HEALTH INSURANCE

Many Australians choose to take out some form of private medical insurance, medical insurance companies are referred to as funds. There are a wide range of cover options available from a variety of suppliers.

The Australian government provide information about private medical cover on the following web pages:

www.health.gov.au/privatehealth

and the Private Health Insurance Administration Council (PHIAC) also provide information and advice including a booklet designed to help you decide whether to take out private medical insurance:

Private Health Insurance Administration Council (PHIAC)

If we have existing health cover in the UK get a copy of the contract as some Australian companies will accept a ‘roll over’ and not make you have a ‘waiting period’

Types of cover

Ancillary cover will insure for what are considered to be those basics that Medicare don't account for, such as dentistry, optometry, podiatry etc.

Hospital cover allows you to choose who will treat us and in which hospital we will be treated (public or private). Do not assume that our full hospital bill will be covered as the level of cover differs from plan to plan.

Government incentives

There are a number of Government schemes in place to encourage those who can afford it to invest in private medical insurance and thus relieve some of the pressure on the public health system.

The Medicare Levy Surcharge (MLS) is a surcharge of 1%, on top of the standard 1.5% Medicare levy on income, which is charged to high income earners who do not choose to take out private medical cover.

A rebate of 30% is offered by the Government on private health insurance premiums. Even if your employer has paid your premium you are still entitled to claim the rebate.

The Lifetime Health Cover incentive scheme aims to encourage Australians to take out cover early in life rather than in their later years when they are more likely to make claims. Taking out cover before the 31st July after your 31st birthday leads to reduced premiums for life. A 2% loading is added to premiums for every year after the subjects 30th birthday that the insurance policy is started. Migrants over 31 can participate in the Lifetime Health Cover scheme provided that they take out insurance prior to the first anniversary of the day they became eligible for Medicare.

Qualifying periods

Most funds have a system whereby for a specified period of time at the beginning of your insurance you cannot claim benefits. A health fund can pose up to a 12 month waiting period for hospital cover and a limitless waiting period for ancillary cover to account for pre-existing conditions which should have been picked up in a medical before you subscribed to the insurance. Health funds cannot refuse you cover due to a pre-existing condition.

If you have an accident after joining the fund the qualifying period does not usually apply

Membership categories

There are 4 types of membership category:-

Membership Cover
Single Cover for one person named on the application
Couple: Cover for contributor and one other adult
Family Cover for contributor, another adult + upto 2 dependent children
Single parent: Cover for contributor and upto 2 dependent children

Funds

Funds must be registered under the National Health Act 1953. The websites of some popular funds can be reached using the links below:

Medibank Private - choose medibank private for health cover and travel insurance
Health Insurance, Private Health Cover, Home & Contents Insurance, Private Health Insurance - Australian Unity
Health Insurance, Travel Insurance, Life Insurance, Retirement Solutions - MBF Group
Private Health Insurance, Private Health Cover, Health Care - HBA Health Insurance Health Insurance
nib health funds
Health Insurance Australia - ahm - provides Health Insurance, Travel Insurance, Health Management, OSHC, Corporate Health Cover and Overseas Visitors Cover
(check if covers dental)

Choosing a health care fund can be a daunting task due to the wide variety of plans available. A number of advisory bodies are available and they should be able to help is with our decision.

Private Health Insurance Australia - iSelect - compares five of the top fund suppliers packages

Health Insurance Australia - HICA - Offers advice on health insurance including a free online health insurance assessment

Australian Medical Association - Australian Medical Association - provides a checklist for comparing funds

Personal Finance, Shares, Money, Superannuation News - moneymanager.com.au - Sydney Morning Herald Money Manager - offers a clearly explained guide to how health care works in Australia

On the last leg, only Part 4 to go!

Dolly