Top claims show the benefits of private health insurance

A health professional writing on a clipboard

Over the 2023-24 financial year Emergency Services Health and Police Health paid out close to $208 million in health benefits to its members, including $298,333  for a single hospital episode.

That episode was for a heart and vascular system procedure, followed by the next two most expensive hospital episodes;

  • Psychiatric episode and treatment - $158,776 benefit
  • Digestive System episode & treatment - $114,303 benefit

It’s an important reminder of the value of private health insurance by providing peace of mind, getting treatment quicker than the public system and avoiding large out of pocket costs.

It’s also relevant to the police and emergency services communities, who have extra workplace stress that may result in developing mental health conditions.

Across Emergency Services Health and Police Health, the most common hospital procedures and treatments last financial year were:

 

Procedure or treatment Average benefit paid
1. Joint Replacements (e.g hip replacement)   $18,282
2. Heart and vascular system (e.g heart surgery) $7,385
3. Gastrointestinal Endoscopy $1,187
4. Digestive system procedures $4,804
5. Hospital psychiatric services $3,716

So, do we know why this is the case?

While Emergency Services Health and Police Health have over 90,000 members across Australia, this data also reflects the Australian Institute of Health & Welfare’s report, Australia’s Health 2024.

It’s a biennial report on the health of Australians, and is a mix of short statistical summaries and long-form articles exploring topical health issues.

It found that many people experience multimorbidity; that is, they have 2 or more chronic conditions at the same time.*

These conditions include arthritis, back problems, cancer, heart, stroke and vascular disease, mental and behavioural conditions, and osteoporosis.

In addition, the proportion of the population with multimorbidity has also increased at a greater rate than the proportion with one chronic condition only – up 33% from 2007–08, compared with an 18% increase for a single condition.

In summary – more people are living with multiple chronic conditions that increase the chance of them requiring to go to hospital.

What about Extras?

Extras cover helps with the cost of services generally not covered by Medicare and focuses on keeping you on top of your health.

Extras include things like dental, glasses, physiotherapy and a range of other services.

The most common benefits used by Police Health members last financial year were:

 

Extras category Average benefit paid Total benefits paid
1. Dental  $325 $39.65 million
2. Optical $336 $12.62 million
3. Physiotherapy $70 $9.24 million
4. Chiropractic $58 $5.14 million
5. Podiatry $112 $3.71 million

 

For more information or to join Emergency Services Health, call 1300 703 703

 *https://www.aihw.gov.au/reports/australias-health/chronic-conditions-challenge