From excess options to new standard categories, see what changes are in store for private health insurance

 Here’s how changes to private health insurance might impact you

Private health insurance is changing. From 1 April 2019 onwards, a range of reforms introduced by the Australian Government will be rolled out. The changes aim to make health insurance simpler to understand, and make it easier to compare hospital products to find cover that best suits your needs.

The key changes include discounts on eligible hospital cover for 18-29 year olds, an option of a $750 excess for some hospital products, standard categories and definitions for hospital services across the health insurance industry and changes to the types of natural therapies you can claim for on extras cover.

How the changes to private health insurance could impact people like you

Whether you’re young and single, a growing family, or you’re at risk of particular health issues, the changes to health insurance could impact you in a number of ways. Read on to find out what the changes could mean for people like you.

Gemma is a young professional who doesn’t have private health insurance; however, with the introduction of the new youth discount, she’s now considering taking out hospital cover. She wants cover that is affordable, and right for her life stage, including cover for accidents as she likes to go snowboarding*.

From 1 April 2019, because of Gemma’s age, she could be eligible for an 8% discount on her hospital premium if she chooses an eligible product.

Read more about discounts for 18-29 year olds

She decides bronze is the right level of cover for her. She can easily compare bronze products across the industry. With the new standard definitions for clinical categories, she has more confidence about what’s included in each hospital product. For example, she knows that the hospital treatments that form part of the category ‘joint reconstructions’ are the same at Medibank as they are at other health funds. She chooses Medibank because of the Accidental Injury Benefit offered on some of their covers*.

Given Gemma is young, healthy and has never been to hospital, she can also consider a higher $750 excess to lower the cost of her hospital premium.

Read more about the choice of $750 excess

Dave and Kylie Tan currently have top hospital and extras cover with Medibank. They are hoping to fall pregnant again this year, and have a young daughter, Edie, who may need to have her tonsils out after a few bouts of tonsillitis. Kylie used remedial massage to help with her back pain throughout her last pregnancy.

Because Kylie and Edie will probably need to go to hospital in the near future, they decide that increasing their excess to $750 is not worth it. They will no longer be able to claim for some natural therapies under their extras cover, but remedial massage is still included.

As existing Medibank members, the name of Dave and Kylie’s cover will change to include the word ‘Gold’. Because they are on top hospital cover, the services included in their cover are not likely to change.

Read more about standard definitions and categories

Trish is a Medibank member with standard hospital and extras cover. She has a strong family history of bowel cancer, so is on cover that includes colonoscopies and cancer treatments like chemotherapy. She also loves jogging to keep fit, but recently injured her ankle. She’s been receiving regular Shiatsu to help with her recovery.

As of 1 April 2019, Trish will no longer be able to claim for Shiatsu massage as part of her extras cover. However, she could still claim on acupuncture, and could also look at having remedial massage — another natural therapy that is still included on her cover.

As part of the changes to categorise products based on the services included, the name of her hospital cover will change to include the word ‘Silver’ before April 2020. The services included in her hospital cover will also change to ensure standard clinical definitions are consistent across the health insurance industry. This may mean some new services will be included in her cover, and/or some current services will no longer be included. Trish is informed about any changes to her product via a letter or email beforehand, and makes sure that colonoscopies and cancer treatment are still included in her cover. If she decides to change her cover, she won’t have to serve waiting periods for any of the services included in her current cover, only for any new services.

Read more about changes to natural therapies, or visit our hub for more information.

* If you have an Accident, you’ll get the benefits of our top level hospital cover, no matter what level of hospital cover you have. For Accidents that occur after your cover starts and for which treatment is sought within 7 days. Excludes claims covered by third parties such as WorkCover and our Private Room Promise. Out of pockets may apply.