The states with the highest and lowest health fund premiums

Where you live and who you work for affects how much you pay in health insurance. See how your state compares.

Where you live and where you work can make an astounding difference to your health fund premiums, potentially saving you $500 per month.

Our exclusive investigation into the private health insurance industry has found Victoria has the most expensive health fund policies in the nation while the Northern Territory has the cheapest.

And we found you could save big money if your employer has a corporate policy with a health fund.

News Corp has launched a simple new tool to help you locate the cheapest hospital policies in your state.

It shows the most expensive gold policy, with a $750/$1500 excess, is Bupa’s Corporate Gold Hospital in Victoria at $626.50 for a family.

The same fund also has the cheapest gold policy charging just $129.20 for its Healthlink Gold policy in the Northern Territory.

If you lived in the Territory and worked for the company offering this policy your health fund premiums could be nearly $500 a year lower than in Victoria.

Even the cost of the exact same health cover policy can vary by state.

In Queensland, Medibank’s Gold Complete Hospital policy costs $21 more than it does in NSW. The same policy is $16.20 more expensive in Tasmania than in NSW but it costs the same in South Australia as in NSW.

Many funds offer corporate discounts of around 10 per cent off the price of health cover.

Corporate policies were among the cheapest in the nation and you could save around $100 a month on premiums if you were lucky enough to be employed in some workplaces.

NSW

For example in NSW Medibank sells its family Corporate Gold Health Cover for $356.80 but the Gold cover it offers to the general public – Medibank Gold Complete Hospital costs $449.80 ($93.50 per month more).

VICTORIA

In Victoria Medibank’s Corporate Gold policy costs $404.40 but the Gold health cover it offers to the general public – Medibank Gold Complete Hospital costs $498.10 ($93.70 per month more).

QUEENSLAND

In Queensland Medibank’s Corporate Gold policy costs $404.20 but the Gold health cover it offers to the general public – Medibank Gold Complete Hospital costs $491.90 ($87.70 per month more).

SOUTH AUSTRALIA

In South Australia Medibank’s Corporate Gold policy costs $379.20 but the Gold health cover it offers to the general public – Medibank Gold Complete Hospital costs $449.80 ($70.60 per month more).

TASMANIA

In Tasmania Medibank’s Corporate Gold policy costs $387.50 but the Gold health cover it offers to the general public – Medibank Gold Complete Hospital costs $482.80 ($95.30 per month more).

NORTHERN TERRITORY

In the Northern Territory Medibank’s Corporate Gold policy costs $187.90 but the Gold health cover it offers to the general public – Medibank Gold Complete Hospital costs $238.10 ($50.20 per month more).

While it might seem smart if you live in Victoria to buy a cheaper Northern Territory insurance policy you can’t.

Paragraph 63-5 (2A)(a) of the Private Health Insurance Act 2007 obliges health insurers to sell a person who resides in a particular State or Territory the product that is priced for that state.

Health funds told News Corp the reasons premiums varied by state included different hospital and real estate costs in the states and the general claiming pattern on that product in the state in which it was sold.

Wage costs are a large part of health insurance bills and registered nurses salaries in Queensland and Western Australia are higher than in Victoria and NSW, and in the ACT and NSW doctors are most likely to charge higher fees.

Wages for doctors and nurses vary by state. Picture Getty Images

Nib’s Chief Executive of Australian Residents Health Insurance, Ed Close, said charging lower premiums to corporate policy holders did not breach rules that prevent funds from risk rating their pricing.

“Premium pricing for corporate groups is not based on any individual member factor such as health status, age or claims history all of which are protected under the principle of community rating,” he said.

Private Healthcare Australia CEO Dr Rachel David said the biggest driver of the premium cost is the amount funds paid to hospitals.

“All sorts of things play into that like the real estate that the hospital is built on, the cost of their food supplies, consumables and so forth,” she said.

“Overall in where the cost of living is lowest, you can expect that premiums tend to be a bit lower,” she said.

FORCED TO RAID SUPER TO COVER CANCER TREATMENT

Jodie Lydeker was shocked to discover her top hospital insurance did not cover over $20,000 of medical expenses after she was diagnosed with aggressive breast cancer three years ago.

“I maxed out credit cards, I borrowed money off my partner, from my mother and I ended up applying for access on compassionate grounds for my superannuation,” the 43 year old told News Corp.

Ms Lydeker had been paying for top health cover for ten years with Australian Unity and was emotionally devastated by the experience.

“I presumed that top hospital cover would include everything but found out very quickly it didn’t,” she said.

“For one procedure, it would have been easily $5000 to $6000 and private health would have covered maybe half of that,” she said.

Every scan she had attracted an out of pocket expense worth hundreds of dollar that neither Medicare nor her health cover paid for.

Her fund suggested she ask her surgeon to take part in their gap scheme but the surgeon “laughed in my face and said if she did that she wouldn’t be able to afford a receptionist”, Ms Lydeker said.

Jodie Lydeker of Williamstown with her cat Bella. Jodie has been inspired to take a new perspective and appreciation of life after a recent battle with breast cancer. Picture: Andrew Henshaw

Some women she knew had to sell their house and car to pay for treatment, she said.

A key problem was the Medicare schedule of fees which underpins private health fund rebate is “way out of touch with the current health service fees,” she said.

Ms Lydeker had major problems accessing her superannuation to pay the bills and initially had her claim rejected.

However when she was finally granted access to $30,000 of her superannuation the government imposed a $10,000 tax bill “so I actually lost 40 grand from my super” she said.

This compares with the recent COVID superannuation rules that let people get $10,000 of their superannuation tax free.

RARE CANCER TREATMENTS AND SCANS NOT FUNDED BY HEALTH COVER

Kate McKenzie was aged just 20 when doctors discovered thousands of precancerous polyps in her bowel. She later developed rare Desmoid Tumours and brain cancer.

The Brisbane mum of seven year old Lucia is now relying on charity to raise money to fund a $100,000 a year treatment that is not covered by the pharmaceutical benefit scheme or her health fund.

It’s not the only health costs her fund won’t pay for.

Kate McKenzie and dogs Jensen and Winnie. Picture: Annette Dew

The tumours growing inside her abdomen have blocked her kidneys and the blood flow to her legs but her health fund stopped covering the cost of scans taken in hospital a few years ago.

“The two key things that we use to manage cancer basically are scans and whatever the bloods are doing and when you’re not covered for those things, because it’s not offered or cancelled, it’s just a nightmare, like I do pay 500 bucks for an MRI,” she told News Corp.

Ms McKenzie credits health insurance with saving her life because she faced a six month wait in the public system for the surgery that identified her brain cancer.

“Fortunately, I had private health insurance and I went and saw a neurosurgeon,” she said.

“I’m very thankful that my mum and dad had me insured from a baby. A lot of people 20 years of age aren’t thinking about private health insurance, they get to 30 and they still don’t,” she said.

However she said the disadvantage with suffering from a rare condition was that it made shifting health funds for a better deal impossible.

“You kind of get stuck in a situation where you can’t move health insurance providers, because you won’t be covered for certain things and you’ll have a waiting period for that help and basically stuck with that insurance,” she said.

If you would like to donate to Kate’s treatment here is a link to her fundraising page story: https://treat.rarecancers.org.au/campaign/2064/helping-kate-mckenzie

Originally published as The states with the highest and lowest health fund premiums