If we’ve learned anything from the COVID-19 pandemic, it’s the need for proper health care and an insurance safety net to protect us in the event of just about any malady. Beyond the basics of the public Medicare system, private health insurance is providing hundreds of thousands of Australians with the coverage they need. Some have been able to garner that access thanks to the help of health funds.
What is a Health Fund?
In Australia, health insurance is provided by a number of insurers called health funds. This insurance is optional and covers the cost of treatment as a private patient in a hospital, including potential extras cover. Australians can look into a list of health funds that will allow them to determine the plan that best suits their financial need, as well as allows them to choose their healthcare providers. Depending on individual insurance requirements, the combination of hospital and general treatment cover is placed under most health funds.
The good news for applicants to health funds is that private health insurance is not risk-rated, so insurance companies cannot refuse to insure any eligible participant. Insurers must also charge the same base premium for the same level of coverage.
Depending on whatever health centers use utilize, health fund membership cards are made available, where your benefits are applied to an invoice by just scanning during a payment transaction. Other health funds may require you to make an upfront payment, receiving reimbursement later on.
What Does a Health Fund Provide that Medicare Doesn’t?
Australia relies on a hybrid health care system, consisting of the public option Medicare and private health insurance. The differences between what Medicare covers and private health insurance covers vary depending on additional covers. For example, Medicare covers 75% of associated medical costs, while a health insurance provider will provide hospital cover to take care of the remaining 25%. With private health fund patients, you can choose your doctor and care team, as well as the health centers you wish to go to.
While Medicare takes care of the full cost of visiting your general practitioner, it takes care of just 85% of the cost of a specialist. Health funds offer coverage or reimbursement for a litany of services that Medicare will not, such as dental care, chiropractic services, and psychology services. However, Medicare does offer forms of financial assistance to get you the proper treatment you’re seeking. One reason many people opt for the private health fund is the waiver of the Medicare Levy Surcharge for participants, no longer having to pay that tax by putting less pressure on the public health system.
How Can a Health Fund Benefit You?
A private health fund can pay for some or all of the costs of your treatment in public and private hospitals, as well as a patient with the doctor of your choice. Be sure to review your insurance policy, or a quote as an applicant, to make sure that health services that are not covered under Medicare are covered by the health fund of your choice. This can be physiotherapy, dental, or even optical. While there is the addition of monthly premiums, health fund patients get their money back via rebates and no longer having to pay the Medicare Levy Surcharge.
Hospital cover and extras treatment cover provides a more expansive net for participants, as well as more effective technical assistance from private insurers. While Medicare does offer this assistance, there are far more people utilizing the system meaning reimbursement and even getting questions answered will take far longer. In the end, a health fund could be the answer to all of your health care qualms going forward.