Private Health Insurance

Transparency of health cover is a huge issue for the private health insurance industry. The Federal Government encourages Australians to take out private health insurance as a means of helping pay for their health needs while taking some of the pressure off an a burgeoning health budget.

However, as the cost of health insurance premiums rise year after year, patients are finding that their increasing premiums are buying less services and that their out of pocket expenses are increasing.

Patients continue to report dissatisfaction with the level of transparency about what is covered or not covered by their private health insurance cover and an increase in the ‘gap’ between what specialists or providers charge for a procedure or service compared to what the health fund will reimburse the patient. The Australian Health Insurance Association is recognised by the ACCC and Australian Productivity Commission as having the most reliable data for Private Health related information in Australia. The AHIA website informs patients about the impact on Private Health Insurance and the wider Australian Health system. AHIA states that any gap only occurs if the doctor charges a fee above the amount the fund will rebate, after taking into account issues such as the overall sustainability of the fund for all members.  The fact that doctors don’t tell patients exactly what they will charge means the patient is unable to make a decision about which doctor will treat them for what charge. A patient should be aware of “Informed Financial Consent” identified as the consent to treatment by a medical practioner from a patient, prior to that treatment whenever possible, when the practitioner has sufficiently explained his or her fees to the patient to enable the patient to make a fully informed decision about costs.

The Private Health Insurance sector has an ongoing commitment to “Informed Financial Consent” for patients.

Tell us about your experience of private health.