Coronavirus FAQ's

Coverage for coronavirus

Does my health insurance policy cover coronavirus? introduced coronavirus support measures, which mean existing customers with hospital cover will be covered for all COVID-19 related hospital treatments as a private patient, as long as you have served your initial two-month waiting periods.

This COVID-19 coverage was initially provided until the end of June 2020, but has now been extended right through to the end of March 2021. We want our customers to have peace of mind during the evolving pandemic situation and extending this coverage is the right thing to do.

If I buy hospital cover now, will I be covered for coronavirus?

If you buy health insurance now to be covered in hospital for coronavirus, the standard two-month hospital waiting periods will apply before you are able to claim benefits.

For customers who are new to private health insurance, the standard two-month hospital waiting periods will apply.

The rules in relation to pre-existing conditions for hospital cover will not apply.

How will the hospital know that you will cover me?

We’ve added wording to hospital eligibility checks to confirm coverage for all of our customers with hospital cover, so the hospitals are aware that you will be covered.

If I need to be quarantined for COVID-19, will I be covered?

Quarantine at home (self-quarantine) isn’t something that would be covered by private health insurance.

What clinical category does coronavirus fall under?

Testing for coronavirus comes under the MBS item number 69485, for microbiology testing for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The treatment of coronavirus doesn’t have its own clinical category or MBS item number, but will likely fall under respiratory disorders under the Lung & Chest category.

Will my health insurance policy cover GP visits and tests for coronavirus? (Private Health Insurance)

By law, we cannot cover outpatient appointments such as GP appointments, blood tests etc. These rules will continue to apply as normal, even for coronavirus. You can learn more here.

Will my health insurance policy cover GP visits and tests for coronavirus? (Overseas Visitor Health Cover)

For OVHC customers on Essentials Workers Cover or Essentials Plus Workers Cover, we do pay benefits towards outpatient services.

This includes cover for consultations with a GP (General Practitioner) or specialist outside of hospital.

Premium increase deferral

In these tough times, it’s more important than ever that we support each other. Here at our 1 April 2020 premium increases were put on hold for the year. This was automatically applied to your policy at the time.

These changes come into effect 1 January 2021, meaning there has been no premium change since 1 April 2019.

Changes to the Government Private Health Insurance Rebate were deferred until April 2021. Please see our Premium Review help section for more details.

Cover suspensions

Financial hardship policy changes

We’ve extended our financial hardship suspension policy during COVID-19 to give customers some premium breathing room.

The maximum financial hardship suspension period allowed has now been increased from 6 months to 12 months.

The 3 month minimum suspension period has been removed, so if you suspend and something comes up that you need to claim, you can reactivate on the spot.

Customers on combined covers have the option to suspend just the Extras portion of their combined cover, so you can maintain hospital cover while still reducing your premium. We’ve had to make some system changes to set this up, so please get in touch if you were previously unable to use this option and we’ll get it sorted for you. 

Please note that this can only be used once per membership during a pandemic. If you choose to reinstate your extras, you will be unable to place them on suspension again.

You don’t need to show any proof of hardship to take up any of these suspension options during coronavirus, however, you do need to have been a member with us for at least 6 months. Simply let us know how we can help and our customer service team will take it from there.

If I want to suspend my cover because of financial stress, can I still make a claim?

As with any other type of suspension, you won’t be able to claim benefits while your cover is suspended.

I have a student dependent that has just come off my policy. What are the options for them if they can’t afford their own cover right now?

Student dependants who require their own cover but are unable to afford it at this time will still be able to take out their own cover. can then apply a hardship suspension straight away. A minimum of one-day premium payment is required. We’ll also waive the minimum suspension period, so they’re able to reactivate at any time.


Other questions

What if I have a pre-booked hospital admission or ongoing hospital treatment?

The Federal Government initially suspended all non-urgent elective surgery from midnight on 26 March due to the coronavirus. Some elective surgery categories are now being rescheduled.

If you have a pre-booked hospital admission or ongoing hospital treatment, we’d recommend checking in with your doctor and hospital before your admission, to make sure you have the most up-to-date information.

Should I keep my cover?

If you’re wondering if it’s worthwhile keeping your private health insurance right now, we’ve broken down some options and things to keep in mind based on the type of cover you currently have.

Hospital only cover

Private hospital cover is complicated, and there’s more to it than just elective surgery. If you are able to, maintaining your private hospital cover is always a good idea, even at a time like this. There may be an even greater backlog of elective surgeries when services eventually return to normal.

Lifetime Health Cover (LHC) loading allows you to drop private hospital cover for a maximum of 1,094 days in your lifetime without incurring a LHC loading penalty. If you decide to suspend your hospital policy instead of cancel, your LHC loading won’t be impacted.

However, there can be tax implications to dropping private hospital cover. If you earn more than $90,000 (single) or $180,000 (family, couple) cancelling your private health insurance hospital cover could mean paying extra tax. It really depends on your individual circumstances, so getting some independent financial advice is always a good idea. An alternative option is to either suspend your cover or temporarily change to a lower cover to reduce your premium.

If this is something that might affect you, it’s always a good idea to seek independent financial advice. You can also read up on Australian Government Surcharges & Incentives to get a better understanding.

If paying your premium is just not an option at the moment, we understand. That’s why we’ve extended our financial hardship policy to allow customers to suspend for up to 12 months if they need to. This means that you can avoid re-serving any relevant waiting periods when you reactivate. Waiting periods do vary, so if you have any questions about those just hit us up on chat. Please note that you won’t be able to make any claims while your policy is suspended. 

Extras only cover

Extras limits are per calendar year and you have until Dec 31st to use your limits.

Please have a read of the section above on telehealth benefits to see if this is a service you can use with your current level of Extras cover.

Cancelling Extras cover now (not just suspending) means that you would need to re-serve waiting periods (ie Major Dental has a 12 month waiting period) should you decide to sign up for Extras cover again in the future with us or any other private health insurer (unless they specifically waive your waits). 

An option now available to customers is to temporarily suspend their Extras cover. While this means you cannot claim any services during this time, you can take a break from payments without having to re-serve waits when your suspension period ends.

Combined cover

Both the Hospital only and Extras only information above will apply to customers on Combined covers.

An option available to Combined cover customers is to temporarily suspend the Extras portion of your cover in order to lower your premium. This option has the benefit of allowing you to maintain continuous private hospital cover and not have to re-serve your Extras waits when the suspension ends.

If you’re unsure, have a read of The Value of Private health insurance during coronavirus.

The most important message we can give is to get in touch if you’re unsure of the best option for you. Our Customer Service team is still available on live chat and email.

We’ll do our very best to help you where we can so we can get through this thing together.