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People in the clever capital deserve smart private health insurance

By Members Own - 14 July 2017 0

Private health insurance

More than just a home for politicians and public servants, Canberra is becoming known as an innovative mini-metropolis. A huge variety of talented, forward-thinking people work across 25,000 private businesses.

Often referred to as the “clever capital”, it’s no wonder the thriving city is leading the way in industries like technology, tourism and hospitality. With so much cleverness in a population of nearly 400,000 people, it makes sense that Canberrans choose wisely when it comes to taking care of themselves.

The decision to take out private health insurance is a big one. It can be expensive and even just researching your options can be tiresome. But it doesn’t need to be that way.

Or read our 2 minute rundown on everything you need to know about health cover.

Why do 50% of Australians take out health insurance?

Every Australian has access to the public health system at no additional cost. All taxpayers pay a Medicare Levy that funds it for everyone. So why pay for health insurance on top of this?

Health insurance provides you with more choice and control when it comes to your healthcare, and it may provide tax benefits.

There are only two types of cover you need to think about: Hospital cover and Extras cover.

Each type pays benefits for different types of treatment. Most people take out combined hospital and extras cover, but you can choose one or the other depending on your needs.

Hospital cover – pays benefits toward the cost of treatment in hospital. It gives you control over:

WHO you’re treated by – some people prefer a surgeon recommended by their doctor
WHERE you’re treated – access to a private hospital close to home and a more comfortable environment
WHEN you’re treated – because waiting times are usually shorter in the private system
The level of hospital cover you choose determines the types of procedures you’re covered for (like pregnancy or heart surgery). The higher the level of cover, the more procedures you will be covered for.

When a procedure is “covered”, that means that 100% of the cost (minus any excess) of your hospital admission, and a proportion of your doctor’s fees, are paid by your health fund.

Extras cover – pays benefits towards treatment for things that Medicare doesn’t cover. This includes non-GP services like general dental, major dental, optical, physio and more.

Extras is all about your lifestyle and it’s the area where you can claim benefits more often. It’s the cover that you’ll actually use, whereas hospital cover is there just in case.

There are two different ways that health funds calculate benefits for extras treatment:

– as a percentage of the fee charged by the provider (eg. 65% back from a dental consultation) – which works out best for occasional treatment, or
– as a fixed dollar per visit (eg. $30 per Physio visit) – which can be more cost-effective for frequent treatment

Choose a cover with the option that’s going to suit you best. Then enquire about the total annual limits your cover will provide across different services.

If you never use these types of services, then maybe extras cover isn’t a must-have for you.

There are also two types of health funds you need to be aware of:

Once you know whether you want hospital or extras cover, or a combination of both, you need to think about which health insurer will give you the best peace of mind and best value.

1. Not-for-profit & mutually-owned – these funds are the unsung heroes of health insurance. To cut a long story short, they’re run to benefit their members so premiums are invested back into increasing benefits and improving customer service

2. For-profits – who answer to investors or overseas owners. Enough said. The big, familiar ‘for-profits’ are Medibank, BUPA, nib and AHM. Their advertising completely dominates our TV screens but that doesn’t mean that they’ll offer you the best value coverage

The not-for-profits give their members more than the big for-profits, so the decision is a pretty simple one.

The Members Own health funds are a collective of not-for-profits and mutuals that provide superior value through better coverage and more benefits, which is why they have happier members.

Now, here’s one of the best kept secrets in health insurance

There are also not-for-profit funds connected to specific industries that millions of people qualify for but many Australians, including people in Canberra, don’t realise they are eligible to join them.

This is a big deal because some of these funds (also known as ‘Restricted’ funds) can provide the best value. You can find out more about these health funds through the Members Own Health Funds comparison service.

Members Own operates the only not-for-profit health insurance comparison service in Australia

You’ve probably seen the advertising from companies like iSelect and Compare The Market – you may have even contacted them for advice on your health insurance. Leading consumer advocacy group CHOICE has conducted its own research in this area and discovered some interesting facts about online comparison services.

The Members Own comparison service is a brilliant way of identifying the top policies for your lifestyle. In the end, the smartest way to ensure you’re getting the best combination of price and benefits is to compare policies and shop around.

Once you’ve decided what you need from your health insurance, you then need to really understand how to get the best value and whether you’re taking out health insurance for the right reasons.

What’s Your opinion?


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