The Australian Dental Association (ADA) recently launched their Time2Switch campaign encouraging policyholders to revaluate their health insurance cover. The ADA believes that we need a health fund reform to improve dental care delivery to fund members.
Who feels better now?
According to the Australian Competition and Consumer Commission (ACCC) there has been a surge of unsatisfied customers lodging complaints to the Private Health Insurance Ombudsman with Medibank toping the list for 60% of all complaints received. This is due to Medibank failing to notify their customers about changes in their policies, leaving thousands of people out of pocket and reduced access to health services. These actions have lead the ACCC to launch Federal Court proceedings against Medibank Private. [ref. 1]
The IssueRoughly half of Australians are currently covered by some form of private health insurance. Premiums steadily increasing each year, and not reflecting in the rebates people get for their health services, has resulted in many dissatisfied customers seeking alternative options. This is especially true when it comes to benefits received for dental services that are part of the ‘extras’ cover according to the ADA.
Do you currently have the right kind of policy, especially when it comes to extras cover?
Making that decision can feel like an almost impossible task with over 20,000 policies on offer (according to the ACCC), all of which come with restrictions and exemptions and vary from fund to fund, leading to a lack of transparency and adding to the confusion.[ref. 2] So ask yourself the following questions to determine if you should look into changing your health insurance provider.
Is my ‘extras’ cover worth it?
Extras cover generally covers you for treatments from ancillary health service providers such as dentists and dental specialists, chiropractors, physiotherapists and optometrists. Do you have 20/20 vision, only see physiotherapist on occasion, have good oral health and only see you dentist twice per year for exam and clean? Perhaps look into your spending on extras cover and decide whether you’re better off putting some money away instead of spending them on that component of your private health insurance.
Are they a not-for-profit or for-profit fund?
Is your health fund putting you before the profits? Non-for-profit health funds are owned by members and with only a portion of the excess funds going towards operational costs. The rest is channelled back to their members and usually results in higher rebates.For-profit insurers return their excess funds to their shareholders and consequently may offer lower rebates on health services. To see which health insurance providers are owned by members rather than big corporations go to https://membersown.com.au/
Do they restrict my choice of the dentist?
Major health funds will often refer you to their ‘preferred providers’ who have a contractual agreement with the health fund based on fee structure rather than the practitioner’s dental abilities. The ADA believes that some of these rules can dictate or sway clinical decision-making. As a patient you should be allowed to choose a dentist and benefit from the continuity of care provided by a longstanding practitioner. It’s a vital component to delivering high standards of dental care. At the end of the day if you pay the full premium, you deserve the best care and the same rebate as any other contributor regardless of which dentist you choose to see.If you believe that you are being short-changed by your current health insurer, and agree that Australians deserve rebates that are more reflective of the cost they pay for the extras cover,
- The Age, October 31, 2016. Health insurance customers left in the dark over policy changes: ACCC http://www.theage.com.au/national/health/health-insurance-customers-left-in-the-dark-over-policy-changes-accc-20161031-gsen78.html
- Time2Change, ADA https://www.ada.org.au/time2switch/The-Issue