Private Health Insurance Expert Reveals How You Could Be Overpaying

Summary:
1. Don’t get caught up in the ‘name’ of a private health insurance policy.

2. Don’t let the new private health categories fool you (bronze, silver, gold).

3. You’re on an old policy that they don’t offer anymore.

4. You’re paying a big gap when you claim on extras.

5. You have a low hospital excess ($0 or $250) but haven’t been into a hospital in a very long time.

6. You let your private health fund get away with increasing your premium every year.
Read below to find out…

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1. Don’t get “caught up” in the name of a private health insurance policy.
Prior to 2019, Health funds could use almost any name to label their hospital and combined policies. Common names such as Advantage, Top Plus, Core, Classic and more were used for differentiating from other funds. By no means is this true of the level of cover or what was included and excluded. To make sure you’re on the right policy, read all the included, excluded, and restricted Clinical Categories.

2. Don’t let the new private health categories fool you.
(Basic, Basic Plus, Bronze, Bronze Plus, Silver, Silver Plus, Gold) The government has introduced new standardized categories for health insurance funds. The aim of this standardization was to simplify health insurance comparisons for the everyday consumer; however, we believe it’s made it more difficult.
Why? Two different health funds can have the same name ‘Silver Plus’ hospital cover but have different inclusions and exclusions. We recommended reading through your policy details to make sure your policy opts into the right benefits for you.

3. You’re on an old policy that they don’t offer anymore.
Some loyal customers (tip: you don’t get any benefits for being loyal) seem to think that because their policy is no longer offered to new customers, they shouldn’t change... and their health fund tells them this too. Most of the time, older policies have painfully low rebates. If you’ve been on a policy for some time and you’ve ever thought “why do I pay so much out of pocket?”. It’s likely your rebates haven’t increased to keep up with providers’ costs, however, your premiums have increased.
More than likely, the reason the policy isn’t on offer anymore is because it wasn’t that popular…

4. You’re paying a big gap when you claim on extras.
Extras are designed to give you a rebate when you use things like dental, optical, physio, massage, etc. Some people receive a fractional return (maybe $15) out of an $80 consultation with a physiotherapist and ask themselves, is this it?! Here’s the good news… by finding the right health insurance policy, you should be aiming for a minimum return of 60% back on extras. Some funds will offer 70%-80% back at your own choice of provider. That means, out of that same $80 consult, you’re now going to receive at least $48 from your fund. In most instances, these new policies cost the same or less than your old policies.

5. You have a low hospital excess ($0 or $250) but haven’t been into a hospital in a very long time.
Your hospital excess is normally capped at one excess per person, per calendar year (generally on adults only). If you’re on a couples policy, and both adults are admitted once every 3 years on a $500 excess, you’re paying $1,000 for hospitalization. In many instances, a $0 excess can increase your premiums by around $600 per year. If you’ve spent this over the 3-year period, you’ve paid $1,800 to save $1,000 on your 2 hospitalizations.
In other words, you’ve short-changed yourself $800. So, we can confirm that unless you go into hospital each year, you’re generally better off with a $500 excess!

6. You let your private health fund get away with increasing your premium every year.
If your health fund is putting your price up without giving you better value for money, it’s time to give them a call to see what else they can offer you. If they don’t offer anything, it’s time to start shopping around…