All guides

How extras (general treatment) cover pays for dental, optical, physio and other services, how limits and combined limits work, and how it fits with Medicare and the rebate.

The government minimum clinical categories for each hospital tier, what 'Plus' and 'restricted' mean, and how to pick a tier from the treatments you expect.

How the LHC loading is calculated, when your base day falls, the 1,094 days of absence, couples' averaging, exemptions and how the loading ends after 10 years.

MLS income tiers and rates for singles and families, what counts as income, which hospital cover avoids it, part-year cover and how couples are assessed.

What Medicare covers, what private hospital and extras cover add, and how the surcharge, Lifetime Health Cover loading, rebate and waiting periods shape the price.

Rebate percentages from 1 April 2026 by age and income tier, the 2026–27 thresholds, premium reduction versus tax return claims, and how tax-time reconciliation works.

The maximum hospital waiting periods, how the 12-month pre-existing condition rule is decided, the mental health waiver, extras waits and upgrades.

How hospital excesses work in Australia, per-admission versus annual excesses, the limits for the surcharge, and a break-even calculation for choosing a level.

A practical method for comparing hospital and extras policies like for like, using policy statements, the rebate, excess, gap cover and a worked comparison.

Side-by-side arithmetic for singles and families at each surcharge tier, including the rebate, LHC loading and excess risk, to see when cheap hospital cover wins.

Test extras cover by comparing the premium after rebate with the benefits you would actually claim, with worked examples for a light user, a regular user and a family.

Ten-year cost of the LHC loading at different joining ages, compared with holding cheap hospital cover from your base day, with every step of the arithmetic shown.

How Medicare's 75%, your insurer's 25%, gap cover schemes, the excess and hospital charges combine into your out-of-pocket cost for an operation, with the arithmetic shown.

How portability protects waiting periods when you change policy or fund, the transfer certificate, timing the switch, extras limits and a worked downgrade example.

Medicare does not pay for ambulances. How ambulance costs work in each state and territory, who is exempt, and when to get cover through an insurer or state subscription.

The steps for disputing a refused claim, a pre-existing condition decision or a billing problem, from the insurer's own process to the Private Health Insurance Ombudsman.

Lifetime Health Cover base days for new migrants and returning expats, the one-year window, time overseas and suspended cover, Medicare eligibility and the surcharge.

A section-by-section guide to the standard policy statement, and which government site to use for tiers, the surcharge, the rebate, Medicare, MBS fees and complaints.

The common errors that lead to surprise bills or tax debts: restricted cover, waiting periods, gap fees, ambulance, the surcharge excess limit, the wrong rebate tier and lapses.

Choosing between public and private patient status in Australian hospitals: costs, choice of doctor, elective waiting lists, emergencies and using private cover in a public hospital.

The difference between covered, restricted and excluded clinical categories, what a restricted benefit pays in a private hospital, and how to check your policy.