Top 7 reasons to have private health cover

Published March 2023 | 5 min read
Words by Lucy E Cousins

With the rising cost of living, investing in your health is one of the best ways you can future-proof your wellbeing, get treatment faster and even save money.

On an average day in Australia, around 32,400 people are admitted to hospital. Another 24,100 Aussies visit an emergency department, and around 1,700 people have elective surgery. As a world leader in publicly funded healthcare, we’re lucky to have access to excellent health services, but understanding how Medicare and the private healthcare system work can be tricky.

That’s where getting private health cover comes in – it can help minimise any out-of-pocket healthcare costs. Private health cover also offers a range of cover to help maintain your everyday health, quicker and easier access to treatment (and the peace of mind that comes with that), choice around who treats you and advantages at tax time.

To really understand the benefits of private health cover, here are the top seven reasons why it should be on your essentials list this year.

1. You can choose who treats you and where

After a few years of elective surgery being put on the back burner thanks to COVID-19, waiting lists around Australia are growing. According to the Australian Institute of Health and Welfare, 50% of Aussies waited at least 40 days for admission for elective surgery in 2021 to 2022, with Indigenous Australians on average waiting even longer. Waiting times have improved but are still lengthy. Private health cover can help you to minimise and, in some cases, significantly reduce the waiting period for your elective surgery, including colonoscopies and endometriosis surgery.

Having private health cover also means you may be able to choose who treats you. You can use our Find a Provider tool to find doctors and specialists in our network who are more likely to charge no-gap or a known-gap (capped at $500 per specialist). Your private health cover may also allow you to be cared for in a private room in the hospital you’ve chosen.

2. You’ll know your out-of-pocket costs upfront

Nobody enjoys going to hospital, but having private health cover can help you keep costs down and provides peace of mind. With any hospital admission you may be charged for doctor or specialists’ fees separately from your hospital bill (which includes your accommodation, operating theatre fees and any other elements of your inpatient care). However, health cover can help cover the costs between what your health care practitioner charges and what Medicare covers.

We want to help members keep money in their pockets and avoid unexpected costs after hospital. Our industry-leading Dr Gap tool finds specialists who have agreed to charge HCF members either a no or known-gap when they go to hospital so our members can make informed choices about their healthcare and know what they can expect to pay. By asking how much your procedure or treatment will cost upfront it’s easier to understand exactly what out-of-pocket costs you can expect to pay.

If you need help with understanding any fees or out-of-pocket expenses, call us on 13 13 34.

3. Your annual eye, dental and physio check-ups are covered

Family visits to the dentist, optometrist and podiatrist can add up across the year, as can treatments by physios, chiros and osteos to help fix any injuries or aches and pains.

Extras cover means you’re covered for the cost of the most popular treatments. Eligible HCF members will get 100% back^* on their first visit with a physio, podiatrist and chiro or osteo with a provider in our No-Gap network.

Eligible members^* can also get 100% back on one or two dental check-ups each calendar year and 100% back on prescription glasses from a selected range, as part of our More for You programs.

4. You can get discounts

Health cover members can save up to 25% on travel insurance^{^}, and up to 15% on pet insurance⁺ and eligible members can access savings on everyday essentials and little luxuries through HCF Thank You^#. Discounts include things like 50% off cinema tickets as well as savings on gift cards for groceries and petrol, with members being eligible after their first week of membership.

Members can now also get a 5% discount^** on selected purchases at Ramsay Pharmacy, when they sign up to the Ramsay Pharmacy better rewards program. You’ll also get:

• $5 in rewards when you join
• $10 rewards dollars as a birthday gift
• 7.5% back on your better rewards account per dollar spent.

You just need to show your HCF membership card and scan your better rewards card to claim the discount.

5. You could save on tax

If your salary is over the Medicare levy surcharge threshold, private health cover could save you at tax time. Aussies who are single and earning more than $93,000 or who are part of a family earning $186,000 total taxable income may be charged the Medicare levy surcharge (which is up to 1.5% of your taxable income and reportable fringe benefits). This surcharge encourages Aussies to take out private hospital cover, to reduce the load on the public Medicare system.

You could also save long term by taking up health cover before the age of 31. This will help you avoid the Lifetime Health Cover (LHC) loading – a government initiative created to encourage Aussies to take out private hospital cover earlier in life. That’s because if you take out cover after the age of 31, you’ll pay an extra 2% for each year you didn’t have cover since the age of 31.

So, if you wait until you’re 42, you’ll pay 24% more than someone who got cover when they were 30 but if you get hospital cover some time after you’ve turned 31 and maintain it for 10 continuous years, the loading is removed. The maximum LHC loading is 70%.

6. You can access support to keep you healthier

Health cover isn’t just for when you’re sick. Having the right cover can also give you access to tools and programs to help you lose weight, manage joint pain, get support for heart health conditions and advice for preventive health care.

If you’re overweight and have osteoarthritis^{^^} or are at risk of developing a chronic condition^{^^}, our health management programs can help you stay healthy and manage your weight. We offer eligible HCF members Healthy Weight for Life, a weight-management program led by trained dietitians and health experts. If eligible, you can also claim towards the cost of some exercise classes, gym memberships and learn-to-swim classes.

7. It’s easier to take care of your mental health

Two in five Aussies have experienced a mental disorder at some time in their life, and while Medicare gives you subsidised access to up to 10 sessions with a counsellor or psychologist, waiting times can be long. A 2022 study found that one in three psychologists in Australia is unable to see new patients due to the current high demand.

We have a range of mental health services that can help you get the support you need, including a free HealthyMinds Check-in with a PSYCH2U psychologist for eligible members^## through PSYCH2U, a mental health online platform for four to 11-year-olds with Calm Kid Central^***, and evidence-based online treatment programs through This Way Up^{^^^}.

AUSTRALIA’S LARGEST NOT-FOR-PROFIT HEALTH FUND

We want to make a positive difference to the lives of our members, our people and our communities by making healthcare more affordable and accessible. As a not-for-profit fund, for every dollar members paid in premiums over the last 10 years, we've paid out nearly 90% in benefits compared to the industry average of 86%⁺⁺⁺.