The Health Insurance Hack That Actually Makes Sense
I’ve been thinking a lot about health insurance lately, and honestly, it’s one of those things that makes me simultaneously grateful for the system we have and frustrated by how bloody complicated it all is. Private health insurance in Australia has become this weird game where you need to be part actuary, part detective to work out if you’re getting decent value or just paying through the nose for coverage you’ll never use.
So I came across this discussion online that really caught my attention. Someone was calling their health insurer to remove their last kid from the policy—you know, that bittersweet moment when your child finishes uni and you realise they’re properly adult now—and the customer service rep actually suggested something genuinely helpful. I know, right? In my experience with insurance companies, that’s about as rare as finding a parking spot on Lygon Street on a Saturday morning.
Here’s what happened: This couple had been paying for family coverage with a $500 excess. The rep looked at their claims history, noticed that only one partner went to hospital regularly, and suggested they split into two separate policies. The premiums would stay the same, but each policy would have a $250 excess instead. So if only one person needs hospital care in a year, they’re saving $250. If both do, they break even. And if neither does? Well, they still have to pay the premiums, but at least the excess structure makes more sense.
It’s one of those things that seems obvious once someone points it out, but I bet most of us never think about it. I certainly hadn’t. We’ve just been conditioned to assume that “family” or “couples” policies are always the better deal. It’s like bulk buying at Costco—sometimes it makes sense, sometimes you just end up with 48 rolls of paper towel you don’t need.
The part that really gets me thinking is how this highlights a broader issue with private health insurance in this country. We’ve created this system where you practically need a PhD to navigate it effectively. There are excess levels, waiting periods, coverage tiers, lifetime health cover loading, the Medicare Levy Surcharge threshold… it’s exhausting. And the onus is entirely on us, the customers, to figure out the optimal configuration. The insurers aren’t going to proactively tell you you’re paying too much or that your coverage doesn’t match your needs.
That’s why this story struck a chord with me. Here was someone in the industry actually helping a customer save money or at least structure their policy more sensibly. Maybe she was just really good at her job. Maybe she was having a particularly generous day. Or maybe—and I’m trying to be optimistic here—there are more people working in these companies who genuinely want to help rather than just extract maximum premiums.
The discussion that followed was pretty enlightening too. Several people mentioned they’d been doing the separate policies thing for years, particularly to avoid one partner paying for coverage they’d never use—like obstetrics for blokes, which makes perfect sense when you think about it. Why should men subsidise pregnancy coverage in a couples policy? Others pointed out that separate policies could mean double the annual limits on extras like dental or optical, which is definitely worth considering if you both wear glasses or need regular dental work.
There were some smart questions raised too. What about ambulance cover? In Victoria, we’re spoiled compared to other states—ambulance cover is free for everyone. But if you’re in Queensland or NSW, you might have family ambulance cover through your health insurance, and splitting policies could complicate that. Someone also raised the valid concern about whether this was actually an upsell—swapping to policies with lower excess often means higher premiums, so you need to do the maths carefully.
The whole thing reminds me of when I finally sat down and properly audited our DevOps infrastructure costs at work. We’d been running services on autopilot for years, and when I actually looked at what we were paying versus what we were using, I found thousands of dollars in waste. Health insurance feels the same—most of us set it up once, maybe review it every few years when the premium increase letter arrives, and otherwise just let it roll on.
Look, I’m not going to pretend I have all the answers here. Private health insurance in Australia is a complex beast, and there’s a whole political dimension to it that I’m deliberately sidestepping for now. But I do think this is a useful reminder that sometimes it pays to question the default option, to actually engage with these systems rather than just accepting them as they are.
If you’ve got private health insurance and you’re in a couple, it might be worth running the numbers. Check your claims history if you can, look at what each of you actually uses, and see if separate policies might work better. Maybe call your insurer—though I’d lower your expectations about getting someone as helpful as the person in this story. And if you discover you’ve been overpaying or poorly configured for years, try not to get too frustrated. We’re all just trying to navigate these byzantine systems as best we can.
The silver lining? Stories like this get shared, people learn, and maybe we all get a bit savvier about this stuff. That’s worth something, even if the system itself remains as clear as mud.