Private health cover confusion stuns customers into silence

HEALTH insurance customers are being paralysed in their decision-making by increasing complexity as funds continue to pile on the changes.

HEALTH insurance customers are being paralysed in their decision-making by increasing complexity as funds continue to pile on the changes.

Insurance specialists say this is leaving the one in every two Australians with private health cover vulnerable to getting stung financially when they have to make a claim.

New research by comparethemarket.com.au has found that more than 70 per cent of health fund members feel overwhelmed by information overload.

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Confusion reigns over things such as what treatments are covered, how much could be claimed back, and excess levels, it found.

Comparethemarket.com.au spokeswoman Abigail Koch said there were many thousands of individual health insurance products available in Australia.

“With many types of insurance, people feel they’re in the dark and don’t get enough information,” she said.

“For health insurance it’s the total opposite. It’s the amount of choice that’s almost stunning people into silence. The information is not being presented to them in the clearest manner.”

The research follows major health fund Bupa moving to restrict cover from July on hundreds of thousands of lower-cost policies, in some cases stopping all benefit payments for things such as cancer, obesity surgery and renal dialysis. It is understood other funds are eyeing similar moves.

Australian Dental Association president Dr Hugo Sachs said fund members had been experiencing more out-of-pocket health costs.

“The system is not working and it’s time to go back to the drawing board,” he said.

Ms Koch said sitting down for just half an hour could be enough to get your head around your policy.

“Think about key areas you want to have confidence you are covered for, then get on the phone and make sure you are happy with the answer.”

“Knowledge is power. The more time you invest in understanding your policy, the more you can get out of it,” she said.

Medibank chief customer officer David Koczkar. Picture: Supplied

Medibank chief customer officer David Koczkar said the fund recommended its customers undertake regular reviews of their cover.

He said the Federal Government’s move to introduce gold, silver and basic hospital product categories from next year would help people understand, compare and choose the right cover for them.

“Medibank has no plans to increase restrictions,” Mr Koczkar said.

A spokeswoman for iSelect, Natalie Pennisi, said consumers’ best bet was to speak with a private health insurance expert. 

“If affordability is a big concern, don’t just cancel your cover or downgrade your policy. You might find a different provider or policy that could provide you better value,” she said.

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