CHOICE membership

Health insurance and COVID-19

Hi,

We are looking for feedback on how you feel you have been treated by your health insurer during the coronavirus crises.

For example, did you get a discount or a hardship premium waiver, did you use online services such as physiotherapy and did you find them helpful, has your surgery been cancelled or rescheduled?

We also especially interested in the communication your might receive from your health fund about premium increases that are scheduled for October 1, for example two funds - HBF and TUH - will not increase premiums this year and one health fund - Medibank Private - applies a discount for members in Victoria.

Please post your experiences, good or bad.

Thank you!

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HCI deferred increases this year.

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I am with HCF.

This was the last communication I received on August 3.

“As Australia’s largest not-for-profit health fund, we’ve continued to put our members’ health first throughout the pandemic, with over $100 million in ongoing benefits and support . This includes the deferral of the scheduled April premium increase for all members for 6 months, as well as a range of financial hardship measures including Involuntary Unemployment Assistance for more than 60,000 members doing it tough.”

Our premiums are increasing in October.
I’m in WA, and have undergone an elective surgery in June (rescheduled from April), bought glasses face to face and contact lenses online, had weekly face to face physiotherapy sessions for a sports injury for the last couple of months. My usage of my policy benefits hasn’t really changed at all.

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Thank you @PhilT do you mean they won’t have a premium increase in October? If yes, if you wouldn’t mind, I’d appreciate if you could forward your premium increase email to me at healthinsurance@choice.com.au.

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Thank you @KAAAAAREN87. Good to hear that you were able to have your surgery in June and were able to use your extras.

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I’m with Phoenix Health, a member owned fund. My premium increase was emailed out yesterday. Although overall I’m satisfied with my cover, (and also I’m in WA and not particularly affected by the pandemic) I wish there was a little more communication on how the pandemic has affected the fund. Beyond a standard ‘we are providing relief to members’ I’ve heard nothing.

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Australians with private health insurance often suspend their membership to take temporary jobs overseas - allowing them to restart their membership when they return without penalty. Many of those currently unable to re-enter the country, will through no fault of their own, be unable to return before the limit of their suspension period comes into force. This means that when they return, they will be forced to take out new policies with waiting periods as if they were new members. The suspension period costs the insurers nothing as no claims can be made during this time. It is unfair that these organisations should further penalise members who are unable to return home. PRIVATE HEALTH INSURERS SHOULD OFFER EXTENDED SUSPENSION PERIODS FOR MEMBERS UNABLE TO RETURN HOME.

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Thanks for posting that ‘wrinkle’ to the system @sjhe1, I merged your topic into this one started by @UtaMihm, Choice staff, looking at the overall issue.

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Do you have any information which says health insurers aren’t extending suspension periods when requested, due to inability to be able to return to Australia. It appears it is the discretion of the insurers in relation to suspension rules.

Even if an insurer is unwilling to extend a suspension period (if this infact has been the case), one has the option to reactivate their insurance while still overseas, if one wishes to maintain their age based discount.

There is also the ability to lodge a complaint with the Commonwealth Ombudsman if one believes their health insurer is being unreasonable.

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@sjhe1 Is right that Australians who are stuck overseas beyond the time their insurer suspended their health insurance will have to take out new policies upon their return and serve waiting periods.

I’d suggest to send a formal request to your insurer to extend the suspension and also contact the Private Health insurance Ombudsman (Part of the Commonwealth Ombudsman) and ask them to help you with an assisted complaint if you have already tried to do this without success.

But the good news is, that if you have been for more than a year overseas, your Lifetime Healthcare status will will not be affected, just make sure to let your insurer know when you return and take out a new policy:

This is from www.privatehealth.gov.au
Going overseas - if you cancel your hospital insurance after your Lifetime Health Cover base day to go overseas for at least one continuous year, the days you spend outside of Australia are not counted towards the 1094 Days of Absence. You can return to Australia for periods of up to 90 consecutive days, per visit, and be considered to be overseas. Any periods of 90 days or more which you spend in Australia during this time will be deducted from the 1094 Days of Absence.

So that means when you get back to Australia, you have 90 days to take out hospital insurance.

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For those individuals stranded overseas it seems the good news is bad news and ‘the system’ is only designed for working or holidaying overseas, not being stuck there because of government.

It seems like government has created a problem and needs to hear about it and fix it, and not just from an ombudsman or accepting the answer must be that every individual deals with their health fund, individually.

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I have had very good assistance from the branch and regional managers of the health insurer. It is worth discussing individual cases with them as they showed that they can operate on a case by case basis.