Whether you're thinking of taking up private health insurance for the first time or only reviewing your existing policy, it's essential to know some basic rules to get the most from your health cover. Here are our top 7 tips:
1. Choose the right health insurance policy
The first and top-priority thing you can do when it comes to private health insurance is to choose the right cover. The 'right' health insurance policy is the one that suits your lifestyle and budget, giving you the most protection and coverage for the price you're willing to spend.
The fastest and easiest way to find the best health cover for you is by comparing health insurance policies available from different Australian health funds. moneytime is a comparison site that allows you to see your various options at a single glance, rather than having to visit multiple websites or calling a dozen various health funds. Compare, save and buy online - our service costs nothing to use, so prices are direct from the health funds to you.
When choosing your policy, be aware of waiting periods, pre-existing conditions, benefit limits and exclusions, so you know what you're getting for your money.
2. Pay your health insurance premium on time
Once you've chosen the health cover that suits your lifestyle and budget, keep up to date with your premiums, as your health fund will generally cancel your cover if you miss two consecutive payments. Rejoining after cancellation may mean you will need to serve all your waiting periods again.
You'll also find that there are numerous advantages to paying in advance or by direct debit:
paying your premium a year in advance can often lock in the current rate before the annual premium rise, which usually happens around April each year
creating a direct debit on your usual account or credit card is an easy and painless way of paying your premium without having to worry about being behind on your payments – make sure you have enough in your account or on your card each month
paying by direct debit can also give you a discount of up to 5% with some health funds, who appreciate not having to chase you up for regular payments
3. Claim promptly
Most Extras benefits can be claimed on the spot using an electronic claims facility. Once the claim is authorised, you pay the difference between the full fee for the treatment, and the benefit amount claimed from your health fund. Most Hospital services will be billed directly to the health fund.
However, you may be required to pay the medical fee upfront, then submit a claim form to the health fund to receive the applicable benefits. Claims should be submitted promptly, as health funds will not pay claims made two years after treatment has been received.
4. Know your benefit limits
Be aware of the benefit limits of your health cover and take full advantage of them to get the most for your money. For example, if your health insurance policy covers $1000 per person for dental services, make sure you go to the dentist and get your teeth taken care of within every 12 months that the benefit applies. By using all the treatments you're eligible for with your health cover, you could very likely recoup the cost of your premium.
5. Go to an Agreement Private Hospital
If you are admitted to hospital and plan to use your private health cover to claim services, make sure you go to a hospital that has an agreement with your health fund, otherwise, you will not be covered for the services provided. All the health funds on the moneytime website are leading Australian health insurers who have extensive agreements with private hospitals in all the states across Australia. To see if your chosen hospital is covered, check on our Agreement Private Hospitals list.
6. Get a quote before undergoing a procedure
If you need to undergo hospital treatment and plan to claim under your health cover, it's essential to find out whether you will be required to pay any amount of the final bill out-of-pocket, which can occur if there is a gap between the cost the doctor charges, and the fees covered by your health fund. To minimise or eliminate any out-of-pocket expenses, ask your doctor for a quote or estimate and the item numbers before the treatment is administered. Ask if there is a Gap payable by you. Then you've to contact your health fund and give them the details, including the name of your doctor, the hospital and the procedure (including item numbers if you know them) to see if there are any out-of-pocket expenses you may have to pay.
If there is a large Gap, you are entirely within your rights to get another quote by another doctor to reduce this figure. Your health fund may be able to direct you to a hospital/doctor who has an agreement with the health fund so you can reduce or eliminate the Gap. For more information, read about the Gap and other out-of-pocket payments.
7. Review your health cover annually
As insurance premiums increase every year, it's worth reviewing your health insurance policy to make sure you're still getting the best deal. Also, as your circumstances change – e.g. getting married, having kids, going back to an empty nest – your health insurance needs also change. It's wise to review your health cover and make sure you're not paying for things you don't need, and have adequate cover for the things you do need.
Your best option is to use a comparison site like moneytime, to compare health funds, health insurance policies and see at a glance which benefits are covered and what your benefit limits are. If you find a plan that suits you better, it's easy to switch funds – make sure you cancel your direct debit payments to your old provider with your bank or financial institution. Your new health fund will take care of the rest. Waiting periods will only apply for new services or increased benefits on your original plan, compared to your old plan.
If you have any queries about choosing health insurance, don't hesitate to contact the moneytime help desk on 1300 88 26 36, Monday to Friday between 8.30 am – 5.30 pm (EST).