Industry Insider Gives His Tips for Better Value Health Insurance
Hands up if you’re life is busy... all the time? Busy is the new normal it seems and at 52 I find life just seems to speed up rather than slow down.
This is the excuse I used when one of the Fiftyup team asked me if I’d done some comparison shopping myself on energy or private health insurance around the lunch room table last Friday.
Our mantra at the FiftyUp Club is to encourage members to always ask one question of your provider….”is this the best you can do?”
As Aussies, we’re used to just paying whatever the going price is and not using the time-tested option of haggling as is common in many other cultures and this is to our detriment.
In the private health sector in Australia there are over 30 health funds on the market and competition is fierce. Why then do we hear time and time again of FiftyUps who have been with the one fund for years, yet complain about their high monthly premiums?
According to Shaun Gath, former CEO of the Private Health Insurance Administration Council, the story began in the 1946 Referendum when we gave parliament the power to make changes to social security payments, including hospital and medical benefits…a good thing. The down side? The section stops the parliament from controlling what doctors charge….and this is at the heart of one of our members biggest complaints…the out-of-pockets.
Think about it. You go to your GP and he/she recommends you see a specialist and writes you a referral. Of you go to see him/her and they recommend treatment in a private hospital where they practice. Now chances are you’re feeling vulnerable, unwell and worried. Is this the time to start questioning your doctors’ charges? Is this the time to go and get maybe a second or third opinion? No. You want to get the treatment started and over and done with as quickly as possible so you can go back to (hopefully), your happy and healthy place.
But this is exactly the time when you call in your Health Fund. Legislation prohibits your Health Fund from approaching policy holders at this time, something the medical fraternity refer to as “managed care” and it’s no coincidence that ATO statistics show that six out of the 10 highest earning groups in Australia are medical proceduralists.
But there is nothing to stop you going to your fund and accessing their treasure trove of information such as which doctors charge what, where and how. Your fund should be on this journey with you as soon as you get that referral rather than at the very end of service when you’re trying to claim back….
During our recent interview with Shaun Gath on the FiftyUp Club show he advises the Top 3 ways you can get the best bang for your private health fund buck.
- Let the private health insurance funds become involved at an earlier stage in the selection of post-primary medical pathways. Unlike their members, insurers know a lot about doctors and hospitals and can provide great information about where to get good, value-for-money treatment. Their presence would transform this torpid market.
- Go to Privatehealth.gov.au. Unlike any other comparison website, it contains information about all the products of all the funds. If you are prepared to do 30 minutes research, you are likely to save a bundle.
- Check your policy inclusions and exclusions every 5 years to make sure it’s relevant to your current health and familiarise yourself with the portability rules when it comes to your rights to switch.
Despite the Federal Health Minister Sussan Ley’s recent savings announcement of $86 million, it’s unlikely we will see premiums decrease any time soon so you will continue to be hit with an extra 5, 6, or 7 per cent each year… but you can try to get best value for money.
Click below to listen to Shaun’s interview
