Health Insurance - Gender specific items

I contacted my Health Insurer today to change my cover to hospital only.
As the Rep and I discussed what I was looking for, I pointed out that maternity and IVF was not required and neither was Male reproductive services

I was surprised to find that this item is standard on all policies regardless of whether the policy holders’ gender. She said it didn’t impact me.

But it does, in a year when our wage increase was 1.7% and Health Insurance will rise, in April, an average of 2.74%.

Why should I pay for this item, yes I am paying for it. Go ahead go to any health insurance site and check the premium difference between maternity and no maternity.

So many single women have health insurance and are paying for this item unknowingly.

Why can’t this item be removed and premiums reduced when we can for maternity and IVF, it’s the same.



I would fathom the reasoning is that if everyone could pick and chose what they needed and nothing more, the cost of (eg) children would become unaffordable, those with cancer would be left to fend for themselves, not had a broken bone yet - no worries reduced premium but have one and too bad, …

I hope some point was made, even if it is is not one you agree with. Insurance is about spreading risks and costs across a population, not maximising any single individuals situation.


According to this SMH article from September 2020 [Thousands drop private health insurance after questioning its value](,membership%20in%20older%20age%20groups".)

APRA also recognises that people are paying more and getting less in return from private health insurers. With our new COVID normal, more and more young people are expected to leave private health insurance which will make it even more expensive for those who stay on. I think this is the beginning of a death spiral for the sector unless major reforms occur.

Perhaps you should join the exodus and not have to worry about paying for unneeded gender specific items? You could utilize the excellent public health system.

If the Federal Government put the money that they give to prop up the private health sector into public health, we could have the world’s best health system.


Thank you for your response.

I’m considering my options.

It seemed funny to the Health Fund Rep I was speaking to, that the online quote provided by their website was $3.00 cheaper than the verbal quote she gave me. She tried to work out why there was a difference, in the end telling me her quote was valid not the quote from their website.

That is crazy, and I’m moving or leaving.


No system is perfect. How would this come about?
If the government did not put this money in, would anyone pay for private health cover?
Possibly not. The insurance premiums paid to the health funds would no longer be available to the health system and the Government would need to pay 100% of the costs for all, Australians. I can see the same level of health care services as we have today with the Government having to increase funding to keep that level. No improvement? It would set up some interesting challenges to control or cap costs. Could Australia continue with private service providers or need to nationalise 100% of the medical profession. That would include all the ancillary services from physio to pathology and imaging.

With a suspicion the Medicare surcharge would increase as a consequence to deliver what we all need, it might be a difficult political choice to sell. I’m not suggesting it’s a poor decision to make. Just a difficult one for those working in Canberra.

For now the principle of shared community risk prevails. Although it is a multi tiered system.

It’s worth pointing out the Medicare levy is also not adjusted for gender, age, physical status or existing medical conditions.

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The system would die very quickly as they punters raced for the door.

You assume that the government subsidy goes into improved medical services. What if it it just goes into increased fees for some very wealthy specialists and profitable private hospitals? Maybe if the saving from subsidies was spread around the public system everybody would benefit? I don’t know short of a detailed costing by an expert. I think it likely such costings have been performed but it will never see the light of day unless there is a huge shift in policy proposed.

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