Health Insurance in Australia and Going to Hospital

AnzWe interrupt this road trip for another reprint of an Australian and New Zealand magazine article.


Well, a couple of reasons. Firstly, we are due another reprint, I like to do them every four weeks. And this article is a follow-up to the last one from June 1 which was called Going to the Doctors: Australia and UK Compared.

The second reason is that yesterday I picked Mrs Bob and Elizabeth up from Cairns Airport and they have now joined me on this road trip. We are just are about to go out from meal, so posting an article I prepared earlier is going to get us to the restaurant quicker. I think that’s a pretty good reason on its own.

This appeared in the magazine’s April edition this year.

Going to hospital

HospitalSo what happens when you need major surgery as a matter of urgency and you do not have health insurance? Funnily enough, that’s something I can help you with.

Last year, all of a sudden, I found I had difficulty walking. I certainly couldn’t jog let alone run, something that I had been able to do reasonably well before, honest. Turns out my spinal cord was being compressed by my own vertebrae. My mobility was deteriorating quite rapidly and as the experts put it, I was literally one minor trauma away from spending the rest of my life in a wheelchair.

You know the sort of thing, young driver, busy texting or updating their Facebook page and running straight into the back of me patiently waiting in my car at a red traffic light. Bang! “Sorry mate, I was texting, my bad!

Yeah great, thanks.

Private health insurance

According to information I found online, private health insurance in the UK is declining. Current take up rates are around 11% at best, it may be as low as 8.7%. Here in Australia, it’s a very different story. Take-up rates are about 50%. Family cover, provided mum and dad are not yet 31 years of age, cost around $250 per month after the government’s rebate.

Those over 31 will pay a loading on their premium, 2% for every additional year is my understanding. Here’s a tip though, if you arrive in Australia as a new permanent resident and take out cover within 12 months, you won’t pay that loading no matter your age. Unfortunately we didn’t know that rule, and with me being 49 when we arrived, by the time we did look into private insurance my loading was quite savage.

So that’s why we didn’t get private insurance.

Most Australians who can afford insurance go for it because it gives them more choice. They can choose the doctor, hospital and their preferred appointment time, as well as receiving those healthy rebates from the government. Despite the high take-up of private health insurance here though, Australia does have a very good public hospital system.

So why did I pay just over $33,000 to have my operation done privately? Ah, let’s say I was unlucky.

The one public surgeon recommended to me for the operation was on holiday. Trust me to need an urgent operation during Melbourne Cup week. Although he promised he would operate as soon as he possibly could on his return, it meant a delay of around 7 to 10 days compared to the date given to me by the private surgeon.

Did I want a wheelchair that bad? No, so I paid the money.

But hold on a minute, let’s just do the maths here. I’ve been living in Australia for eight years now, I’ve not been paying that health insurance. Even if I had secured it before that loading, I would have been paying $3000 per year. So far then I’ve saved $24,000.

Like most insurance companies, they don’t actually pay for everything. Some don’t pay for the anaesthetist, for example. Who knows what else they don’t pay for, you’d need to check the small print. Most charge some kind of excess. Bottom line is you won’t get 100% of everything back, so in reality, I’ve probably broken even.

NB. Some temporary visa holders will require medical insurance.


Jagoda asked a very interesting question in the very first comment on this post. He wondered what the deal was with dental treatment. As part of the answer, I included a link to the following post which you may find useful:

Visa Assessment Service
{ 17 comments… add one }
  • Rod June 13, 2017, 7:46 am |

    My wife and I will soon be visiting Oz for a month which brings up a couple of questions about medical insurance.

    As an Australian citizen by birth (living in the U.S.) am I good for emergency medical care while visiting Oz?

    Anyone have suggestions for medical travel insurance for U.S. citizens? Our current policies do have a foreign benefit but it’s minimal, only $50K coverage.


    • BobinOz June 13, 2017, 9:38 pm |

      Well, don’t take my word for it, as a doctor would say, get a second opinion :-), but as an Australian citizen by birth I see no reason why you would not get medical care in a public hospital. You may, under the circumstances, have to prove your citizenship though with either a passport or your birth certificate.

      And I say though, you might like to doublecheck that, better safe than sorry. As for insurance for US citizens, it’s probably best that you look into travel insurance, you will get much better coverage with that. For example, if you fall seriously ill and are unable to travel, so you don’t even begin your holiday, I believe travel insurance will cover that and refund some costs incurred.

      Whether it’s best for you to get that travel insurance in the US or through an Australian company though, I just don’t know, but I would look into it.

      Good luck and enjoy your holiday when you have it.

  • Karen May 15, 2017, 1:52 am |

    Hi Bob, very helpful info thanks! We’re moving (hopefully) next year to Australia with our kids. We were hoping to trust the public health system, but we might go for a basic insurance to avoid that age loading, as you suggested. Anyway, I’d like to know if public ERs are reliable, if hospitals are well maintained and have enough resources. We’re from Argentina and public health here is, well, awful (insane long waiting, dirty badly maintained facilities, lack of basic resources) we’re kinda forced to go for private health and it’s a huge waste of money. Would you say it’s better over there? Thanks!

    • BobinOz May 15, 2017, 6:06 pm |

      I think you will be pleasantly surprised by the public health system here Karen, my experience of it so far is that it is very efficient. Yes, the public hospitals do have emergency departments where you can just present yourself for treatment. I’ve been a couple of times and I was impressed.

      In my experience, our hospitals are clean, modern and well maintained. Without doubt, I would say it’s better than what you’re currently experiencing in Argentina.

  • Andriy K July 13, 2016, 1:50 am |

    Hi Bob
    Love your posts, always really helpful. I was wondering if you know how the medical expenses are with pregnancy in Australia? Is it something you think the public system would be good enough or do people look to the private sector?
    Thank you in advance

    • BobinOz July 13, 2016, 9:15 pm |

      No, sorry, I have no idea on this one. I’m sure the public system is perfectly capable of taking care of childbirth, but you would need to be here on a visa that does qualify you for the public system. Hope that helps, Bob

  • Michael July 4, 2016, 8:43 pm |

    Another reason to get private health insurance is to dodge the Medicare levy surcharge. Depending on your annual income you have to pay a Medicare levy surcharge if you have no private health insurance. So for example if you are single and earn more than 90,000 AUD a year you would have to pay Medicare levy surcharge. Getting the cheapest private health insurance means you don’t have to pay that surcharge.

    • BobinOz July 5, 2016, 12:35 am |

      Interesting comment Michael, I do have one of those cheaper medical insurance policies, I mention it below a few comments down. I pay $90 per month but I still had to pay the Medicare levy surcharge of 1.5% on my earnings.

      I thought the Medicare levy exemption only applied to hospital policies, so has the tax office made a mistake taking levy off of me?

      I will definitely be looking into this.

      Cheers, Bob

      • Michael July 5, 2016, 7:44 pm |

        Slight mistake on my side: There is now a minimum excess to avoid the surcharge (500 AUD for singles and 1,000 AUD for families). With 90 AUD per month you should be over the 1,000 AUD per year minimum excess that is required to avoid the levy surchage. However if any “extras” are included in those 90 AUD like optical, dental, physiotherapy or chiropractic treatment then the tax office might take that out from your excess.

        • BobinOz July 6, 2016, 12:55 am |

          Ah, sounds like I’m stuffed then, pretty much all my policy cover is for extras. All it pays for prescription glasses, dental and physiotherapy. Plus a few other things I’ve never used.

          Oh well 🙂

      • Dan June 13, 2017, 7:39 am |

        What you might be thinking of is the medicare levy, not the surcharge. The medicare levy surcharge is charged to high income earners without hospital insurance. The medicare levy itself is charged to everyone.

  • Pete July 1, 2016, 6:06 am |

    Hi Bob,
    How do you go if you have a bad road smash, do they put you back
    together then look for payment or look for money first?

    • BobinOz July 2, 2016, 12:26 am |

      They will put you back together as best as they can, and if you are a permanent resident or Australian citizen, you will get it sorted for free via a state run hospital.

      If you are able to speak, or if anyone who is with you can communicate, they will ask if you have private medical insurance before putting you back together. If you do, then they would take you to a private hospital and they will fix you up instead.

      If you can’t speak, and it turns out you are not a permanent resident or Australian citizen and a state-run hospital fixes you up, you might just end up with a bill if you don’t have travel insurance.

      That’s the way it works, I think.

      • Dan June 13, 2017, 7:37 am |

        To be honest, in most cases the large public hospitals are the most appropriate places for major trauma casualties anyway.

        • BobinOz June 13, 2017, 9:29 pm |

          Yes, that’s true Dan, I’d certainly head for a public hospital emergency department for that kind of treatment as well if I needed it. They do seem more geared up for that kind of thing.

  • Jagoda Stewart June 30, 2016, 4:11 am |

    Hi Bob,
    I cannot thank you enough for your precious comments and information.
    I was wondering about the dental private insurance in Oz. Do you need it, or public is ok enough? Please advice. Thanks, Jagoda

    • BobinOz June 30, 2016, 6:03 pm |

      Glad you found it helpful.

      It’s pretty much the same deal for dental, you can either take out insurance or pay for your dental treatment yourself each time you need it.

      Funnily enough, although I didn’t mention it in the above article, we do have a very minimal family insurance cover which costs us around $90 a month. It does cover dentistry, prescription glasses and physio, but not really much else of any use.

      It also has limits on everything, so if you need major dentistry for ongoing physio then you will be unlucky. You will hit the annual limit and then have to pay up yourself.

      For example, I needed periodontal treatment, you can read about it here…

      But my insurance didn’t cover it.

      So, as I say, it’s pretty much the same deal, you don’t need it but if you are very unlucky with your teeth, then it may have been best to have got it.

Leave a Comment

If your comment doesn’t get answered, find out why…..
FAQs and Comment Policy.