We’re committed to helping our Members live better lives through better health and this has never been more important than now as we navigate the current COVID-19 environment. We continue to look for ways we can support our Members through this difficult time with important Member information below.
1 April 2020 Premium increases delayed for six months (updated 31/08/20)
On 1 April every year, all private health insurers advise their Members of the new premium they are required to pay. This year, due to the impacts of COVID-19, a decision was made to defer our annual premium increase until 1 October 2020. Along with our Emergency Assistance Package, this has given our Members some much needed relief during this time.
In February we notified all Members of the upcoming premium increase. This letter outlined the expected premium and details about your current level of cover. With the six month deferral period coming to a close, we have notified our Members and confirmed changes to premiums effective 1 October 2020.
Assistance for Members impacted by COVID-19
We acted quickly to make an Emergency Assistance Package available. While each event is different and every Member’s circumstances are considered individually, for Members directly affected by COVID-19 the package includes one-month financial assistance on our health insurance products.
For Member’s who require a longer term solution, you can apply to suspend your policy for up to six months. If your application is approved, it is important to note the below:
- During your suspension period, you are not required to pay any premiums
- While your policy is suspended you are unable claim or receive any benefit payments for any persons listed on the policy.
- All people on the policy are viewed as not holding a current level of Hospital Cover. This may have an impact at the end of the financial year particularly if your income is subject to the Medicare Levy Surcharge. If you need further information on this, we ask that you please make contact with your tax adviser.
- Where a Member is currently serving waiting periods, the period of suspension does not contribute towards completing waiting periods.
Does private health insurance cover COVID-19?
If you are diagnosed with COVID-19 and require hospitalisation, at this stage it is likely you will be treated in the public system. However, private health insurance can cover COVID-19 if you are admitted into hospital as a private patient, provided you have the appropriate level of cover.
Treatment for COVID-19 would typically fall into the clinical category of Lung and Chest; this category is an inclusion on all our hospital policies. As with all claims, potential patients must have served any applicable waiting periods in order to make a claim and the Excess applicable to your hospital cover would apply.
Should any other medical condition develop due to a complication, those services would need to be an inclusion on your chosen level of hospital cover. Click here to find out more about the full range of benefits associate with your level of cover.
Extras Cover – Two new ways to claim
Telehealth consultations have been expanded to include a much wider selection of providers.
Telehealth is the use of current technologies to exchange health information and provide health care services. It will give Members the opportunity to attend appointments with certain healthcare professionals over the phone or via video call technology such as FaceTime or Skype.
During COVID-19 we have expanded the eligible service providers and we will now pay standard consultation benefits for telehealth for:
- Speech Therapy
- Exercise Physiology
- Occupational Therapy
- Orthoptic Therapy
- Childbirth Education
We encourage Members to check with your provider to see if they offer telehealth consultations. To find out what we will pay for each service check your level of extras cover and your available benefit amount in the Mobile App or Online Member Services.
Online gym membership
As well as helping you to get well, we want to help you stay well. Following the closure of gyms and the introduction of social distancing we received Member feedback of the growing importance of online gyms. Our Healthy Living benefit helps you live a healthy lifestyle and in response Members can now claim their online gym membership as part of the Healthy Living benefit. The criteria below must still be met:
- You must have been referred by your health care professional to participate in a health management program to address, improve or prevent a specific health or medical condition.
- A Health Management Program Benefit Approval Form must accompany a claim for these benefits. The form must be completed by a Health Care professional electronically if you are unable to attend their practice.
- Online Gym Memberships must have a registered ABN.
- An approved receipt including your name, date and description of service, total fee charged and provider name and address.
- Benefit payable subject to overall benefit limit.
The Value of Private Health insurance
We understand that the ever-evolving COVID-19 pandemic has created confusion and anxiety about access to healthcare. We are also extremely mindful of affordability issues and realise some Members are questioning whether it is still beneficial to maintain their private health insurance cover.
The role of health funds and private hospitals was explained by the Federal Health Minister Greg Hunt “…there will be very much for all of the non-coronavirus-related conditions continued access and needs - whether it's in relation to cardiac, or cancer, or rehabilitation, or so many of the other areas, allied health services, that are covered. So, there will remain a very, very significant and important role for the ongoing private health and private health insurance services.” (ABC Radio Melbourne, 1 April 2020).
What value does private hospital health insurance currently provide?
Our Members enjoy the peace of mind and choice that private health insurance provides, and some important facts are below*:
- Demand will still exist for hospital treatments for diseases and illnesses that are not from COVID-19 and private health insurance will cover this.
- Health fund members can still elect to be treated as private patients when admitted to a public hospital for treatment, including if they have COVID-19.
- Private health insurance will continue to fund vital treatments and surgeries such as pregnancy, cancer and cardiac to name a few. Members are still able to choose their own specialist for continuity of care.
- Demand for elective surgery will likely rebound and create a huge bottleneck in the health system. Having private health insurance means Members can avoid even longer public hospital waiting lists – by having access to timely private care with their choice of doctor.
*Subject to your level of hospital cover and applicable wait periods. If you require further information in regards to your level of cover, please contact our friendly team by phone on 1800 623 893 or email via email@example.com
What value does my Extras Cover currently provide?
To ensure our Members receive the medical care, treatments and services they require we have already announced two new claiming options for Members with Extras cover above.
Depending on your location, some healthcare providers may have closed their practices for treatment or reduced their services, many are still available in circumstances where you are in considerable pain and require urgent treatment.
For example, Dentists, Chiropractors and Optometrists. Extra measures have been put in place to ensure the safety of providers and their customers. In these circumstances, your Extras benefits can still be accessed providing a benefit is payable under your level of Extras cover.
We continue to look for ways we can support our Members through this difficult time and will keep you updated.
Here to help
I have booked to have elective surgery in a private hospital. What will happen?
We would like to assure our members that claims are operating as normal, and this includes in-hospital procedures as covered by their policy. We encourage members to speak directly with their doctor and chosen hospital to confirm if their surgery will still be going ahead.