Private Health Insurance and Their Affiliated Hospitals

Insurance companies contract with various providers such as dentists, hospitals, doctors, physiotherapists, and so on, to fix the fees that an insurance member will pay. These “no gap” policies can be restrictive on who a member can use, some insurers will still allow a member to use another provider but the cost may not be fully covered, other insurers require that the service is performed by one of their contracted providers.

A member has the choice to use the insurer of their choosing, in doing so they must accept the terms and conditions of the policy or they can select another insurer whose terms and conditions suit them better. This is why it is important to read the PDS to ensure the fund suits a member’s needs. The insurer is largely allowed to set the terms and conditions of their policies as long as they have been clearly stated in the PDS, they cannot however breach any laws. So setting a preferred or only choice of provider is allowed, the member must then decide if that is acceptable to their needs.

As to naming the insurer for the purposes of comparison and discussion, that is perfectly acceptable. Only If the discussion becomes potentially libellous will posts be moderated to ensure the Community terms of service and guidelines are maintained. There are a number of topics that are specifically about particular named funds, your fund may be included.

As examples

Of further interest may be the following topic

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