We’re all about helping people live healthier lives—and part of that is making sure you’ve got the right info to make smart choices. So, we’re busting some common myths about private health insurance to help you see the real value it can offer and figure out if it’s a good fit for you.
Common misconceptions about private health insurance
1. I don't need private health insurance if I have Medicare
Medicare is funded by our taxes, and while it provides great coverage towards the costs of many health services Australians need, it doesn’t include everything. That’s where private health insurance comes in. For example, Hospital cover can give you more say in where you’re treated and who you’re treated by*, as a private patient in either a public or private hospital. And Extras cover can help with day-to-day health needs that aren’t typically covered by Medicare like new prescription glasses, dental check-ups, remedial massage and more. Without Extras cover, you may have to pay the full cost out of your own pocket.
Learn more about the difference between Medicare and private health insurance.
2. I don’t need health insurance if I’m young and healthy
Life’s unpredictable—even if you’re fit and healthy, things like joint injuries can still happen (in fact, joint reconstructions are one of the top claims for Aussies aged 25–39).1 With private hospital cover, you can skip long public hospital wait times and get more choice and comfort in your care. Plus, Extras cover can help with recovery services like physio and remedial massage, and even everyday stuff like dental and optical. With eligible Medibank Extras, you could get 100% back on up to two dental check-ups a year at any Members’ Choice Advantage dentist—that’s worth around $500 in value!=
Plus…if you’re aged 18 to 29, you could score a discount on eligible hospital cover. The earlier you sign up, the bigger the discount—10% off if you join before 26, and 2% off if you join at 29.
And it’s not just a short-term deal. Keep your cover and that discount sticks around until you’re 41, gradually phasing out after that. So, you’re locking in years of savings just by getting in early.
Want to stay on top of your health game? See how private health insurance could help.
3. Private health insurance is too expensive and not worth it
An unexpected medical bill can sometimes be even more expensive. Private health insurance can come in handy—helping you skip long wait times, get access to more treatment options, and avoid the stress of surprise medical bills. Depending on your cover, you might even score extras like dental, optical, and physio, which Medicare doesn’t usually cover.
So yeah, it might seem like a big cost upfront, but the value and peace of mind can make it worth it.
There are also the costs that you might have from not being insured, like government levies and taxes. Particularly if you’re over the age of 31, or earn more than $101k as a single and choose not to take out private Hospital cover.
Learn more about the Lifetime Health Cover Loading and the Medicare Levy Surcharge and use our Medicare Levy Surcharge Calculator to find out how much extra tax you could be paying without Hospital cover.
4. Health insurance comparison sites compare all health funds
Buh-bow! Most comparison sites only show options from insurers who pay to be listed—and they typically focus on price and basic product inclusions. At Medibank, we believe value goes beyond what’s listed on a comparison site. That’s why our health cover is designed to offer more—benefits and support that aren’t always visible in a side-by-side comparison.
100% back on up to two dental check-ups every year on eligible Extras=
Unlimited emergency ambulance^
Better value through our Members' Choice provider network&
Medibank member perks
Accident Cover Boost+
24/7 Medibank Nurse & Mental Health Support@
5. Health funds that aren't on comparison sites aren't good value
Although lots of people find comparison sites handy, we’re not on any comparison sites at the moment. But that doesn’t mean we’re more expensive! We’re competitively priced and have options for different budgets. Wondering how Medibank compares to other major health funds? Take a closer look at how we stack up against Bupa and HCF to help you choose with confidence.
We're also proud to be the longest running health insurer to win Canstar's Outstanding Value Health Insurance award, at 17 years running.
If you’ve got a quote from a comparison site, give us a call. We’d love to show you what we can offer and help you find the best private health insurance for you.
6. The cheapest option is the best option
"Cheap" and "value for money" are two different things. With “cheap cover” you can expect to receive fewer benefits, and potentially pay higher out-of-pocket costs or a higher level of excess for services that you may be covered for. No matter what level of cover you choose, you should make sure it aligns with your needs and how you look after your health.
Learn more: How to choose health insurance
7. If I have an existing health condition, my cover will be more expensive
To ensure that people with a higher level of claims are not disadvantaged, the Australian government put into place a community rating system. Community rating means that everyone, regardless of their health status, age or claims history, are entitled to buy the same cover, at the same price, and are guaranteed the right to renew their cover. This system ensures that private health insurance is available for everyone, whether you have an existing health condition or not.
Learn more: Pre-existing conditions explained
8. I must get private health insurance to avoid the Medicare Levy Surcharge
Short answer is: it depends, based on your annual income, and whether you’re a single, couple, or family. The longer answer is:
To encourage Australians to take out private hospital cover and relieve stress on the public system, the government applies an additional levy for those without private hospital cover, depending on your annual income. This is known as the Medicare Levy Surcharge.
You could save money on tax with Hospital cover If you earn more than $101k as a single or $202k as a family, couple or single parent. You could be paying an additional tax surcharge of 1% (up to 1.5%) of your income as an additional tax surcharge, if you or any of your dependents don’t hold an appropriate level of Hospital cover for the full financial year.$ You can use our Medicare Levy Surcharge Calculator to find out how much extra tax you could be paying without Hospital cover.
Learn more: Medicare Levy Surcharge
9. I will need to re-serve waiting periods if I switch health funds
When you sign up for private health insurance, you usually have some waiting periods. It’s to stop people from joining a health fund, claiming big, and bouncing—because that would hike up costs for everyone.
Here’s the quick rundown on common waiting periods on health cover that includes the following services:
🚑 Ambulance: 1 day
🤰 Pregnancy & pre-existing conditions: 12 months
🏥 Most general hospital services: 2 months
🛠 Extras (like dental & physio): 2–36 months
🧠 Mental health support: No wait!
If you’re switching from another fund within two months of leaving that fund, good news—you won’t have to re-do waiting periods you’ve already served. So, you’ll be able to make the most out of your new cover straight away.
For more information about which waiting periods apply to your policy, it is important to check the Cover Summary. New waiting periods may apply if your health cover has new or upgraded services and benefits.
10. I don't get any value from my private health insurance
Totally get why it might feel that way — but there’s more to it than just hospital and extras cover. With Medibank, you can earn points and redeem rewards with our health & wellbeing program — Live Better — just for doing everyday healthy stuff like walking, meditating, or hitting your sleep goals. Those points? You can redeem them for gift cards, fitness gear, or even discounts on your premium. Plus, members get access to perks like gym discounts, and deals on things like pet and travel insurance. It’s not just about health cover—it’s about being supported to live better, every day.
Those myths? Officially out of excuses.
Now those myths have been busted, it's time to consider getting health insurance...
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Things you need to know
* Subject to doctors’ availability and hospital resourcing.
1 Based on FY23 Medibank internal claims data for Bronze Plus Progress.
= Eligible members on Medibank extras (excluding Healthy Living Extras and Gold Ultra Health) can claim a maximum of two 100% back dental check-ups per member, per year at a Members’ Choice Advantage provider (including up to two bitewing x-rays per check-up, where clinically required). For members on eligible extras, the first two check-ups do not count towards your annual limit. Members with Healthy Living Extras can get 100% back on one dental check-up each year at a Members’ Choice Advantage provider (including up to two bitewing x-rays per check-up, where clinically required) or at a Members’ Choice dentist (excluding x-rays). Members with Gold Ultra Health can get 100% back on up to three dental check-ups at a Members’ Choice or Members’ Choice Advantage provider (including up to two bitewing x-rays per check-up, where clinically required). Members’ Choice and Members’ Choice Advantage providers are not available in all areas. Two month waiting period applies. Some products may have other dental benefits, check your cover summary for details.
^ Waiting period applies. For ambulance attendance or transportation to a hospital where immediate professional attention is required, and your medical condition is such that you couldn't be transported any other way. TAS and QLD have State schemes to cover ambulance services for residents of those States.
& Members' Choice providers are not available in all areas and may change without notice.
+ For Accidents that occur in Australia after your cover starts. Must seek medical treatment within 7 days, and receive hospital treatment within 12 months of the Accident occurring. Excludes Private Emergency Department Benefit, hospital bonus, claims covered by third parties and our Private Room Promise. Out-of-pocket costs may apply.
@ Some referred services may involve out-of-pocket costs and waiting periods may apply.
$ The single parent/couple/family income threshold is increased by $1,500 for each MLS dependant child after the first child. 'Income’ and 'dependants' have a specific meaning for Medicare Levy Surcharge purpose. Learn more.
While we hope you find this information helpful, please note that it is general in nature. It is not health advice and is not tailored to meet your individual health needs. You should always consult a trusted health professional before making decisions about your health care. While we have prepared the information carefully, we can’t guarantee that it is accurate, complete or up-to-date. And while we may mention goods or services provided by others, we aren’t specifically endorsing them and can’t accept responsibility for them. For these reasons we are unable to accept responsibility for any loss that may be sustained from acting on this information (subject to applicable consumer guarantees).