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    What healthcare providers need to know ahead of Government reforms

    The next phase of the Federal Government’s reforms to the private health sector will start to come into effect from 1 April, so its important hospitals and healthcare providers understand how these reforms may impact their patients.

    These reforms are designed to make private health insurance simpler and more affordable for all Australians, and at Medibank we are committed to delivering these changes as seamlessly as possible.

    New categories of hospital cover

    Hospital insurance policies will be classified into four tiers - Gold, Silver, Bronze and Basic - with standardised clinical categories for treatments to make it clear what is and isn’t included in policies. These new tiers need to be adopted by 1 April 2020.

    We’ve begun contacting our customers about these changes, as some people may be impacted before others, depending on their level of cover and what policy they have with us. We’re encouraging customers to contact us if they have any questions about the potential impact of the Government’s reforms and review their level of cover if needed. We have extra capacity in our customer care teams to assist with these enquiries.

    Medical Benefits Scheme changes

    38 new standard clinical categories will be introduced from 1 April 2019, and private health insurers have until 1 April 2020 to adopt these categories for all policies.

    The individual Medicare Benefit Schedule (MBS) items within each clinical category will also be standardised and this means that, depending on their type of cover, customers will see some hospital products being changed, with some MBS items being added or removed so the products comply with the Government’s requirements.

    How the new types of cover and clinical categories will affect patients

    If a customer’s cover will be impacted by the reforms, Medibank will honour any hospital treatment they had booked at least 30 days before their policy is impacted. Some customers will be affected before others, and as we write to these customers, we're asking them to contact us if they have any questions about potential changes to their cover.

    Not all customers are directly impacted by the Government reforms, but for those that are, our focus is on making the transition as simple as possible.

    Hospital excess changes

    The Government has increased voluntary excess levels, allowing consumers to choose hospital insurance products with higher excesses in return for lower premiums. From 1 April, our customers will have the option to choose a higher excess on their hospital insurance policy of $750 for singles (or $1,500 for couples or families. There is no requirement for customers to change to products with higher excesses.

    More information about the reforms can be found on our website. Our focus is on ensuring the Government reforms are implemented as smoothly as possible for our customers and our healthcare partners.

    Private health insurance is an important part of Australia’s health system and it is vital to ensure it remains sustainable both now and into the future.

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