Looking to Compare Health Insurance?

With so many health insurance policy options on the market today in Australia, it can be tricky to know which one is best for you. There are so many choices, not only the amount of health funds in the market but also different combinations of hospital, extra’s and excess cover. In this blog we will cover off why it’s so important to discuss with your provider your options and waiting periods on offer before you sign up.

For example, if you are planning to have a baby within the next 12-18 months , you’ll need to adjust your health insurance policy to ensure the birth of your child is covered under the policy.  Every private health insurance fund has a 12-month waiting period before your baby is due so you will need to consider when to take out cover for the first time or upgrade your cover to ensure this is covered.

Some other factors that may come into play and you should consider based on your situation are:

  • A sports or fitness-related injury
  • Knee surgery or full replacement
  • Needing a hip replacement or other procedure.

Why does it matter having the right health insurance plan?

There’s no all-encompassing product when it comes to private health insurance, so it’s important to find a policy that offers benefits you think you’ll use. As individuals we are never quite prepared for health issues that arrive out of the blue.  Being prepared with an insurance health policy for general cover is always a good idea. Some important points to consider when searching for insurance health polices in NSW are:

  • Who needs to be covered? Just yourself as a single, a couple, a family with 2 adults and children or even single-parent policy with kids. Nowadays, health funds have specific coverage for your individual life situation.
  • Pre-existing Conditions – A pre-existing condition is defined as any ailment, illness, or condition where, in the opinion of a medical adviser appointed by the health insurer, the signs or symptoms of that illness existed any time prior to the 6 months leading up to when the person became covered the health insurance policy.
  • Budget – if you have a particular budget in mind that is affordable to cover yourself or your family, we recommend talking us so we can search across a wide range of fund to find out the best insurance health plan to fit your financial circumstances.
  • Age – Some providers offer specific health policies and packages for those aged 50 and above. Other health care plans have policies more suitable for seniors and retirees aged 65 and up. Never has there been a better time to ensure your policy matches your needs.
  • Inclusions & Exclusions – Each health insurance policy has a range of inclusions and exclusions. These are a list of clinical categories that you can add or remove from your select health policy. It is important to know which of these services you need coverage for as it will be a determining factor in your premium.
  • Waiting Periods – as briefly covered off above, certain procedures and services have waiting periods. These can range from as little as 2 months to as much as 36 months – it’s recommended you check these before signing up for a health insurance policy.

Finding the cheapest health insurance in Australia isn’t always the best insurance for your family.

The cheapest health insurance isn’t necessarily the best insurance and the most expensive is not always the best coverage.  For example, a not-for-profit health insurance provider is one that invests its profits back into its members rather than shareholders. For-profit health funds pay stakeholders with their remaining surplus, while a not-for-profit fund uses that money to better improve and serve their policyholders.

It’s worth shopping around and comparing private health insurance to find the best deal for your individual needs. Nationally, there are more than 30 health plan insurers proposing a wide variety of benefits and health insurance products. There are several policies on the market that will differ depending on where you live and your circumstances. Comparing health fund offers can help you to decide and find a policy that suits your needs.

Whatever your insurance health plans needs are, be sure to arm yourself with the very best research and recommendations before making a final decision. It’s what works best for you or your family and your situation. Remember to review your policy regularly – don’t just set and forget. Visit our website for further resources to assist.

Chat to us Today

To compare health insurance funds and work out which cover is best for you, speak to one of our friendly team members about your health insurance policies today Telephone 1300 861 413 or email us hello@health.compare

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Peace of mind for pregnancy cover with private health insurance

It’s a special time in many couples lives when they make the decision to start planning for a baby. Pregnancy brings a host of new and exciting feelings, taking care of your health is vital during this exciting time. In this month’s blog we’ll give you guidance on everything you need to know about planning for pregnancy and affordable health insurance options.

It all starts with making sure you have the right health insurance policy and adding a little pre-planning. This will give you the ability to choose your obstetrician and then find the hospital you would like to give birth to your little bundle of joy.

What to ask your Private Health fund?

What maternity and obstetric services will be covered in a private hospital on my policy?

With private health insurance you get to choose your hospital (agreement private or public) and your obstetrician to care for you and deliver your newborn. Delivery of your child can be either naturally or via caesarean section. Health insurance plans vary from provider to provider so it’s always a good idea to check the fine print.

What are the waiting periods for pregnancy and birth?

With all health insurance policies, the waiting period is 12-months. This is the time where you cannot claim any pregnancy-related expenses. So don’t forget once you start planning your pregnancy journey, update your policy straight away and by the time baby arrives you will be covered.  

My partner and I are not on the same policy, do we need to upgrade?

There will be a point in time when the policy needs to be upgraded. This can be completed in 1 of 2 ways. Upgrade to a single parent cover to include the new born or to a family level of cover. Depending on your situation this may be easily done over the phone with your private health insurance provider.

Will I be covered to claim on assisted reproductive services like IVF?

Health insurance policies that cover assisted reproductive services will require you to wait 12-month’s to use the service due to the waiting periods. Not all levels of cover will cover both pregnancy and birth and assisted reproductive services. Make sure you check the level of cover before deciding on it.

Healthcare professionals you may need during Pregnancy

Once deciding to have a baby, you may need to visit a few different healthcare professionals. This may be a combination of your doctor, a midwife, and an obstetrician. It depends on what care you require and where you want to give birth.

Your Doctor (GP)

Your GP (general practitioner) is trained in many different aspects of healthcare. You would normally see your doctor when you find out you are pregnant for initial blood tests to confirm the pregnancy.

Midwives

Midwives are health professionals who work with you to provide support, care, and advice during your pregnancy. They often run the antenatal classes you and your partner can attend prior to the birth of your newborn.  They sometimes also check in on you after returning home from hospital.

Obstetrician

Obstetricians are trained doctors that specialise in (medical care before, during and after childbirth). They can deliver babies naturally or via caesarean section. If you want to give birth at a certain hospital, check with your fund and obstetrician to ensure they work out of that hospital.

Anaesthetist

An anaesthetist (a doctor who provides pain relief during surgery) might be involved in your labour. They get involved if you need have an epidural or your baby is delivered via a caesarean. Compare private health insurance funds to see if you can claim fees for an anaesthetist.

Let’s look at your Health Policies Extras cover for Pregnancy

Physiotherapy

With the many changes to your body during pregnancy, you may also experience sore and tired muscles. Seeing a physio can help stretch out and treat any issues. Check the specific physio extras coverage on your private health insurance policy.

Remedial Massage

Relax with a remedial massage to help reduce fluid retention and muscle soreness in the later stages of pregnancy. It’s important to ensure your massage therapist is trained in pregnancy massage, especially if you are in your first trimester.

Gym & Fitness

If your health professional has recommended a gym or fitness program during your pregnancy and it’s deemed medically safe, you may be able to claim gym membership on your extras cover.

Visit your Dentist

Often during pregnancy, the gums are more susceptible to plaque and inflammation or bleeding.  This is due to hormonal changes, visit your dentist for a check-up during your pregnancy.

Taking care of your Mental Wellbeing

Pregnancy can bring mental and emotional changes along the way. It’s an overwhelming time for some and feeling anxious is common. Don’t go at it alone. Talking with a psychologist about how you’re feeling is paramount.

Diet & Nutrition

Now your baby will grow and flourish from the nutrients and food you put into your body. Speak to your midwife or a nutritionist about what to eat and when.

Some important things to keep in mind

Adding your newborn onto your level of cover is important. You want to make sure they are covered at the time of birth. This changes by fund. General rule of thumb is to always upgrade your cover a few months before the birth of your child. To be sure, always confirm directly with the fund.

If you’re looking to upgrade your policy jump on to our website http://health.compare/ and see for yourself which health fund is right for you. We have it all wrapped up into one, easy to navigate comparison portal to make it easy to compare private health insurance.

Chat to us Today

To compare health insurance funds and work out which cover is best for you

Visit http://health.compare/ or speak to one of our friendly team members about your health insurance plans today Telephone 1300 861 413 or email us hello@healthmarketing

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Health Insurance Waiting Periods

Waiting periods for private health insurance are normal, although they do vary when it comes to both Hospital and/or ‘Extra’s’ levels of cover, and can also vary by fund.
 
Let’s take a look at waiting periods across the board and guide you through the basics. For more detailed information on this, we recommend speaking to an expert who can help answer any additional questions. [click here to book a call]
 
What type of waiting periods can be found across the Private Health Industry?
Health insurance is split into effectively two categories: Hospital cover and Extras (This may also be referred to as general treatment or ancillary cover).
 
The waiting periods for Hospital cover are very different to those for extras. Let’s start with the waiting periods for hospital cover.
 
Hospital waiting periods are governed by the Private Health Insurance Ombudsman (PHIO) who outline what the maximum limits will be for specific hospital benefits. The good news is, no waiting period is longer than 12 months for coverage to start. For ‘Hospital Cover,’ the standard waiting periods are as follows:
 
• 12 months for pre-existing conditions or illnesses you showed signs or symptoms of in the 6 months leading up to taking out a hospital policy;
• 12 months for pregnancy and birth (obstetrics). This means you’ll need to consider health insurance for you and your unborn child before you fall pregnant;
• two months for palliative care, rehabilitation, and psychiatric care; and
• two months for other services that require hospitalisation (and aren’t pre-existing conditions or subject to other waiting times).
 
For more information on Pre-Existing conditions click here.
 
What about waiting periods on ‘Extra’s’ cover?

The waiting periods for ‘extra’s’ products are set by the health funds themselves and vary by each insurer.
 
Typically, health funds operate with similar waiting periods for general treatment and optical, that being 2 or 6 months. For more complex items such as major dental, hearing aids, or medical appliances, these waiting periods typically start at 12 months but can be longer depending on the fund. See below for more examples of typical waiting periods:

  • 2 months for general dental benefits and physiotherapy
  • 6 months for optical items, like glasses or contact lenses
  • 12 months for major dental procedures, like crowns or bridges
  • Up to 3 years for some high-cost procedures, such as braces and other orthodontics
     

Why does Private Health Insurance have waiting periods?

Insurers in Australia put waiting periods in place for a number of reasons, the first being governed by the Private Health Insurance Ombudsman (PHIO) and second to make pricing fair for all existing members. If hospital cover didn’t have a waiting period, people could effectively sign up to a level of cover, claim on an expensive service (such as major eye surgery) and then cancel the level of cover before paying anything significant.  
 
By allowing this, the cost of Private Health Insurance would increase significantly, pricing out those wanting to join, as premiums would need to be adjusted accordingly.
 
I already have health insurance, what happens to my waiting periods?

Great question!
 
All waiting periods you have served/serving will transfer with you. This means you don’t have to restart waiting periods because you want to change policies or insurers. The only time a waiting period will apply is if you don’t have that service covered or you’re looking to upgrading your policy to include it moving forward.
 
An example of this would be:

Current Policy Waiting Periods
New Policy Waiting Periods
Bronze Hospital All Served Bronze Hospital
Different Fund
No Waiting Periods
Bronze Hospital All Served Bronze Hospital
New Fund
No Waiting Periods for All Service
Waiting Periods for All Other Added Service
Gold Hospital All Served Gold Hospital
Existing/New Fund
No Waiting Periods
Silver Hospital 4 Months of Pre-existing Served Silver Hospital
New Fund
Additional 8 Months for Pre-existing Cover

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What is Dental Cover?

What is it and how does it work?

Dental coverage comes in two forms, general and major treatment.

These will vary from fund to fund. Typically, general dental will encapsulate services such as:

  • Preventative dental
    • Check-ups
    • Cleaning
    • Plaque removal
  • X-rays
  • Small Fillings

While major dental will pay benefits on more involved treatments like:

  • Crowns
  • Bridge work
  • Endodontics (Root Canal Treatment)
  • Dentures
  • Extraction of teeth
  • Orthodontics (Braces)

What would the waiting period look like?

This is going to depend on several things. Do you currently have cover? Are you new to compare health insurance? The answer to the first question will depend on your situation.

Finding the right level of cover can be confusing when it comes to adding dental. If you’d like to find out more and how this works for your situation, call us here.

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Finding the right level of cover

Navigating your way through the landscape of Private Health Insurance can be confusing and complex.

I’m still young enough, do I need cover for joint replacements? We think we’ve finished with pregnancy, should I take it off now or wait a little bit longer? I don’t know what extra services are, how do I know what I should or shouldn’t have?

These are all great questions.

I’ve never had health insurance; how do I even start?

By talking to us!

It’s a mine field – legislation, tax, age penalties? Do any of these apply to you and if so, why?

What does each level of hospital cover me for? Do I need extras? How do I use them?

These are all common questions and ones we talk about all the time.

I think it’s time for me to switch?

You’ve been thinking of switching for a while, what’s prompted this?

You’ve had a chat with friends at a BBQ? Your current health fund is increasing premiums? You’re at a very different point in my life and it’s time to upgrade my policy?

If you haven’t checked your health insurance in a number of years, it’s time to do it!

Comparing health insurance is not like comparing apples with apples. Every policy and every fund is different. You need to find the right level of cover for you.

So, what should I do?

Have a conversation with an expert.

Most people put comparing health insurance in to the ‘too hard basket.’ It’s something they know they need to do, but the investment at the time doesn’t feel important. Sound familiar?

Take 15 minutes with us to figure out how we can help. If you’re on the right level of cover, what have you lost other than 15 minutes?

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Pre-existing conditions

Under the Private Health Insurance Act 2007, a health insurer may impose a 12 month waiting period on benefits for hospital treatment for a pre-existing condition. Some important facts to remember about this rule:

  • A pre-existing condition is defined by law as any ailment, illness, or condition that you had signs or symptoms of during the six months before you joined a hospital cover or upgraded to a higher hospital policy. 
  • It is not necessary that you or your doctor knew what your condition was or that the condition had been diagnosed. A condition can still be classed as pre-existing even if you hadn’t seen your doctor about it before starting the hospital cover or upgrading to a higher hospital policy.
  • The decision is made by a medical practitioner appointed by your insurer.
  • In forming an opinion about whether or not an illness was pre-existing, the medical practitioner must take into account information provided by your own doctor.
  • Your health insurer will need time to advise you if your condition is pre-existing, so check with your insurer well before you go to hospital to make sure you are covered.
  • Even if you have a pre-existing condition, health insurer must allow you to purchase any type of cover, at the same price as any other person. Once you have served any waiting periods, you will be entitled to claim.

The exceptions to the 12 month waiting period for pre-existing conditions are psychiatric treatment, rehabilitation and palliative care. These services have a two month waiting period, even if the condition pre-existing. 

In some cases, you may be able to access an exemption to the two month waiting period for upgrading psychiatric benefits – see Mental health – waiting period exemption.

For more information, see the Ombudsman’s factsheet on the pre-existing conditions rule.

Source – https://privatehealth.gov.au/health_insurance/howitworks/waiting_periods.htm

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Switching Health Funds

It must be harder to change my Health Fund than changing my bank!? Sound familiar?

It’s not! It’s easy and we are here to help and explain why.
 

People’s needs change all the time and with this, so should your health insurance plan.

Most of these changes occur during ‘life stages’ or ‘events’.

  • You’re looking to start a family and would like cover for pregnancy
  • You’ve finished with having children and it’s time to remove it from your cover
  • It’s time to get some major work started on your teeth
  • Playing sport means more trips to the physiotherapist?
  • You took out a policy a decade ago and just want to make sure its still relevant to you!
  • Cost of living is putting pressure on you/family and its time to check what we are covered for

But you probably already know that, this is why you’re here.

Let’s get into the most common questions around switching.


What about my waiting periods? Someone told me I have to start them again?!
That’s simply not true.

If this was the case, you wouldn’t see hundreds of people across the country changing private health insurers every day!

The private health industry is heavily regulated and designed for situations with this in mind. People’s needs change. This policy within the legislation is called ‘Portability’. It allows members to switch funds to an equivalent or lower level of cover without having to restart waiting periods for services on the policy.

For more information on Health Fund Waiting periods, click here.

How does this happen though between two different health funds?

I see you’re paying attention!

Simple; with the use of what we call a clearance or transfer certificate. The old insurer will provide this certificate to the new insurer with all of the relevant information to complete the transfer. It is this request that will also finalise any payments and debits to the old insurer.

*This process can take between 14-21 working days, so don’t be alarmed if you see additional payments being deducted. These will all be refunded back to you.

I need to claim during the transfer? Am I still covered?

As long as you’re a current member of a health fund, covered for that service, have served your relevant waiting period and are not in arrears with your premium, absolutely yes!

This can be completed a number of ways however this will be fund specific.

Ok, I’m ready to compare my cover, what do I do?

The best way would be;

  • Find your current policy information
  • Set aside 15 minutes
  • Give us a call!
  • Enjoy your new benefits
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