Do I need private health insurance?
Nobody likes to think of themselves or their family falling ill or having a nasty accident, but private hospital insurance is there to provide complete peace of mind should the worst happen.
Ancillary cover is also there to provide peace of mind, but on a more practical day-to-day level, such as helping with the cost of visits to the dentist or optician. Moreover, it also helps you be more proactive in looking after yourself, stopping little niggles before they become bigger problems. For instance, a trip to the physio today might prevent a trip to the surgeon in the future.
How long can children remain on family policies?
With HIF, dependants are covered up until the age of 21, or up to 24 years of age for those registered as full-time students at a recognised educational institution.
If I have health insurance can I still be admitted to hospital as a public patient?
Yes. Every public hospital is required to ask if you wish to be treated as a public or private patient. It’s your choice if you use your insurance or not.
What are waiting periods?
Waiting periods are the time you need to be a member of a health fund before you can claim a benefit. They’re there to protect the fund and its existing members from people who simply join a fund to make a big claim, only to cancel their membership afterwards.
But there’s good news. If you join us from another Australian health fund and take out an equivalent level of cover with us, you don’t have to re-serve any waiting periods that you’ve already served. Even better, it’s really easy to switch – we’ll take care of all the paperwork for you.
What bills would I claim from HIF and which ones would I claim from Medicare?
If you don’t have health cover, Medicare pays benefits for all medical accounts – for example, accounts for doctors, specialists, eye examinations, X-rays and pathology.
However, if you have HIF Hospital cover, we’ll process your hospital accounts. We also pay up to one quarter of the Medicare schedule fee for any medical accounts resulting from your time as a private inpatient in a hospital.
If you have HIFExtras cover, we also process all your bills for ancillary services, such dental, physiotherapy or optical treatments.
What is Private Health Insurance?
Private health insurance can be broken up into two parts. Firstly, there’s hospital cover, which gives you access to private hospitals, your choice of doctor and control over the timing of surgery, whether it’s urgent or elective.
Then there’s ancillary cover (also known as ‘extras’, ‘the essentials’ or ‘general services’). Ancillary cover helps with the cost of services that Medicare doesn’t pay for, such as dental, optical, chiro, physio and ambulance services.
What is the Lifetime Health Cover loading (LHC)?
For all the details about Lifetime Health Cover (LHC) loading, please visit our Lifetime Health Cover page.
What is the Medicare Levy Surcharge (MLS)?
The Medicare Levy Surcharge (MLS) is levied on Australian taxpayers who earn above a certain income and don’t have private hospital cover.
The MLS is a Federal Government initiative designed to encourage individuals to take out private hospital cover and, where possible, to use the private hospital system to reduce demand on the public system. The surcharge is calculated at the rate of 1% of taxable income, in addition to the Medicare Levy of 1.5% that’s paid by most Australian taxpayers.
The MLS is imposed on individuals earning over the threshold who do not have an appropriate level of hospital insurance. If you currently earn over $80,000 per year as a single or $160,000 for couples or families, then you will pay an extra 1% Medicare Levy Surcharge at tax time.
However, the family threshold increases by $1,500 for each dependent child after the first dependent child (i.e. the threshold for a family with three dependent children would be $157,000). You can avoid this by taking out hospital cover with an excess of no more than $500 – all of our hospital cover options meet the requirement to avoid the MLS.
See our Pay Less Tax page for more information.
What is the Private Health Insurance Rebate?
The Private Health Insurance Rebate was introduced by the Federal Government to help Australians meet their health cover costs.
If you currently hold a green or blue Medicare card, you are entitled to claim the rebate on both hospital and ancillary products when applying for private health cover. Alternatively, you can choose to pay full contributions through the year and then claim the rebate back at the end of the financial year through your tax return.
Previously, the minimum rebate was 30%. However, you may have heard in the media that as of 1 July 2012, the Private Health Insurance Rebate will be means tested and health fund members will no longer be guaranteed the standard 30% rebate.
In addition, the Medicare levy surcharge (MLS) will also be progressively increased based on annual income levels. This means high income earners could potentially be taxed up to the maximum of 3% (1.5% Medicare levy + 1.5% MLS) of their income if they do not have private hospital cover.
To find out all the details about the new amendments to the rebate, please visit our Rebate Changes in 2012 page.
What is the Savings Provision Entitlement?
The Savings Provision Entitlement ensures that people remaining on a membership that has been eligible for the 35% or 40% rebate do not have their rebate reduced to the standard 30% when the member aged 65+ years leaves or cancels the membership.
How does the Savings Provision Entitlement work?
When the member of 65+ years leaves or cancels the original policy (due to death, divorce or separation), the Savings Provision Entitlement is triggered.
As a result, the original policy will continue to receive the higher rebate, and the remaining members on the policy (at the time), other than dependants, will be entitled to receive the higher rebate if they transfer to a single policy or even a different fund.
If a member aged 64 or less leaves the policy before the member aged 65+ does, then the Savings Provisions Entitlement will not be triggered and the person leaving the policy will have their rebate revert back to 30%.
How do I lose the Savings Provision Entitlement?
If a policy is receiving the higher rebate as a result of a Savings Provision Entitlement, the Savings Provision Entitlement will be lost when another person, other than a dependant, is added to this policy. The rebate entitlement for the policy will be recalculated based on the age of the oldest person on the policy.
When does the Savings Provision Entitlement not apply?
A dependant is not entitled to take the Savings Provision Entitlement with them. This means if they take out their own policy, their rebate will revert back to the standard 30% rebate.
What isn't covered by private health insurance?
Private health insurance doesn’t cover you for outpatient services. These services include visits to your GP and consultations with specialists, as well as X-rays and blood tests (unless they’re taken once you’re admitted to hospital).