What Does ‘no Gap’ mean with Private Health insurance?

So you have private health insurance and want to know how much you might have to pay for medical treatments out of your own pocket? We’ve got you covered with our easy guide FAQ.

Q: What does ‘no gap’ mean when it comes to private health insurance?

A: Basically, it means that you won’t have to pay anything out of your own pocket for certain medical procedures, these are covered by your private health insurance. It’s the difference between what your doctor or hospital charges and what your private health fund will pay and it’s known as the ‘gap’.  With a ‘no gap’ arrangement, your insurance will cover the full cost of the service minus your excess if applicable.

Q: So, I won’t have to pay anything extra?

A: That’s right! With the ‘no gap’ arrangement, you won’t be left with any unexpected bills to pay. Your private health insurance will cover the full cost of the medical procedure, so you can focus on your health and recovery.

Q: How does it work?

A: To be eligible for a ‘no gap’ service, you’ll need to use a provider who is a part of your private health insurance preferred provider’ network. This means that the provider agrees to charge you a set fee for a particular medical service, and your private health insurance will cover this fee in full. This way, you can be sure that you won’t have to pay anything out of your own pocket.

Q: Can I get ‘no gap’ for any medical procedure?

A: Unfortunately, ‘no gap’ is only available for some medical services, and only if you use a provider who is part of your private health insurance provider’s ‘preferred provider’ network.

Q: Is ‘no gap’ the same as ‘bulk billing’?

A: No, they’re not the same thing. ‘Bulk billing’ is when medical providers bill Medicare directly for their services, so you don’t have to pay anything out of your own pocket. ‘No gap’ is a service that’s offered by private health insurance providers, and it covers the full cost of certain medical procedures.If you’re interested in comparing health insurance policies, give us a call at 1300 861 413 or check out our website at http://health.compare/. We’re here to help you make informed decisions about your health!

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What happens when I switch private health funds?

Are you thinking about switching private health funds but don’t know where to begin? The process can be daunting, but we’re here to help. Let us guide you through the steps to switch private health funds and give you some tips to make it easier.

Why should you consider switching private health funds?

There are a variety of reasons, such as your current policy no longer suiting your needs or you want to reduce your premiums. Maybe you’ve heard good things from friends about other health funds and want to explore what they offer. Regardless, it’s crucial to compare private health insurance options to ensure you’re getting the best deal for your needs.

Step 1: Compare Private Health Insurance Options

Start by identifying what you need and want from your policy. Do you need coverage for a specific condition? Are you looking for extras like dental or optical coverage? Once you know what you need, start researching different funds to find a policy that suits you.

When comparing private health insurance policies, look beyond the price tag. Consider the level of coverage you need, the excess you’re willing to pay, and any additional benefits or perks that may be included with the policy. Look for policies that offer a balance of coverage and affordability, and don’t hesitate to ask questions if there’s anything you’re unsure about.

Step 2: Apply for Your New Private Health Policy

When you have found the right level of cover, its time to start organising the transfer. This part is relatively simple and typically completed over the phone. During this process a number actions will occur, your new membership pack will be organised, your waiting periods will transfer from your existing fund and your direct debit details will automatically be cancelled. You won’t have to have any uncomfortable conversations with your old fund during this process. Ensure you have all the necessary information and documents on hand, such as your Medicare card and any relevant medical history, to ensure a smooth application process.

Step 3: Cancel Your Current Policy

As mentioned before you wont need to worry about any uncomfortable conversations with your current private health fund. Your new private health provider will contact your previous fund and cancel the policy and the direct debit on your behalf. This will enable you to claim with your new fund.

Step 4: Review Your New Policy

Before you relax and sit back, it’s important to give your health insurance policy a careful read. Start by going over the specifics of your coverage, such as waiting periods, excess amounts, and benefit limits. Remember, any waiting periods that you’ve already served with your previous health fund will carry over to your new one in accordance with health insurance regulations. Be sure you understand what’s covered and what’s not, and don’t hesitate to ask your new health insurer any questions you may have. It’s crucial to make sure that your policy is tailored to your individual needs and that you’re getting the most bang for your buck. So, take your time and give it a thorough review!

Switching private health funds doesn’t have to be challenging.

Visit https://health.compare/ to compare private health funds and find the policy that best suits you. Alternatively, speak to one of our friendly team members by calling 1300 861 413 or emailing us at hello@health.compare  

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Dental waiting periods explained

When it comes to dental work, nobody wants to wait – especially if you are in pain. Waiting periods are a fact of life when it comes to private health cover, and they can vary depending on the type of dental procedure you require. Policies can vary from provider to provider, so we have put together a quick guide of what to look for when it comes to wait times for dental procedures. 

What is a waiting period?

Dental waiting periods are a set amount of time that you have to wait before you can claim on certain dental procedures included on your private health policy. This waiting period is put in place by your private health insurance provider and is designed to ensure that you have held your policy for a certain amount of time before you can start claiming benefits.

Waiting periods can vary between policies and providers, but generally, you can expect a waiting period of around 2-6 months for general dental procedures, and up to 12 months for major dental work such as crowns or bridges.

What dental procedures have waiting periods?

The waiting periods for dental procedures can vary between policies and providers, but in general, you can expect waiting periods for the following types of procedures:

  • General dental procedures: waiting periods of 2-6 months may apply for procedures such as check-ups, scale and cleans, fillings, and extractions.
  • Major dental procedures: waiting periods of up to 12 months may apply for more complex procedures such as root canals, crowns, bridges, and dentures.
  • Orthodontic treatments: waiting periods of up to 12 months may apply for orthodontic treatments such as braces or aligners.

It’s important to note that some private health policies may also have waiting periods for other dental procedures such as wisdom teeth extractions or periodontal treatments. So, make sure you check the specifics of your policy to ensure you understand the waiting periods that apply to your cover. Compare private health insurance options with various providers and see what suits your current health requirements.

No Waiting Period

A waiting period is the amount of time you have to wait before you can claim benefits on your extras dental cover. The length of the waiting period can vary depending on the health insurance provider and the type of dental cover you have. However, some health insurance providers offer no waiting period for certain dental services, such as check-ups and cleaning.

Three types of Dental procedures explained

There are three main types of dental procedures: preventative, general and major. Preventative procedures include things like check-ups, cleans and x-rays. General procedures include fillings and extractions, while major procedures include things like root canals, crowns and bridges.

Preventative procedures usually have shorter waiting periods than general and major procedures. For example, most private health insurance policies have a waiting period of two months for preventative procedures. This means that you can claim for a check-up, clean or x-ray after two months of holding your policy.

General procedures usually have longer waiting periods than preventative procedures. The usual waiting period is six months for general procedures. This means that you can claim for a filling or extraction after six months of holding your private health policy.

Major procedures usually have the longest waiting periods, these are usually a waiting period of 12 months for major procedures. This means that you can claim for a root canal, crown or bridge after 12 months of holding your policy.

Do any health insurance providers offer no waiting period?

Some private health insurance providers may waive dental waiting periods as part of a promotion or special offer if you are a new member. It pays to compare private health policies as a number of health insurers may offer to waive two- and six-month waits on services such as dental, optical and physio by signing up to a combined hospital and extras cover plan.

Does Medicare cover dental services?

Medicare does not generally cover dental services. However, some dental services may be covered under Medicare in certain circumstances, such as if the dental treatment is required in a hospital setting. This includes essential dental services for some children and adults who are eligible. Medicare offers a $1000 rebate over 2 calendar years for kids aged 2 to 17 years for basic dental work. Adults with  a Health Care Card or Centrelink Pensioner Concession Card may also be eligible.#

Taking care of your dental health is just as important as taking care of your overall health. However, dental procedures and treatments can be expensive, making dental extras insurance a valuable investment for many individuals and families. It pays to compare private health funds and explore the different types of dental extras coverage available, whether any health insurance providers offer no waiting periods, and whether you are eligible for Medicare coverage with any dental services.

Compare health insurance dental coverage today by visiting  https://health.compare/ or speak to one of our friendly team members call 1300 861 413 /  email hello@health.compare

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Who has the highest claim limit for Physiotherapy?

This month we’ll explore why physiotherapy Extras are important when it comes to your private health policy and how to get the best out of your cover. Physiotherapy is the third most claimed extras cover in Australia. It can be beneficial for a range of conditions, including musculoskeletal injuries, chronic pain, and rehabilitation after surgery. With extras cover, your private health policy you can access a range of physiotherapy services including consultations, assessments, and treatments such as exercise therapy, massage and electrotherapy.

Why are physiotherapy extras important?

Physio focuses on improving your physical function and reducing pain. It’s a critical part of rehabilitation following an injury or surgery, managing chronic pain conditions, and maintaining overall physical health. However, the cost of physiotherapy can quickly add up, particularly for those who require ongoing treatment.

This is where your Extras part of your private health policy comes into play. With Extras cover, you can receive rebates on the cost of physio, reducing the financial burden on you and your family. Depending on your policy, you may also be able to access additional services such as chiropractic, osteopathy, and remedial massage.

Who has the highest claim level for physiotherapy?

Here’s some of the groups that have the highest claim levels for physiotherapy Extras in Australia:

  1. Those aged 65 and over – This group accounted for the highest number of claims and the highest overall cost of physiotherapy.
  2. Those with chronic conditions – Patients with chronic conditions such as arthritis, back pain, and sports injuries often require ongoing physiotherapy.
  3. Those with private hospital cover – Patients who have undergone surgery or been hospitalised for an injury often require post-operative physiotherapy as part of their recovery.
  4. Those living in regional areas – Patients in regional areas may have limited access to healthcare providers and may require more frequent or intensive physiotherapy treatment.

How to get the best out of your physiotherapy extras cover

If you have physiotherapy extras cover, there are several ways you can ensure that you’re getting the most value from your policy. Here are eight tips to keep in mind:

  1. Understand your private health policy – Take the time to read through your policy’s terms and conditions, so you know exactly what’s covered and what’s not.
  2. Choose a preferred provider – Many private health funds have preferred providers, who offer higher rebates and lower out-of-pocket costs. Find out if your physiotherapist is a preferred provider and consider switching if they’re not.
  3. Check the waiting periods – Most extras policies have waiting periods before you can claim benefits. Make sure you understand these waiting periods, so you’re not caught out.
  4. Don’t exceed your annual limits – Many private health policies have annual limits on how much you can claim for physiotherapy. Keep track of your claims throughout the year, so you don’t exceed these limits.
  5. Consider bundling policies – If you have other health needs, such as dental or optical, consider bundling your policies with the same health fund. This can often result in lower overall costs and higher rebates.
  6. Use your benefits regularly – Regular physiotherapy can help prevent injury and improve overall physical health. Don’t wait until you’re in pain to use your benefits.
  7. Keep your receipts – Make sure you keep all receipts and invoices for physiotherapy treatments, as you’ll need them to make a claim with your private health provider.
  8. Compare private health insurance – Finally, don’t be afraid to shop around and compare policies from different health funds. You may be able to find a policy that better suits your needs and budget.

In conclusion, physiotherapy extras are an essential part of any private health policy. It can help reduce the financial burden of physiotherapy treatment and promote overall physical health and well-being. By understanding your policy, choosing a preferred provider, and comparing private health plans before going ahead will assist in your wellness journey.

Compare private health insurance coverage today by visiting  https://health.compare/ or speak to one of our friendly team members call 1300 861 413 /  email hello@health.compare

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Will I get a refund if I change my health insurance?

If you change your private health insurance, you will be entitled to a refund of any premiums you have paid in advance. The amount of the refund will depend on the number of days you haven’t used on your policy at the time of your cancellation.

Any refunds will take place on the completion of your health insurance transfer. The refund will happen automatically once your new policy has been setup. This refund by law can take up to 21 business days to complete.

Additionally, it’s important to keep in mind that if you cancel your policy, you may lose any continuity of cover benefits you have accumulated. Continuity of cover benefits can help you avoid waiting periods and exclusions when you take out a new policy, so it’s important to weigh the pros and cons before deciding or ensure you transfer within a certain period of time. Those time frames vary by health fund. Reach out to us to find out more.

In summary, you are entitled to a refund with your private health insurance when you switch or transfers your health insurance. The amount of refund will be determined by the pro rata amount of unused premiums. For more information on transferring or switching, give us a call!

Thinking of moving funds? Find the best health coverage today by speaking to one of our friendly team members call 1300 861 413 or email hello@health.compare

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