Hospital vs extras, fund comparison, and choosing the right level of cover.
Hospital tiers, extras cover, Medicare Levy Surcharge, and Lifetime Health Cover loading — everything you need to make an informed decision about private cover.
Hospital cover and extras cover serve completely different purposes. Here is how each works, what it costs, and when combining both makes sense.
Five things to check before you switch funds — clinical categories, premiums, excess, waiting periods, and provider networks.
How family policies work, when it makes sense to combine, and what happens to adult children as they age off a family policy.
How the Gold/Silver/Bronze/Basic hospital tiers and extras categories work under the private health insurance reforms.
How the MLS works, current income thresholds, and when a basic hospital policy costs less than the surcharge.
Common questions about health insurance in Australia.
What is the difference between hospital and extras cover?
Hospital cover helps with in-hospital treatment costs for included procedures, subject to waiting periods and exclusions. Extras cover supports everyday services like dental, optical, and physio up to annual limits. Many people combine both, but you can compare either separately depending on your needs.
How do Medicare Levy Surcharge and Lifetime Health Cover loading work?
The Medicare Levy Surcharge may apply to higher-income earners without eligible hospital cover. Lifetime Health Cover loading adds a premium penalty if you take out hospital cover after age 31 unless an exemption applies. These rules are personal to your income and history — consider official ATO guidance when deciding timing.
Can I compare health funds if I have pre-existing conditions?
You can compare policies, but waiting periods and exclusions still apply when you join or upgrade. Insurers cannot refuse cover for pre-existing conditions on hospital cover in the same way as general insurance, but waiting periods protect the fund when you first take up higher levels of cover.
What is a gap payment?
A gap is what you pay out of pocket after Medicare and your insurer pay their share of a treatment. Gaps depend on the doctor’s fees, the insurer’s agreement with providers, and your product tier. Use fund tools and informed financial consent discussions to understand gaps before treatment.
How often should I review my health insurance?
Review at least annually at renewal and whenever your family, income, or health needs change. Funds adjust premiums, benefits, and network agreements over time — a plan that was good value two years ago may no longer suit you.
Does Moneyhero provide personal health advice?
No. Information here is general and designed to help you compare products. For personal advice about tax, health, or suitability, speak to a qualified financial adviser or health insurance specialist.