Can I use health insurance for heart disease treatment? 

If you’re likely to need heart surgery, health insurance could be worth your while. While treatment in public hospitals will always be free under Medicare, 1 in 6 Australians are living with heart disease (according to the Heart Foundation), so there may be a wait for non-urgent cardiac treatment in public hospitals. According to Private Healthcare Australia’s Hospital High Claims Report, cardiovascular treatments were among the highest hospital claims paid by insurers in 2024. 

Here, we answer your top 4 questions about health insurance for heart disease treatment. 

1. What health insurance covers heart surgery and heart disease treatments?  

Heart disease treatments – including surgeries and treatments for heart failure, heart attack and varicose veins – are covered under the Heart and Vascular System clinical category of Hospital Cover, a mandatory inclusion on Silver tier policies or higher (including Silver Plus policies). If you have Extras Cover that includes Exercise Physiology and Psychology, these could help you maintain heart health.  

Remember that Hospital Cover only applies to in-hospital treatments, so you can’t claim for appointments with a cardiologist at their clinic, for example. You will get a Medicare rebate for specialist appointments.  

Here’s a breakdown of some health insurance treatments that could help you manage heart disease: 

What does restricted cover mean? 

2. Can I get health insurance if I have heart disease already? 

Yes, you can get health insurance if you have heart disease but you’ll have to serve a waiting period (usually 12 months) before you can claim on a new policy, because you have a pre-existing condition. But if you’re changing from a policy which included cover for Heart and Vascular System, you won’t have to serve waiting periods again for cardio cover.  

What is a pre-existing condition for health insurance?  

3. Is cardiac rehabilitation covered by health insurance?

Yes, but only on Gold tier policies of Hospital Cover. It’s sometimes included on Basic, Bronze or Silver policies, but at a restricted level, which means large out-of-pocket costs for you.

Cardiac rehabilitation can make a big difference to your long-term health. A 2026 Victorian study found people are four times more likely to die from another heart attack without cardiac rehabilitation programs. So if you’re not covered for private cardiac rehabilitation, ask your cardiologist about publicly funded cardiac rehabilitation programs, or check the Heart Foundation’s cardiac services directory to find what’s available in your area.

4. How do I get the best value out of Extras Cover for heart disease?

If you need help changing your lifestyle to manage heart disease, your Extras Cover may reduce some of your costs, depending on your policy. Make sure you check your policy limits and waiting periods.  

• Nutrition support – Eating a healthy diet will help keep your heart healthy, says the Heart Foundation. The cost of appointments to see an accredited practising dietitian may be partially covered by policies that include Dietetics/Dietary Advice.  

• Exercise advice – While physical activity is important for a healthy heart, it’s best to see an expert about the safest forms of exercise for you. Talk to your doctor, and consider seeing an accredited exercise physiologist – you can claim partial costs if your policy includes Exercise Physiology. 

• Heart disease education – If your policy includes the Health Management/Healthy Lifestyle category, you may be covered for classes or therapies such as heart-disease management and quit-smoking programs. Your gym membership costs might be covered too – check with your insurer.  

• Mental health support – Better Health Channel says anxiety and depression can be common after heart surgery, so if you’re struggling mentally, seek support from your GP or a health professional. If you have Extras Cover that includes Psychology, your insurer may partially cover appointments with a psychologist. 

5. How do I find the best heart surgery health insurance?  

If you’re living with heart disease, try the free healthslips.com.au calculator to find the best Hospital or Extras Cover (or Combined cover) for you. If you already have health cover but it isn’t meeting your needs, compare your existing policy with our calculator to find a better deal. Our calculator includes every policy from every insurer in Australia without any bias, and you won’t have to enter any contact details see your results. 

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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