Does Private Health Insurance Cover Coronavirus?

Does Private Health Insurance Cover Coronavirus?
Covid-19 positive test
Covid-19 positive test

Do I need private health insurance for Covid-19?

In the short term, Australian residents and citizens do not need private health insurance for COVID-19 treatment as it will be completely funded by Medicare. However, this isn’t to say that it will not be needed in the long term after treatment has been refined and a vaccine well and truly rolled out. Visitors on a VISA that do not have Medicare certainly need an Overseas Visitors health insurance policy to cover Coronavirus treatment.

Whether you already have health insurance or not, it would be appropriate to get advice about comparing health insurance funds in relation to the treatment of Coronavirus. Making sure you hold a private hospital cover policy that includes the right categories, treatments and procedures pertaining to COVID-19, particularly Lung & Chest treatment. It’s also important that your policy includes cover for medical treatments that arise as a result of contracting the illness. Some health funds only cover emergency road ambulance but some also cover non-emergency transport for air, land and sea. Finally, it’s important to ensure that your nearest private hospitals have an agreement contract with your health fund.

IF YOU ALREADY HAVE PRIVATE HEALTH INSURANCE

We can help you bring up your current policy and check your level of cover for Lung & Chest treatment, non-emergency ambulance cover, and if your nearest private hospitals have a contract with your health fund. If required, we can also help you find a new policy that does cover these things properly. When you switch health funds, you do not re-serve waiting periods by law so don’t worry about not being covered if you were to switch. Your new fund will have to cover you from day one. Period.

To skip the queue, call us on 1300 955 691 or fill out the form at the bottom of this page to get in touch a helpful health insurance adviser waiting to answer your questions about Coronavirus and health insurance.

IF YOU DON’T HAVE PRIVATE HEALTH INSURANCE

People who do not have private hospital cover at all or are upgrading to include Lung & Chest treatment will need to serve a waiting period of 2 months before new conditions are covered (12 months if pre-existing). Now would be a very good time to get covered and start your 2 month waiting period.

Four things to consider when asking if private health insurance may cover treatment for Coronavirus:

Health insurance coronavirus

Currently, there is no reason to panic. Like most countries, we are in High-Alert status. That may change to self-isolation and closed borders any day.

UPDATE 3rd March 2020: Australia now has 29 confirmed cases and 1 confirmed death. Two of the most recent in New South Wales are Australia’s first human-to-human transmission of the virus. The Government has activated some emergency health protocols and banned travel to Iran and other heavily affected countries.

UPDATE 10th of March 2020: Latest reports are that Australia is now at 100 confirmed cases. A total of three people have died as a result. 54% of confirmed cases are in NSW. Australia has been put into an ‘Alert’ status, as State and Federal Government begin to roll out plans for a worst-case scenario of a wide-spread pandemic. The reality is, these are just plans and there is no need for panic.

UPDATE 18th of March 2020: 454 COVID-19 cases in Australia. 210 are in New South Wales. Australia is in High Alert. According to Our World in Data statistics, Australia takes 3 days for our infected count to double. This means that by Friday, Australia should have over 900 cases. This means that the numbers will compound every three days: 450, 900, 1800, 3600, 7200 and so forth. Advice from the Government is to work from home if possible, social distancing, hand washing, cancellation of people gatherings larger that 500 people.

Does my private health insurance cover Covid-19?

  • You need a private hospital policy that includes adequate cover for lung & chest treatment.
  • It is also advised to check that your ambulance cover includes non-emergency transport.

 

Yes, it can. Health insurance hospital cover policies have a clinical category named Lung & Chest. With most health insurers, at least a Bronze Plus level of hospital cover is required to cover the Lung & Chest category. This means that anyone currently on a Public, Basic or Bronze level of hospital cover may not be properly insured against Coronavirus treatment in a private hospital. To throw a spanner in the works, some health funds require you to be on a Silver level of hospital cover to cover Lung & Chest.

That being said, there are many uncertainties related to Coronavirus treatment and health insurance. In the short term, any infected patients will more than likely be quarantined in a dedicated facility funded by Medicare. Private health insurance may only come into play when the disease has become widespread in Australia and cannot be contained. It is more than likely that the Australian Government will create large infection facilities completely separate from general hospitals in order to treat infected patients. Cross-contamination in our public or private hospitals would be a disaster.

In a worst-case scenario, the virus may reach a pandemic phase in Australia and all of our hospitals will be treating infected patients at full capacity. Hopefully, it doesn’t come to this, however, it’s important to plan for the worst. According to Australian health experts, this is not a case of ‘if’ but ‘when’ and is nothing short of inevitable. With media though, it is becoming increasingly difficult to separate fact from speculation.

One thing to take seriously would be what level of ambulance cover you may need if you were to require medical transport. Some health funds only cover emergency transport, which means that if the ambulance transport is not coded as an emergency, then the patient will receive a hefty ambulance bill. It is expected that most ambulance trips for people infected with COVID-19 will not be an emergency except in dire cases.

Ambulance transfers between hospitals or from hospital to home may not be covered either. Imagine starting off in a public hospital and then being given the green light to move to a private room in a nearby private hospital. You don’t want to be paying an estimated $1,000 to be moved around in a non-emergency ambulance vehicle. Some health insurance funds include non-emergency ambulance cover as part of their policies. An alternative is to take out a comprehensive ambulance subscription with the state ambulance service in your state.

Can I get private health insurance cover for Covid-19 without waiting periods?

  • If you’re not already covered for lung & chest in private hospital, then now is the time to start your 2 month waiting period for new conditions.

 

Like with most clinical categories, there is a 2 month waiting period before you are covered for new conditions and a 12 month waiting period for people who have a pre-existing diagnosis of Coronavirus. This means that the people who insure themselves for Lung & Chest before contracting the virus will only have to wait 2 months before they are covered in a private hospital. If any other pre-existing conditions or complications are treated alongside the virus treatment in a private hospital, you’ll need to ensure that you’ve served your 12 month waiting period for pre-existing conditions. Don’t forget, you don’t have to re-serve waiting periods when you switch health funds.

It’s important to understand that any additional medical attention required as a complication or result of contracting Coronavirus must also be covered on your private hospital cover. For example, if a person contracts a blood disorder as a result of an impaired immune system from fighting the virus, then the clinical category ‘Blood’ must also be insured on your health insurance policy.

Contact Fair Health Care Alliance for advice on how Coronavirus might apply to your health insurance policy. We can give you a comparative quote and explain everything you need to know about your new health fund and policy with absolute clarity and care.

Which Australian private health fund is best for covering Covid-19?

Some factors that make one health insurance fund better than another is their average performance in the private system of your state. These can be measured by average hospital-related charges covered by the fund, how the fund performs in relation to medical gap cover and private doctors propensity to participate in no-gap or known-gap arrangements. This pertains directly to what sort of medical gap bill you may be charged after treatment. We don’t want you breaking the bank.

Other important factors are excess rules, ambulance coverage and which private hospitals have a contract with your health fund. The best thing you can do is speak to us for advice and a quote. We have all the information you need and have a proven track-record for being able to convey this information with absolute clarity and care. Call us directly on 1300 955 691 or fill out the contact form below.

Does Private Health Insurance Cover Coronavirus?

Founder at Fair Healthcare Alliance

Aaron Savrone, founder of Fair Health Care Alliance (FHCA), is a health insurance expert with over 15 years of experience. Specializing in transparent, customer-focused advice, Aaron launched FHCA in 2017 to address the lack of genuine care in the health insurance comparison space. With a commitment to simplifying complex policies and data, Aaron and the team have earned FHCA top ratings and awards, including a 5-star Google Review score from hundreds of reviews and Best Insurance Comparison Website in 2023 and 2024 (ProductReview).

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