When should I review my cover?
The Ombudsman recommends it’s worthwhile reviewing your health insurance at least once a year and comparing it with other policies offered by your fund and other health insurers.
This is particularly important if your circumstances change or your health fund changes the:
• benefits they pay;
• services included on your policy; or
• providers they have contracts with.
How do I review my cover?
The Government’s Private Health website is the most comprehensive comparison tool.
You can also contact brokers (such as iSelect and Compare The Market) or speak with health funds directly, to discuss which policy is best suited to you.
There are thousands of different products to choose from, so we have a couple of resources that may help:
Private Health Insurance Checklist
Reviewing your private health insurance can be overwhelming, so we have summarised below the important steps recommended by the ACCC and included some additional resources to make it easier:
1. Know your needs – Assess your healthcare needs to tailor your level of cover now and into the future. To assist, we have created a list of clinical categories by gender and age, based on our clinical experience.
2. Shop around – Compare products them in detail, some cheaper products may not be value for money in the long run. Make sure you’ve got the right policy with the right health insurer for your needs. To assist, we have brought together information from the Ombudsman annual report on the service delivery and performance of health insurers.
3. Don’t set and forget – Consider switching insurers to get a better deal - it won’t cost you anything to switch, and as a general rule it is not necessary to ‘re-serve’ a waiting period for similar hospital cover. The Government’s Private Health website is the most comprehensive comparison tool.
4. Understand the terms and conditions – Check your policy covers the doctors, hospitals and other providers and services you may want or need to use. Ramsay has agreements with every health insurer, except Bupa.
Clinical categories by gender and age
The Government’s four-tiered health insurance products make it easier than ever before to know which treatments and services (called Clinical Categories) are covered or excluded under each product.
Gold and Silver products are the most comprehensive options. Bronze or Basic products are the least comprehensive options. Whilst less comprehensive products could be significantly cheaper, they may not be sufficient for some people.
It is hard to predict what treatments and services you might need in the future, so we used our clinical experience to create a list of the most common reasons for admission to our hospitals: