Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad. He emphasizes clear information, neutral analysis, and practical decision support.
Australia Skilled Visa Insurance Requirements
Australia's Skilled Independent (189) and Skilled Nominated (190) visas grant permanent residency to skilled professionals. As a permanent resident, you're eligible for Medicare—Australia's public healthcare system. However, private health insurance plays a unique role in the Australian system.
Key Insurance Considerations
- • Medicare access granted with PR (after visa approval)
- • Private health insurance is optional but incentivized
- • Medicare Levy Surcharge (MLS): 1-1.5% extra tax without PHI if income >$93,000
- • Lifetime Health Cover (LHC): premiums increase 2%/year if you join PHI after age 31
- • International insurance doesn't exempt you from MLS or LHC penalties
- • Waiting periods apply for pre-existing conditions (12 months by law)
Australia's system is unique: Medicare covers most essential care, but private insurance provides faster access to elective surgery, choice of doctor, and private hospital rooms. The government actively incentivizes private coverage through tax penalties (MLS) and lifetime loading (LHC).
For skilled visa holders planning to stay in Australia long-term, Australian private health insurance is typically the best choice for cost and tax efficiency. International insurance makes sense during the transition period or if you'll be moving countries again.
Quick Comparison: Insurance Options for Skilled Visa Holders
Skilled visa holders have three main paths: international coverage, global insurers with Australian products (like Bupa), or local Australian private health insurance:
| Feature | Cigna Global | Bupa Global | Australian PHI |
|---|---|---|---|
| Skilled Visa Acceptance | ✓ Accepted | ✓ Accepted (Bupa AU available) | ✓ Standard for PR holders |
| Australian Network | Good (private hospitals) | Excellent (Bupa Australia) | Excellent (all private hospitals) |
| Medicare Access | No (separate) | No (separate) | Complements Medicare |
| Pre-existing Conditions | Moratorium option | Moratorium option | 12-month wait (by law) |
| International Coverage | Worldwide | Worldwide | None |
| MLS Exemption | Does not exempt | Bupa AU exempts | ✓ Exempts from levy |
| Annual Maximum | Unlimited | Unlimited | Varies by procedure |
| Best For | Global movers | Transitional coverage | Long-term PR holders |
Cigna Global
Cigna Global provides comprehensive international coverage that works well for skilled migrants who may not stay in Australia permanently or who travel internationally frequently.
Strengths
- • Worldwide coverage (great for global movers)
- • Access to select Australian private hospitals
- • No waiting periods for most conditions
- • Comprehensive coverage including mental health
- • Portable if you leave Australia
- • 24/7 multilingual support
Considerations
- • Does NOT exempt from Medicare Levy Surcharge
- • Does NOT count toward Lifetime Health Cover
- • Much more expensive than Australian PHI
- • Limited Australian network vs. local PHI
- • Not cost-effective for long-term AU residence
Get a Cigna Global Quote
Global coverage for internationally mobile professionals.
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Bupa Global / Bupa Australia
Bupa is unique—they offer both international coverage (Bupa Global) and Australian private health insurance (Bupa Australia). This makes them ideal for skilled migrants transitioning from international to local coverage.
Strengths
- • Bupa Australia product exempts from MLS
- • Bupa Australia counts for LHC purposes
- • Excellent Australian hospital network
- • Can transition from Global to Australia product
- • Strong brand recognition in Australia
- • Bupa Global offers worldwide coverage
Considerations
- • Bupa Global doesn't exempt from MLS
- • 12-month wait for pre-existing (Bupa AU)
- • Bupa Global is expensive for AU-only living
- • Need to choose correct product for needs
Get a Bupa Quote
International coverage with Australian local options.
Get QuoteWe may earn a commission when you apply through our links. This does not affect our recommendations.
Australian Private Health Insurance
Australian PHI (from Bupa Australia, Medibank, HCF, NIB, etc.) is the standard choice for permanent residents. It exempts you from tax penalties, provides choice of private hospitals, and integrates with Medicare.
Strengths
- • Exempts from Medicare Levy Surcharge
- • Counts toward Lifetime Health Cover
- • Most affordable option for AU residence
- • Full private hospital network access
- • Extras cover for dental, optical, physio
- • Integrates seamlessly with Medicare
Considerations
- • 12-month waiting period for pre-existing
- • 2-month wait for most services
- • 12-month wait for pregnancy/birth
- • No international coverage at all
- • Gap payments for some procedures
Compare Australian PHI at: privatehealth.gov.au (government comparison site), iSelect, Compare the Market, or directly with insurers like Bupa Australia, Medibank, HCF, NIB. Premiums are regulated and similar across insurers—differences are in network agreements and extras benefits.
Coverage Comparison
Here's how coverage compares. Remember that skilled visa holders get Medicare—PHI supplements it:
| Coverage Type | Cigna Global | Bupa Global | Australian PHI |
|---|---|---|---|
| Inpatient Hospital | 100% covered | 100% covered | Private hospital access |
| Outpatient Care | 100% covered | 100% covered | Extras cover required |
| Emergency Evacuation | Unlimited | Unlimited | Not covered |
| Prescription Drugs | 100% covered | 100% covered | PBS (separate system) |
| Dental | Optional | Optional | Extras cover |
| Vision | Optional | Optional | Extras cover |
| Mental Health | Full coverage | Full coverage | Hospital cover included |
| Pregnancy/Birth | Optional add-on | Optional add-on | 12-month wait |
Medicare covers GP visits, public hospital care, and most pathology. PHI adds private hospital choice, shorter waits for elective surgery, and extras (dental, optical). International insurance provides comprehensive standalone coverage without Medicare integration.
Pricing Comparison
Australian PHI is dramatically cheaper than international coverage. These ranges represent hospital + extras cover:
| Age Group | Cigna Global | Bupa Global | Australian PHI |
|---|---|---|---|
| 25-30 | A$350-550/month | A$400-620/month | A$100-200/month |
| 30-35 | A$420-650/month | A$480-740/month | A$100-200/month |
| 40-45 | A$600-920/month | A$700-1,050/month | A$150-300/month |
| 50-55 | A$850-1,300/month | A$980-1,480/month | A$200-400/month |
The cost difference is significant. For a 35-year-old, Australian PHI is roughly 20-30% the cost of international coverage. Factor in MLS savings (1-1.5% of income over $93,000) and the financial case for local PHI is strong.
Network Access in Australia
Australia has excellent healthcare in major cities. Here's network access comparison:
| Region/City | Cigna Global | Bupa Global | Australian PHI |
|---|---|---|---|
| Sydney | Good - select private hospitals | Excellent - Bupa network | Full private network |
| Melbourne | Good - select private hospitals | Excellent - Bupa network | Full private network |
| Brisbane | Good | Excellent | Full private network |
| Perth/Adelaide | Limited | Good | Full private network |
| Regional Australia | Reimbursement | Limited | Regional private facilities |
| International | Worldwide | Worldwide | Not covered |
Australian PHI provides the broadest local network. International insurers have more limited Australian partnerships but offer worldwide coverage. For Australia-only living, local PHI provides better access.
Real-World Scenarios
Scenario 1: Skilled Professional Settling in Sydney
32-year-old software engineer with 189 visa, earning $150,000, plans to stay in Australia long-term.
Recommendation: Australian PHI (Hospital + Extras)
MLS savings alone justify PHI cost. Get hospital cover to avoid MLS, add extras for dental/optical. Start before turning 31 to avoid LHC loading. Most cost-effective long-term.
Scenario 2: Globally Mobile Professional
38-year-old consultant with 190 visa, travels internationally 40% of the year for work.
Recommendation: Australian PHI + Travel Insurance OR Cigna Global
Get minimum Australian PHI to avoid MLS/LHC penalties. Add comprehensive travel insurance for international trips. Alternatively, Cigna Global if you might relocate within 2-3 years.
Scenario 3: Young Skilled Migrant, Lower Income
28-year-old nurse with 189 visa, earning $75,000, healthy, no immediate healthcare needs.
Recommendation: Basic Australian PHI now
Income below MLS threshold ($93,000) but get PHI now to avoid LHC loading after 31. Basic hospital cover is affordable (~$100/month). Can upgrade later when income grows.
Scenario 4: Skilled Migrant with Pre-existing Conditions
45-year-old engineer with 189 visa, has managed diabetes and needs regular care.
Recommendation: Australian PHI + Medicare
Medicare covers your diabetes care immediately (no waiting periods for public system). Australian PHI has 12-month pre-existing wait but provides private hospital access after wait period. International insurance offers no waiting but costs 3-4x more.
Scenario 5: Couple Planning Family
30-year-old couple with 189 visas, planning to have children in Australia.
Recommendation: Australian PHI with pregnancy cover
Get PHI with pregnancy cover immediately—there's a 12-month waiting period before you can claim pregnancy benefits. Medicare covers public birth (excellent), but PHI adds private obstetrician choice and private room.
Our Verdict
For most skilled visa holders planning to stay in Australia, Australian Private Health Insurance is the clear choice—it's more affordable, exempts you from tax penalties, and provides better local network access. International insurance only makes sense if you're highly mobile internationally or uncertain about staying in Australia long-term.
Choose Australian PHI If...
- • Planning to stay in Australia
- • Income over $93,000 (MLS)
- • Under 31 (avoid LHC loading)
- • Want best local network
Choose Cigna Global If...
- • May relocate in 2-3 years
- • Travel internationally often
- • Want immediate full coverage
- • MLS is acceptable cost
Choose Bupa If...
- • Want transition flexibility
- • Bupa AU + Global options
- • Prefer single insurer
- • Value brand recognition
Frequently Asked Questions
When do I get Medicare access with a skilled visa?
Medicare eligibility starts when your permanent visa is granted (not just applied for). Once you have your 189/190 visa, enroll at a Medicare service center. You can then see any bulk-billing GP for free.
What is the Medicare Levy Surcharge (MLS)?
MLS is an extra 1-1.5% tax on top of the standard 2% Medicare Levy if you earn over $93,000 (single) and don't have Australian PHI hospital cover. At $150,000 income, MLS costs ~$1,875/year—often more than PHI premiums.
What is Lifetime Health Cover (LHC) loading?
If you don't get Australian PHI hospital cover by July 1 after turning 31, your premiums increase by 2% for each year you delay (up to 70% loading). This loading applies for 10 years. Getting PHI before 31 avoids this entirely.
Can international insurance exempt me from MLS?
No. Only Australian government-registered private health insurance with hospital cover exempts you from MLS. Cigna Global, SafetyWing, and other international policies don't qualify. You'd pay MLS on top of international premiums.
What about the 12-month waiting period for pre-existing conditions?
Australian PHI has a legally mandated 12-month waiting period for pre-existing conditions. During this time, Medicare still covers your care in the public system. After 12 months, PHI covers private hospital care for those conditions.
Should I get "Hospital" or "Extras" or both?
Hospital cover is what exempts you from MLS and is essential for private hospital access. Extras cover dental, optical, physio, etc. Most people get both. If budget-constrained, prioritize hospital cover (for MLS exemption) and pay for dental/optical out-of-pocket.
Disclaimer: Medicare, MLS, and LHC rules change. Verify current requirements with Services Australia and the Australian Taxation Office. Compare Australian PHI at privatehealth.gov.au. Confirm policy details directly with insurers before purchasing. This comparison is for informational purposes and does not constitute insurance, tax, or immigration advice.
