Compare up to three hospital policies on premium after rebate, excess and benefit cap against an admission cost you choose.
Use this when you are choosing between hospital policies that all cover the treatment you have in mind. A cheaper policy that excludes the clinical category you need is not a real option, so check each Private Health Information Statement first.
Enter each policy's annual premium after the rebate, its excess for one admission, and a cap if the policy limits benefits (enter 0 if not). Then enter the hospital charges the insurer would be asked to pay for one admission: accommodation, theatre and the 25% of the doctors' schedule fees that Medicare does not pay. The tool calculates your share = admission cost − min(admission cost − excess, cap), adds the premium and sorts the policies.
Worked example (illustrative). With a $6,000 admission: the $750-excess Bronze costs $1,650 + $750 = $2,400; the $250-excess Bronze costs $1,890 + $250 = $2,140; the Silver Plus costs $2,420 + $500 = $2,920. With no admission the $750 excess is $240 cheaper, so the lower excess pays off only if you expect an admission. Set the admission to $0 to see the no-claim year.
Limits. Doctors' gap fees above the schedule fee are not included; see the gap fee guide. Some policies charge the excess once a year, others per admission, and many waive it for children. The tool does not model waiting periods, co-payments per day or restricted benefits.
Worked Examples and Checklists
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.
Worked Examples and Checklists
A practical method for comparing hospital and extras policies like for like, using policy statements, the rebate, excess, gap cover and a worked comparison.
Costs, Tiers and 2026 Rules
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.
Mistakes, Disputes and Official Sources
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.
Mistakes, Disputes and Official Sources
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.
Mistakes, Disputes and Official Sources
The difference between covered, restricted and excluded clinical categories, what a restricted benefit pays in a private hospital, and how to check your policy.
