3 Health Reforms for Private Health Cover in Australia in 2019

3 Health Reforms for Private Health Cover in Australia in 2019

According to the Australian Government’s Department of Health, more than half of Australia’s population are covered by private health insurances. However, many Australians are having troubles understanding the complexities of their private health insurance (what is covered and what is not). So, to make private health covers simpler and easier to understand, the Australia’s Federal Government has introduced a wide range of reforms to the health insurance industry, which has taken effect last 1 April 2019.

Here are three major health reforms for private health insurances in Australia (as of 1 April 2019).

  1. The private hospital cover will now have four tiers.

This new classification system will provide you with an easier way to compare and choose the most suited health cover for you. The new hospital cover product tiers are Gold, Silver, Bronze, and Basic. You can download the fact sheets here.

Basically, the cover levels are as follows:

Basic – covers little (if any) in private hospitals. You may have access to the following treatments with restrictions:

  • Rehabilitation
  • Psychiatric Services
  • Palliative Care

Bronze – low cover. Same as basic tier but may also provide unrestricted cover for the following (but not limited to) treatments:

  • Nervous system
  • EENT
  • Bone and muscle
  • Kidney and bladder, digestive system, male reproductive system, hernia, appendix, gynaecology, breast surgery
  • Pain management
  • Skin
  • Chemotherapy
  • Diabetes

Silver – medium cover. Same as bronze tier but may also provide unrestricted cover for the following (but not limited to) treatments:

  • Heart and vascular system, blood
  • Lungs, chest, back, neck, spine
  • Plastic, Dental, and Podiatric Surgery
  • Implantation of hearing devices

You may choose any of the basic, bronze, and silver tiers and opt to upgrade it to basic plus (+), bronze plus (+), and silver plus (+) respectively. Upgrading to a plus (+) means that you will enjoy the benefits of the tier itself, plus one additional treatment available in the higher category.

Gold – high to full cover. This is the ultimate level of the tiers. It covers the full range of benefits included in the clinical category. These include (not limited to):

  • Dialysis for the kidney
  • Cataracts and eye surgery
  • Birth and overall pregnancy
  • Joint replacements
  • Insulin pumps and other pain management devices
  • Weight loss surgery
  1. The private health insurers will be able to offer several benefits

These benefits include:

  • Premium discounts for people from 18-29 years old. They can be offered discounts of up to 10%. View the fact sheet here.
  • Health insurers are now able to offer policies with higher excesses in exchange for lower premiums. You will be able to choose an increased excess of 750$ for singles and $1500 for couples/families. Private health insurance reforms with increasing voluntary maximum excess levels fact sheet can be downloaded here.
  • Accommodation and travel benefits for regional and rural consumers. People under hospital cover who need to travel long distances for hospital treatments can enjoy this benefit. Download the fact sheet here.
  • An accessible mental health treatment. Patients also have an improved access to drug and alcohol treatment. View the fact sheet here.
  1. Private health insurers can no longer offer natural therapies as benefits of health policies

The Australian government has found out that there is no clear evidence that these natural therapies are clinically effective; hence, the removal of some natural therapies. View the explanation here.

From April 1, 2019, these natural therapies will no longer be covered by your hospital policy:

  • Alexander technique
  • Aromatherapy
  • Bowen therapy
  • Buteyko
  • Feldenkrais
  • Herbalism
  • Homeopathy
  • Iridology
  • Kinesiology
  • Naturopathy
  • Pilates
  • Reflexology
  • Rolfing
  • Shiatsu
  • Tai chi
  • Yoga

Be Updated Always!

If you already have a private hospital cover, your insurer should update you on these reforms for your information and classification.