Private Health Insurance in Australia underwent a reform from 1 April 2019. Changes were introduced by the Government to make private health insurance simpler and more affordable. Changes are to hospital cover only (don’t apply to extras cover) and include:
- Introduction of 4 tiers of hospital cover, classified as ‘Gold’, ‘Silver’, ‘Bronze’ or ‘Basic’ which will make it easier for customers to compare different policies and have certainty about the treatments that are covered by a policy. Insurance companies have until 1 April 2020 to transition current policies to the new tiered classification.
- Introduction of 38 clinical categories (i.e. standardised names) for hospital treatments and each tier has a set list of minimum requirements for treatments that must be covered under each tier. For example, ‘Pregnancy and birth’ is a clinical category under the Gold tier only and covers the investigation and treatment of conditions associated with pregnancy and child birth. See PrivateHealth.gov.au for a full list of clinical categories and a summary of which tiers cover each clinical category.
- Removal of 16 types of natural therapies (e.g. naturopathy, tai chi, Pilates, yoga, aromatherapy) as there is a lack of evidence that these are effective. See fact sheet from the Department of Health.
- Introduction of insurance premium discounts for young adults (aged 18 to 29 years). In addition to the Lifetime Health Cover, this aims to encourage young adults to take up private health insurance earlier in life. See fact sheet from the Department of Health.
- Customers can lower their insurance premiums by voluntarily increasing their excess levels.
- Travel and accommodation benefits for people living in regional and rural areas, although this will not be compulsory for insurance companies to allow this.
Insurance companies can still (and likely will) offer ‘Plus’ policies which can be confusing when comparing policies. Although ‘Pregnancy and birth’ are covered under Gold policies, it may also be included in ‘Silver Plus’ policies.
If you already have private health insurance, your insurance company will let you know what will happen to your existing policy. It may just be a name change to reflect the new tiers (e.g. Gold, Silver, Bronze, Basic) or your current policy may have different clinical categories that will be covered.
PrivateHealth.gov.au is an Australian Government initiative for independent information about Australian health insurance companies and private health insurance.