Frequently Asked Questions (FAQs)

2020 Premium Rise


There are plenty of reasons that we believe private hospital cover is important. Things like:

  • knowing you can have access to private hospitals with state-of-the-art facilities
  • being able to choose your doctor
  • not having to spend months (even years) on a public hospital waiting list by going into a private hospital
  • if you earn over the threshold for Medicare Levy Surcharge (currently $90,000 for singles and $180,000 for families), you may save tax by not having to pay the Medicare Levy Surcharge.
  • avoiding a Lifetime Health Cover loading (by having hospital cover before you turn 31)

You might be surprised by just how much it costs to enter hospital as a private patient. Here are just some of the claims we paid in 2019 and early 2020:

  • $16,700 for a teenager’s jaw surgery
  • $71,300 for a man’s heart surgery
  • $71,600 for a woman’s spinal surgery
  • $39,600 for a woman’s Cochlear implant
  • $93,200 for a woman’s leg surgery

When you think about health insurance, it is important to think about more than just the cost. Health insurance is about giving you more choice for your healthcare, less time waiting for the services you need and (most importantly) the peace of mind to know that you’ll be looked after when you need it most.

In short, we need to be able to pay members’ claims. To do that we need to keep up with medical costs that are growing every year, as well as having more people claiming for these services.

We made a conscious decision this year not to increase extras benefits, for instance, because any increase in benefits would push premiums up. We have been listening to members, who generally want us to do everything possible to keep premiums as low as possible. An increase to certain extras benefits does not always benefit everyone (if you aren’t claiming those specific benefits); keeping premiums down benefits all members. We will continue to review our benefits on an annual basis to ensure we are offering the best possible value at affordable prices.

This is our lowest average premium rise in the last eight years at 3.08%. The other good news is that this is we are not-for-profit, which means we only charge what it costs to pay claims and run our fund. In fact, last financial year we paid $12.9 million for member benefits out of $15.9 million in premiums (or 81% of our revenue), but rising health care costs and usage necessitate an increase in premiums.

We try to keep our costs down in other ways too, such as:

  • running as efficiently as possible so we have low administration costs
  • working with the Australian Health Service Alliance (AHSA) to have more bargaining power with hospitals and doctors
  • working with industry bodies to push the Government for changes that make healthcare more affordable for everyone

If you get a Government Rebate, the increase to the amount you pay for health cover is made up of two things – an increase to our premiums and a change in the rebate percentage the Government pays towards your cover (which we have no control over). If you want the exact percentage of your rate increase, it is important to take the Government Rebate into account.

Put simply, healthcare and medical costs are rising faster than CPI (inflation). We know money is tight for a lot of people and we can promise you that we’re always looking for ways to keep costs as low as possible while still giving you great value and service.

We only ever increase membership payments by what it costs to pay claims and keep our fund running. All health fund increases are reviewed and approved by the Government.

If you have paid in advance you will not have to start paying the new amount until your next payment is due. For example, if you are paid up to 4 May 2020, you will start paying the new amount from 5 May 2020.

For more information, please call us.


About Private Health Insurance


Finding the right health cover can be confusing. And it can be even more so when comparing your cover with another policy.

We can help in a few different ways. Firstly, every health fund has a short summary of every product in a standard format, to help you compare them side by side. You can easily get this Private Health Information Statement (PHIS) from the Private Health Insurance Ombudsman’s website at

If you would like some personalised help, we are just a phone call away. Our experts are happy to help you choose the right level of cover for you, and can help you compare your old cover so you know exactly what you’re covered for. Call us on 1800 027 299.

Simply get a quote online and submit an application.

Just give us the details when you join (in the online join or over the phone) and we will take care of it all for you.

Have a look at covers online and call one of our cover experts on 1800 027 299 and we can help you.


Manage your cover


Enter some of your basic details here to start Online Member Services. You can find it at any time by clicking Log in.

You can find the login button at the top right of your screen.

You can change your cover any time you like.

You can do it using Online Member Services.

Of course, if you would rather talk about it, simply call us on 1800 027 299.

If you are upgrading your cover, you may have waiting periods for things you were not covered for before.

Set up regular direct debits

The easiest way to pay your premiums is through a regular direct debit from your account. This makes sure your account is kept up to date and you do not have to remember to make your payments because they come out of your account automatically on the day you choose.

It is easy to set up your direct debit in Online Member Services. On the Payments screen, click the ‘Change’ button. This is where you can add or update a direct debit, change your payment dates and change the payment frequency.

Other payment options:

  • Pay by credit card, BPay or cheque.
  • Make a one-off payment:

You can also make credit card payments through Online Member Services to pay your cover’s outstanding balance or to a date in the future. Click to the Payments page, and you will also find a calculator to see what date a lump sum payment will take you up to and how much you need to prepay to reach a certain date.

Call us a on 1800 027 299 with the student number and place of study and we will update your cover for you.

You are covered on your parents’ membership until you are 18, or 25 if you are studying full time (as long as you’re not married or in a de facto relationship).

Yes. You can do it in Online Member Services. Details → People Covered → Add person

Get straight to it here. Details → People Covered → Add person


Forms & statements


Tax statements should automatically populate with your tax agent or on the ATO's tax system. But you can also get it from us on Online Member Services. Details → Statements → Select person → Select Tax Statement.

The most common forms are available on our website, click here.


Saving money


You will probably be surprised to learn that, on average, couples actually claim more than families with kids. This is mostly because a high proportion of couples are older people whose healthcare costs are generally higher than younger people, and also because kids generally have lower healthcare costs and do not need to claim as much.

All health funds are covered by Government legislation that says we have to charge everyone the same amount (for the same level of cover) – regardless of their age, health status or claims history. It is called Community Rating, and we think it is pretty fair to keep health cover more affordable for most people.

We get this one a lot, but unfortunately Government says no. Private Health Insurance legislation says that health funds are not allowed to offer no-claim bonuses.

This is another thing that is controlled by Government legislation. We are only allowed to pay benefits for products and services that treat a specific medical condition. If you have a medical condition and there is something you think you might be able to claim for, contact us and we will see what we can do.