Common types of cover
Depending on the policy selected, 485 health insurance may provide benefits towards hospital treatment, medical services and emergency ambulance. The amount paid, participating providers, benefit limits and exclusions can differ substantially between products.
Hospital treatment
Eligible treatment as a private patient in hospital may be covered, subject to the policy's benefit rules, exclusions, waiting periods and any applicable hospital excess.
Doctor and specialist services
Some products provide benefits towards eligible medical services such as GP and specialist consultations. The benefit can be based on scheduled fees and may not cover the full amount charged by the provider.
Emergency ambulance
Emergency ambulance benefits are commonly included in OVHC products, but the circumstances and limits should be checked in the insurer's current policy information.
Pathology and radiology
Depending on the level of cover, benefits may apply to eligible pathology, X-rays and other diagnostic services. Out-of-pocket costs can still arise.
Hospital cover and the excess
A hospital excess is an amount you may need to contribute when admitted to hospital under the terms of your policy. A product with a lower monthly premium can sometimes have a higher excess or different benefit structure. Compare the excess alongside the premium rather than looking at price alone.
Medical and outpatient cover
Outpatient services are services received without being admitted to hospital. Depending on the product, these may include GP consultations, specialists, pathology and diagnostic imaging. Insurers can calculate benefits differently, and a doctor may charge more than the amount recognised by the policy, leaving you with a gap payment.
What may not be covered?
| Area | What to check |
|---|---|
| Excluded services | Some treatments or services may be excluded entirely under a particular level of cover. |
| Waiting periods | Benefits for some treatments may not be available until you have served the applicable waiting period. |
| Pre-existing conditions | Special waiting-period rules can apply where a condition is assessed as pre-existing. |
| Pregnancy and birth | Pregnancy-related services may require a higher level of cover and can be subject to a waiting period. |
| Extras | Dental, optical, physiotherapy and similar extras are not automatically included in every OVHC hospital product. |
| Gap costs | The insurer's benefit may be less than the provider's charge, so you may have an out-of-pocket expense. |
Waiting periods and pre-existing conditions
Waiting periods are periods during which you hold the policy but cannot yet claim certain benefits. Rules vary between insurers and products. If you are transferring from another Australian health insurer, ask the new insurer whether any waiting periods you have already served can be recognised.
Pregnancy cover
Do not assume pregnancy and birth services are covered simply because a policy is suitable for a 485 visa. Check the specific product, applicable waiting period, hospital benefits and any restrictions before relying on the policy for pregnancy-related treatment.
Does 485 insurance cover dental and optical?
Dental and optical services are generally associated with extras or ancillary cover rather than standard hospital-only cover. Some insurers offer additional options, so check whether extras are included, optional or unavailable with the product you are considering.
How to compare cover properly
1. Check visa suitability
Make sure the particular product is appropriate for your subclass 485 circumstances and any health-insurance condition that applies to you.
2. Compare hospital benefits
Review what hospital treatment is included, restricted or excluded and whether an excess applies.
3. Review medical benefits
Check GP, specialist, pathology and radiology benefits and understand where gap payments may arise.
4. Read waiting periods
Pay particular attention to pre-existing conditions and any pregnancy-related waiting periods relevant to your circumstances.
Five insurers available to compare
Policy Direct currently compares 485 health-cover options from AIA Health, nib, Medibank, Allianz Care and Bupa. Because their product structures can differ, use the provider pages and live insurer quote pages to check the current benefits and terms before purchasing.
Compare 485 Visa Health Insurance
Compare indicative prices and provider information from five insurers.
Compare 485 Health InsuranceFrequently asked questions
Does 485 health insurance cover GP visits?
Some products provide benefits towards eligible GP consultations, while more basic products may be more hospital-focused. Check the exact product before purchasing.
Does 485 health insurance cover hospital treatment?
Hospital treatment is a core feature of many OVHC products, but covered treatments, benefit levels, exclusions and excesses vary by policy.
Does 485 health insurance cover specialist appointments?
Some products provide benefits towards eligible specialist consultations. Benefit levels and possible out-of-pocket costs depend on the policy and provider charges.
Are pathology and radiology covered?
Depending on the level of cover, eligible pathology, X-rays and diagnostic services may receive benefits. Check the exact product because limits and gap costs can apply.
Does 485 health insurance include ambulance cover?
Emergency ambulance benefits are commonly included in OVHC products, but check the insurer's current terms for circumstances, exclusions and limits.
What is a hospital excess?
A hospital excess is an amount you may need to contribute when admitted to hospital under your policy. The amount varies by product.
Are pre-existing conditions covered?
Cover can be subject to a pre-existing-condition waiting period and other policy rules. Review the insurer's current terms for the product selected.
Does 485 health insurance cover pregnancy and birth?
Pregnancy and birth benefits depend on the product and may require a particular level of cover and a waiting period. Check this specifically before relying on a policy for pregnancy-related treatment.
Are dental services included?
Not necessarily. Dental is commonly associated with extras or ancillary cover rather than standard hospital-only cover.
Is optical cover included?
Optical benefits are generally associated with extras cover and are not automatically included in every 485 or OVHC product.
Does 485 health insurance cover physiotherapy?
Physiotherapy may be available through extras or broader products, depending on the insurer and cover selected. Check applicable limits and waiting periods.
What are waiting periods?
A waiting period is a period during which you hold the policy but cannot yet claim particular benefits. Waiting periods vary between products and services.
Can I still have out-of-pocket costs with 485 insurance?
Yes. Provider charges can exceed insurer benefits, and excesses, co-payments, exclusions or benefit limits can also result in out-of-pocket costs.
Is every 485 health insurance policy the same?
No. Products can differ substantially in hospital benefits, outpatient medical services, excesses, waiting periods, exclusions, limits and extras.
Which 485 health insurers can I compare through Policy Direct?
Policy Direct currently compares AIA Health, nib, Medibank, Allianz Care and Bupa. Review the main comparison and individual provider pages before obtaining a live quote.
General information only. Benefits, exclusions, limits, excesses and waiting periods differ by insurer and product and can change. Always read the insurer's current product information and policy terms before purchasing.