In 2017, the Australian Federal Government announced changes to private health insurance, to make the industry simpler, more affordable and provide better access to mental health services.
The reforms impact all health funds across the private health insurance industry and will essentially affect all members in some way.
What health insurance reforms are being introduced in 2019?
At frank, we’re on a mission to make health insurance easy and affordable.
Keeping your costs down
We are seeing healthcare costs rise due to an ageing Australian population, more chronic disease cases and innovation in medical technologies and treatments
From April 2019, these reforms will enable us to keep cover affordable with:
- discounts for 18–29 year olds on selected products
- increased hospital excess to improve affordability
Easier to understand products
To make it easier to compare products and know what you are covered for there will be a standardised Gold, Silver, Bronze & Basic hospital categorisation
The main comparison website, privatehealth.gov.au will also be upgraded to make comparisons easier.
Insurers will be required to use standard clinical categories across the industry so you know exactly what you are covered for.
How will these changes impact frank members?
There will likely be some changes to your cover when the reform is implemented such as;
- new inclusions or exclusions on your product
- a change to your product name
- a change to your excess amount.
If any of these changes are going to affect your cover, we will communicate with you directly.
Below is a summary of the major changes you need to know about.
|What has changed?||What does it mean?||Effective date|
|New product categories||Hospital products will be simplified with the introduction of easily understood tiers of cover. There are four categories of hospital products - Gold, Silver, Bronze and Basic – across all health funds.||1 April 2019|
|Discounts for 18 to 29 year olds||Frank and other insurers will be able to offer discounted cover for 18-29 year olds. Legislation currently prevents insurers from offering discounts on basis of age.||1 April 2019|
|Increase to the maximum excess levels||The Government will increase the permitted excess level to $750 for singles and $1500 for couples and families.
An excess is only payable if you’re admitted to hospital. An excess is a fixed amount you agree to pay towards your hospital admission.
Having a higher excess can help to reduce the cost of your premium.
Most Frank products will have a $750 hospital excess for singles and $1,500 for couples from April 1, 2019.
|1 April 2019|
|Removal of rebate for some natural therapies||A review by the Department of Health found there is not enough evidence to demonstrate the effectiveness of a number of natural therapies. Removing benefits for selected Natural Therapies is a requirement of the Australian Governments Private Health Insurance reform
The Government will no longer provide rebates for the following natural therapies: Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, shiatsu, tai chi, and yoga. This means that these treatments will be removed from your cover.
If your product includes benefits for Natural therapies being removed including Naturopathy, Homeopathy & Pilates by a Physiotherapist, you will be able to still claim for any service received before 1 April 2019 for up to 2 years after the date of service.
Any service provided after 1 April 2019 will not be payable.
You can still receive treatment across a range of other included natural therapies such as acupuncture, remedial massage & Chinese Medicine on applicable extras covers. Your extras limits won’t change and benefits will still be paid for services being removed from your extras cover as long as your treatment is before 1 April 2019 (subject to annual limits).
|1 April 2019|
|Travel and accommodation benefits for regional and rural areas||Private health insurers will be able to offer travel and accommodation benefits under hospital cover.||1 April 2019|
|Standard clinical definitions||Private Health Insurance are required to communicate all standard clinical categories across all product documentation to make it easier for members to compare.||1 April 2019|
|Accessing mental health services||Members who have held limited cover for at least two months will be able to upgrade their cover to access in-hospital mental health services, and waive the waiting period. This enables members to seek help when they most need it.||1 April 2018|
|Prostheses List benefit reductions||Minimum benefits payable for almost all medical devices listed on the Prostheses List have been reduced.Total estimated savings to private health insurers over the next four premium years (2018 to 2021) are estimated to be $1.1 billion dollars. Savings will be passed on directly to members by reduced premium increases.||1 February 2018|
What changes to health insurance have been introduced already?
Reduction to the minimum benefits for prostheses
The prices paid for items on the Prostheses List is generally lower in the public sector.
Reductions in prostheses expenditure by health insurers is estimated to save members $1.1 billion over 4 years which is directly passed on to members through reduced premium increases.
Enabling better access to mental health services
Members who have held limited cover for at least two months will be able to upgrade their cover to access in-hospital mental health services, and waive the waiting period. This enables members to seek help when they most need it.
Where can I find out more information?
The Department of Health has a lot of useful information and a range of helpful fact sheets.