Picking hospital cover is about fit, not just price.
Use these questions to make a confident choice and get the right protection.

What are hospital tiers?

Hospital cover is grouped by clinical categories into ‘tiers’. Some services are fully covered, some are restricted, and some are excluded.

These tiers are set by the government and are the same across the industry. Health insurers will sometimes offer ‘plus’ products which include the base level categories ‘plus’ some additional categories.

How do I know what’s covered

Inclusion

Services and treatments you are covered for under your policy.

Restricted

Services and treatments that have limits or require approval before you can claim.

Waiting periods

A set time you must wait after joining before you can claim on a specific service or treatment.

If you’re switching health funds and move to a Latrobe Health equivalent or lower hospital policy, you don’t serve waiting periods you’ve already completed.

Pre existing conditions

A pre-existing condition is any illness or condition where signs and symptoms were present in the six-month period prior to joining your health cover, increasing your cover or reducing your excess. A formal diagnosis is not required for a condition to be considered pre-existing. 

How much will I pay if I go to hospital?

Excess

The amount you agree to pay upfront when you make a claim on your hospital cover. This helps reduce your premium. Latrobe Health offers policies with excess amounts of $750, $500 and $250

Out-of-pocket expenses

Costs you pay yourself for services that are not fully covered by your policy, such as gaps between provider fees and your benefit amount.

Private vs public care

Private care allows you to choose your doctor, have a private room (if available), and avoid long public hospital wait times.

Public care treatment is usually free, but you may have limited choice of doctor and longer waiting periods.

Latrobe Health tip! Ask your specialists to bill under Access Gap Cover. Participating doctors either charge no gap or a known gap capped at set amounts, with written consent.

Why am I getting health insurance?

Ask yourself why you’re getting health insurance. Is it for tax purposes? Is it for just in case or is it for a planned procedure? Are you about to turn 31? Answering this question is important in understanding what product is going to best suit your needs.

Some people purchase health insurance to avoid paying the Medicare Levy Surcharge and to avoid Lifetime Health Cover loading.

Medicare Levy Surcharge (MLS)

The Medicare Levy Surcharge is an additional tax applied to high income earners who don't have the appropriate level of private hospital cover. It is designed by the government to encourage people to take out health insurance to reduce pressure on the public healthcare system.

Lifetime Health Cover (LHC) loading

The Lifetime Health Cover Loading is a government initiative that adds a 2% loading fee to your private health cover premium for each year you’re aged over 30, when you first take out hospital cover. The loading fee can go up to 70% and is applied to your premium for 10 years.

Age-based discount

The age‑based discount is a government initiative designed to incentivise younger people to take out health insurance earlier. If you take out eligible private hospital cover between ages 18–29, Latrobe Health offers you a discount of up to 10% on your hospital premium (extras are not discounted). This discount is determined by your age when you first take out cover.

You keep this discount until you’re 41 where is then begins to reduce by 2% per year. By age 45, the discount phases out completely. If two adults are on the same policy, the discount is averaged out between them.

Just in case

Taking out health cover for peace of mind, even if you’re healthy now? Great decision! Private health cover helps protect you against unexpected medical costs and gives you more choice and control over your care, when you need it.

Latrobe Health’s hospital policies include Accident Advantage, providing top-tier coverage for accident-related treatments. If you’re injured in an accident and see a doctor or emergency department within 72 hours, you get top tier hospital cover for related treatments for up to 90 days. Submit the Accident Advantage form within 21 days and your hospital excess for the related admission is waived. 

A planned procedure

Taking out private health cover for a treatment or procedure you know you need can help you avoid long public hospital wait times, have a private hospital room (if available), and gives you the ability to choose your own doctor.

Our friendly Victorian based call centre team are experts in helping understand your needs and finding the right policy for you. You can get a quote online here or contact our team on 1300 362 144

The information shared in this article is general and not meant to guide specific financial choices. Always consult with a professional who understands your personal situation before making any financial decisions.