ICONIC. She has a Bachelor of Creative Industries in Fashion Communication & Journalism from the Queensland University of Technology. At Oiyo, Katie is responsible for overseeing editorial strategy.

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