I’m looking to potentially get health insurance in Australia, due to ongoing psychology appointments. I’ve never had it before, and have Medicare for general GP claims (including 10 session under Mental Health Care Plan)
There’s a lot of buzzwords, but I literally don’t understand how it works. Can someone explain how Australian Health Insurance works, but in basic terms?
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I work in the industry, so…yes, I can!
There are two different kinds of health insurance in Australia. There’s “hospital” cover, which is exactly what it sounds like – backup for Medicare coverage – and there’s “extras” cover, which is coverage for things Medicare either won’t cover, or covers to a limited extent. Extras includes things like new glasses or going to the dentist, can reimburse you for travel vaccinations or medications that aren’t on the PBS and so on. Psychology usually falls under extras, unless you’re an inpatient somewhere.
You can also get “combination” cover, which is where you pay for a single policy that includes some of both.
When you take out a policy, you have a yearly limit on each kind of thing you’re covered for. For example, you might get $200 back per year on your new glasses. This resets every calendar year. Even if you join in July, it will reset in January.
You can also have “lifetime limits” for some things. You’re unlikely to need more than one set of braces in your lifetime, right? Your health insurer will eventually go “well, we’ve paid out several grand on braces for him, he’s not going to need us to pay it **again**…this is all he gets.”
If you approach a health insurer about a policy, they are legally required to have readily available fact sheets telling you what the policy covers, how much you can expect to get back and so on. Always read these.
Any questions?
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