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Overseas Visitor Health Cover (OVHS) in Australia

Working as a patient finance liaison officer (PFLO) in a public hospital I assist visitors to Australia with their claims for health insurance taken out with an Australian private health insurance. Consistently these Australia Private Health Insurance Companies lie to their clients about the cover that they get for their money.

These health insurers say to their clients that the hospital cover is 100% however in the small print of the policy you will find that the cover is actually 100% of the MBS scheduled fee (for services provided) or state rate (which is a facility fee for the bed, nursing care etc whilst a person is in the hospital).
Of note is that Australian public hospitals typically charge more than the state rate.

These visitors also have to serve the same waiting periods as Australian citizens for hospital services and so when they present to hospitals, they are almost guaranteed to be within waits: overseas visitors are usually here on a holiday and so will never be able to serve the 12 month waiting period for hospital cover.
I have had one case (Medibank Private was the insurer) where the staff member I spoke to told me that the visitor “had no right to claim as they were within the first 12 months of taking out their insurance” even though the policy document states that cover starts within 24 hours.

NIB, IMAN (subsidiary of NIB) and HCF are only a few of the companies where OVHC only covers 100% of the inpatient stay in contracted hospitals. As these are always private hospitals who - generally - do not have Emergency Departments, the overseas visitors presenting to an Australian hospital are continuously trapped between a rock and a hard place. For example: in the hospital I work in these patients have a minimum of $1000 out of pocket expenses per night.

I think these practices need to be investigated as IMHO these insurance companies deliberately exploit the very limited knowledge of the Australian Private Health Insurance that overseas visitors have and cause an enormous amount of stress for these visitors once they land in hospital. I have had patients discharging against medical advice because they could not pay for the out of pocket costs and re-present the next day being a lot worse off and requiring admission to ICU, where the costs are 250% of the medical ward admission.

These companies also place a huge burden on the public health system in Australia as hospitals will always provide care first and have to try and recover the expenses made afterwards, which, in most cases result in a total write-off of the invoice as patients will have left Australia and there is no way to retrieve the money owed.

This is yet another way for these for profit private companies to grab the cash and leave the Australian taxpayer to foot the bill for health care for overseas visitors.

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Welcome to the Forum, and thanks for highlighting this issue Dominique.

I thought the health insurance for overseas visitors was provided by businesses in their home country. If Australians travel overseas, isn’t the health insurance provided by businesses in Australia?

ARRRrrr… more complexity and things to look out for when travelling!

Thank you for the warning. :slight_smile:

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Hi Meltam,

My boss never paid for health insurance on my private travel and I doubt any boss does. The boss usually does pay for travel insurance on business trips, maybe that was what you were referring to?

In any case, as a traveller it is your responsibility to make sure you have travel insurance or be prepared to pay a LOT of money - and I am talking possibly hundreds of thousands of dollars in more serious hospital admissions!

Some countries such as the US will not even allow you to be admitted unless you pre-pay for your stay!!

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Not necessarily. We have German friends who will be in Australia for a while and have Australian health cover through Medibank. Their cover is called Overseas Visitors Health Cover. I expect there will be other similar service providers (just checking looks like most health insurance companies provide similar insurance cover for visitors)

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There are indeed 12 month waiting lists for a fairly long list of maladies that are considered pre-existing conditions. That puts a person between the rock and hard place and in a possibly worse situation than getting travel insurance for pre-existing conditions since ‘going home’ might not be an easy option if one is posted to Australia on the job.

As with anything, it pays to read all the print, large and small.

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Of note, overseas visitors insurance is required under certain visa types, including 457. However, this visa is not counted as having private insurance for tax purposes but rather as ‘travel insurance’, meaning people are forced to pay for private insurance all year round and get slugged with a levy at the end of the year.

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Hi Justine, and welcome to the forum.

I believe the 457 has been replaced by the 482. A salient difference between Overseas Visitor policies and our Private Health is that the OV is an equivalent to medicare subsidies, eg the subsidy for GP and prescription services, not just in-hospital services. Some policies have more than others included, but the base remains a medicare equivalent payment.

Most of these policies do not replicate our private health plans so do not qualify as being private health, most of them are designed to be what Home Affairs requires with comparatively attractive costs. As with many insurances, the idea of ‘attractive’ is in the eye of the seller not the buyer.

A temporary visa holder is and has always been treated differently and often unfairly compared to ‘locals’, and more often comparatively disadvantaged than not.

Australia has a very long and consistent history regarding its insular nature on many things. Re medical care and insurances the policy makers responsible are worried about people taking advantage so this is how it is for temporary residents.

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Hi Dominique
I’m sorry. I should have been clearer. When I said overseas businesses, I was referring to overseas health insurance businesses.

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That would be new information for me. My understanding is the USA as well as most other countries can require proof you have the ability to pay all your costs while in each country.

Whether an electronic waiver or requiring a formal US visa, the requirements are here. Regarding medical treatment in the US, if that is your purpose for the trip you need proof that your transportation, medical, and living expenses in the United States will be paid. This may be in the form of bank or other statements of income/savings or certified copies of income tax returns (either yours or the person or organization paying for your treatment).

‘Nothing USA’ requires pre-payment. If you have evidence to the contrary I would be appreciative to know about it.

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