Can I claim vaccinations on health insurance? 

If you’ve got Extras Cover, you might be covered for the cost of vaccinations, but the type of shots you can claim and the amount can be wildly different.  

Let’s look more closely at cover for vaccinations on health insurance. 

Are vaccinations covered by Medicare? 

Yes, if a vaccination is recommended for your age group or circumstances, the cost is free under Medicare. For example, an annual flu vaccination is free for people over the age of 65 or who have certain health conditions. If you don’t meet that criteria, you can still get a flu vaccination but you will have to pay for it yourself. To find out more about Medicare funded vaccines for children and adults, check the National Immunisation Program Schedule and chat to your GP.   

For vaccines that aren’t listed on the National Immunisation Program Schedule, you may be able to claim on your Extras Cover, depending on your policy.  

Are vaccinations covered by health insurance? 

Yes, if you have Extras Cover that includes the Vaccination category, you may be able to claim back the cost of vaccinations that aren’t funded for you under the Pharmaceutical Benefits Scheme (PBS). For example, vaccines for cholera or yellow fever if you are travelling to an area such as Africa, or vaccines that aren’t funded for your age group, like the shingles jab (which is only free for people aged 65+, or Aboriginal and Torres Strait Islanders aged 50+). It’s a good idea to contact your insurer first and find out whether the vaccine is covered.  

Vaccines eligible for health insurance cover must be: 

• approved by the Therapeutic Goods Administration (TGA)  

• given by a doctor, pharmacy or vaccine clinic (you’ll need to keep the receipt) 

• not funded under the PBS. 

There may be limits to how much you can claim for each vaccination, as well as an annual limit. And if it’s a new policy, you may have to serve a waiting period before you can claim. Waiting periods on Extras Cover can vary, but are usually 2 months on new policies.   

How much is health insurance for vaccinations? 

Using the healthslips.com.au calculator, the cheapest health insurance covering vaccinations for one adult living in Victoria was $16.15 a month, which allows you to claim back $15 per vaccination up to a limit of $100. The most expensive was $176.98 per month which allows you to claim $80 per vaccination, with a limit of $500. However on both policies, the limits are combined with Non-PBS Pharmaceuticals, which means if you’re claiming for medications you’ll reach your limit much faster, and there may be sub-limits which means a set proportion you can claim on vaccinations. 

What’s the best health insurance for vaccinations? 

The best health insurance for vaccinations is one that allows you to claim enough to get good value out of it, and the premiums are within your budget. We recommend using the healthslips.com.au calculator to compare every Extras Cover policy in Australia to find one at the best price. It’s fast, free and has no commercial bias. Make sure you check the policy details to see what limits apply for vaccinations.  

Search for a new Extras Covers policy on the healthslips.com.au calculator or compare your current Extras policy to others available. You don’t have to give any contact details to get your results, so you can be completely anonymous.  

healthslips.com.au does not provide general or personalised advice. Your particular circumstances are likely to impact the accuracy, completeness and relevance of the information or results. Take this into account before making a decision and talk to an expert for financial advice.   

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

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