Please DO NOT DELETE this page.

Blog //
  • Membership

How Private Health Insurance Works

09 October, 2014

It’s useful to know the basics of health insurance when shopping around for a package. Most private health insurance providers offer two main types of health cover: hospital cover and general treatment policies. Members can access packages - which offer a combination of the two - or opt for separate policies in the two categories for a ‘mix and match’ policy.

Hospital cover

Hospital cover is designed to assist policyholders with the expenses associated with in-hospital treatment. In-hospital costs can include medical treatment, accommodation and theatre costs.

While most medical services can be covered by private insurance, other services such as laser eye surgery or cosmetic surgery may not be covered at all or may only be covered to a limited extent. These are the four key types of hospital cover:

  • Top - This type of coverage includes all services for which Medicare pays a benefit.
  • Medium - This level of cover may restrict or exclude certain services such as pregnancy and birth services, joint replacement, hip replacement, sterilisation, cataract and eye procedures, dialysis, cardiothoracic, palliative care, bariatric care and more.
  • Basic - Basic cover generally restricts or excludes services such as palliative care, psychiatric services, cardiac services, non-cosmetic plastic surgery and more.
  • Public - Public hospital cover usually includes default benefits for treatment available in public hospitals. The covered items will vary depending on the insurer.

Ancillary and general treatment policies

Also known as “extras cover”, ancillary or general treatment policies cover additional services, such as optical, physiotherapy and dental treatment.

There are three key types or levels of ancillary policies:

  • Comprehensive - This level of cover will usually include general and major dental, physiotherapy, psychology, non-PBS pharmaceutical, optical, additional services such as hearing aids and other services.
  • Medium - Medium cover usually includes general and limited major dental. It may include additional services such as podiatry, chiropractic, optical, and more.
  • Basic - Basic cover will include a limited number of hospital-related services.

Packaged plans

Many funds include packages that combine different levels of hospital and general treatment services depending on lifestyle requirements. Others allow policyholders to pick and choose to suit their needs. CBHS offers a range of options, and members can choose packaged plans or individualised plans with hospital and extras components.


Important things to know

Waiting periods

A waiting period typically applies when cover is being purchased for the very first time, or when the member is upgrading their cover. This means that certain benefits cannot be claimed during the waiting period, which may be 2, 6 or 12 months.


Members should take time to understand what is and is not covered under their policy. This assists with financial planning and management of expectations for situations where the member may need to pay for some of the expenses.

Reviewing cover

Everyone should review his or her insurance policy on a regular basis. Lifestyle changes can mean changing healthcare and insurance requirements, particularly in regards to your family.

CBHS members are encouraged to review the CBHS website to ensure that they have the most appropriate cover for their needs.

1911_CBHS Skyscraper Banner-07

Suggested Articles

  • Older adults using fitness gadgets

    Top Fitness Trends of 2020

    We put our ears to the ground and asked the pros what top health and fitness trends we can expect to see in 2020.
    • Fitness
    21 January 2020
  • A tropical smoothie

    Treat yourself to a tropical smoothie

    Keep up your good intentions as January draws to a close and stay off the high fat, processed snacks. Treat yourself to this delicious tropical smoothie instead.
    • Nutrition
    21 January 2020
  • A person checking weight Loss

    Four simple rules to lose weight

    Dieting but not losing weight? You may have been given bad advice. Try following these four simple food rules to speed up your weight loss efforts.
    • Wellbeing
    16 January 2020
  • Face mask

    Should I be worried about smoke haze?

    Australia’s bush fire crisis has devastated many towns and rural communities. Cities not directly affected have been blanketed in smoke, but how hazardous is it?
    • Wellbeing
    16 January 2020

What Our Members Think

I joined as a CBHS member in 1978. Through many health events and challenges CBHS has always been there for me and my family. Their exceptional service over this time has always been appreciated.

- Jenny J

What Our Members Think

I've not long joined CBHS from another fund, but so far I've been impressed by the super helpful and friendly staff, the higher claim limits and rebates at a very competitive premium, and how easy it is to lodge manual claims through the app. Thanks CBHS - you've won me over! 😃

- Jessica B

What Our Members Think

What I love about CBHS is their customer service - friendly staff and always ready to help and email you the information you ask about. Keep up the great work!!!

- Linda S

What Our Members Think

I love CBHS as its so so easy to lodge a claim and whenever i need a question answered friendly consultant is one phone call away. The phone back option instead of waiting is brilliant!

- Rachel N

What Our Members Think

I have been with CBHS since I began at CBA 15 years ago...Now I have three beautiful children, one who has a disability. Our top extras cover has been really essential for his early intervention. I do love the ease of claiming online.

- Annette E

What Our Members Think

I am relatively new to CBHS and am loving it already. I worked for a CBA subsidiary a long time ago but was still eligible to join. So much better that the for-profit funds - our premium is only a little more and we pay a lower co-contribution and get great benefits. I am loving the massage rebate for my partner and gym rebate for me!

- David G

What Our Members Think

I'm extremely happy with CBHS! I have been a customer for about six years. I think the price is reasonable. And i would refer you to my family and friends any day. Thank you CBHS!!!

- Karen W

What Our Members Think

Love CBHS as I never have to doubt that they've got my back when I need it. Been through other insurers who have limited options or limits, yet cost the same or more.

- Mark F