The guide to understanding private health insurance

Admittedly, there’s a lot to private health insurance. Here’s a simple breakdown of some of its key concepts, terms and jargon to help you make the best insurance decision for you and your family.

When you’re looking to secure the good health of you or your family, it’s almost impossible to look past private health insurance. It acts as a financial buffer as you lock in the comprehensive healthcare required to keep everyone in tip-top shape and also during health emergencies where hospitalisation comes into play.  

For something so important, it can sure get complicated. To help you wrap your head around private health insurance, the team here at ExtrasJar has compiled this handy glossary that breaks down a few of its key concepts, terms and jargon. We hope it assists your search for the perfect health insurance policy for you.

Private health insurance glossary

Accident An unforeseeable event caused by an external and unintentional force that results in bodily harm or damage and requires immediate medical care.

Annual limits – The maximum amount of money, per year, that you can claim as dictated by your specific policy. 

Benefit – The amount you’ll pocket when you claim on a health treatment.

Co-payment – The amount you agree to pay your insurer each time they pay hospital benefits for you.

Extras – Also known as health extras, general treatment or out-of-hospital care, extras include an array of services both conventional and complementary that are not supported by Medicare. This encompasses things such as physiotherapy, psychotherapy, dental care and hearing aids.

Fixed fee – A payment that a number of private hospitals will charge on admission. 

Gap – Out-of-pocket costs that cover the difference between a practitioner’s charge and the benefit payable by your insurance provider.

Healthcare provider – Any practitioner or clinician that provides healthcare. Some insurance providers, like ExtrasJar, tap into a network of partnered practitioners that provide exclusive discounts and benefits to their customers.

Hospital cover – Insurance for hospitalisation and in-hospital treatment. It provides a level of financial compensation based on your policy which differs from provider to provider.

Hospital excess – Varies depending upon your policy, but is the amount you have to pay when admitted into hospital.

Inclusions and exclusions – Inclusions are what are included in your specific health insurance policy. The exclusions are what isn’t. Ensure your “non-negotiable” healthcare requirements are included.

Loyalty benefits – Some insurers, like ExtrasJar, provide claim increases or premium discounts as a reward for staying with them for an amount of time.

Medicare – The public healthcare system of all Australia. It provides subsidised or free cover for specific healthcare services that can be tapped into by Australian citizens and residents.

Packaged/bundled cover – Health insurance that includes both hospital and extras cover.

Pre-existing conditions – Illnesses, ailments, diseases or conditions that are affecting someone’s well-being at the time, or just before, they take out or upgrade health cover. Many insurers will appoint a doctor to decide whether conditions are pre-existing, as it could possibly affect the cost of cover.   

Restrictions – Situations where you cannot claim benefits for healthcare. This is mainly due to a too low level of cover for a certain treatment. If you go through with a healthcare process that is restricted, expect large gap payments or no support at all. ExtrasJar’s extras cover hates the idea of that, which is why we offer extras cover without restrictions so you can tap into the care you need with confidence. 

Tiers – Levels of cover ranked by their comprehensiveness. Hospital cover is required by Australian law to split be into basic, bronze, silver and gold tiers. Many insurers follow this pattern with extras cover too. Tiers based only on included items are quite restrictive, which is why ExtrasJar extras cover lets you break away from that status quo if you desire.

Waiting periods – The time it takes before insurance benefits kick in. The length of time varies provider to provider, but there is almost always a set period that cannot claim.

Transparent insurance that covers what’s important to you

At ExtrasJar, we’re spearheading an insurance revolution underlined by transparency, freedom and equality. We understand there’s no one-size-fits-all approach to extras or hospital cover, so we’re making it easier to understand and lock-in the health security you require without breaking the piggy-bank.

Find versatility, discover true control and grasp the healthiest version of yourself, inside and out, with ExtrasJar today. Make the system work for you – and only you.

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