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Last Updated on 7 October 2019

How to Compare Private Health Funds

Private health funds provide clients with added benefits compared to public health insurance coverage. Private health funds can cover hospital in-patient services or ancillary services, or a combination of both.

Each fund is unique, offering different services and levels of coverage. In fact, every package offers very specific and discernible features down to which hospitals are covered and what operations. You won’t necessarily know in advance what services you’ll need in a given time frame, so evaluating the various policies available through private health funds can help you make an informed decision at the end of your private health insurance comparison.

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If you want to compare private health insurance funds, it doesn’t have to take all that long to produce a list of those that fit within your desired specifications. Here is the fast track method for determining which private health funds fall into your suitable range.

Compare Private Hospital Cover

Hospital cover is divided into four main categories that provide different levels of benefits. Within each main category there are many subcategories, the precise details of which depend on the insurer and policy. When looking into these funds, consider whether you require hospital coverage, medical services coverage, or both.

While many healthy people don’t require any medical treatments at all in a given period, anything can happen, which is why people choose to insure themselves through private health funds. In most cases, the likelihood of needing outpatient treatment is greater than the likelihood of needing a hospital stay. This, of course, depends on many factors that are individual to you and your family, including age and relevant risk factors.

Hospital insurance can be divided into coverage levels as follows:

Highest – Covers almost all services, including pregnancy and birth, reproductive services, cataracts and lenses, joint replacements, dialysis and more. Exact coverage terms and conditions for each private health fund many vary.

Medium – Similar to top level, but with the exclusion of one or more services.

Basic – More than public hospital insurance will cover, but excludes more services than the higher levels. Services that potentially  may be excluded or limited include psychiatric care, palliative care and rehabilitation.

Public – covers the most basic benefits, but only in public hospitals.

General Health Insurance Cover

The other branch of health coverage to consider when you compare private  health insurance is general treatment. What sort of services do you need outside of a hospital setting, such as basic health care, dental treatment, and so on? There are, again, different general levels of coverage available from private health funds:

Comprehensive – as the name implies, this covers all or most services, including dental, psychology, optical and podiatry.

Medium – this level includes dental treatments and lets you choose a range of other services while excluding others.

Basic – this type of coverage covers basic services but leaves out many ancillary services.

Do you envision becoming pregnant in the near future? If yes, and you would want services provided only through private health funds, you will need to look into getting that insurance coverage in place beforehand. If you have experienced difficulties conceiving, some private health funds will cover the cost of reproductive assistance services.

Private Health Insurance to Suit You

Bear in mind that many private health funds allow you to combine different levels of coverage for hospital and general treatment categories. Not only that, but in addition to their pre-defined packages, you may be able to create your own custom package, picking and choosing the best options for your family’s specific needs.

Can You Afford Private Health Insurance?

The cost of private health insurance premiums may be a factor in your decision. Most similar policies are similarly priced, but one area in which you may be able to influence premiums is with the excess. Funds generally require some excess, which is the amount you pay up front for a service in addition to the cost of the fund.

Typically, the lower the premium, the higher the excess, and vice versa. If you envision needing many services, you may choose a higher premium so that you pay a lower excess each time you use a services, or the opposite – if it’s strictly “just in case,” you may choose a lower premium, and if you then need to use a service, you may have to pay a higher excess.


Disclaimer: The above information is correct and current at the time of publication

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