Australian Medical Association reveal the best and worst of health funds
OUTRAGED by your latest health fund premium rise? Some funds pay out $737 less than others for a hip replacement, $794 less for delivering a baby.
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EXCLUSIVE
THE best and worst health funds have been revealed and Medibank, the nation’s biggest health fund, has been found to offer some of the lowest benefits for common procedures.
For the first time ever the Australian Medical Association will today unveil what the major health funds will pay out for 22 of the most common hospital procedures.
The information comes as health fund members are finding their premiums are rising well in excess of the average 5.59 per cent rise.
Premiums for Bupa’s top hospital cover rose by 8.5 per cent, some of Medibank’s policies rose by 6.85 per cent. All health fund premiums rise on April 1.
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The AMA’s information will allow health fund members to tell if they are in the best health cover for their needs and assist them if they decide to switch health funds.
Health fund HBF emerges as the fund with the highest benefit payouts for 9 of the 22 common procedures — cataract surgery, removal of tonsils, craniotomy, complicated and uncomplicated delivery of a baby, carpal tunnel release, hysterectomy, chemotherapy and sleep apnoea.
And 25 of the smaller players you may never have heard of including ACA Health benefits fund, Defence Health, Australian Health Unity and Frank Health Insurance, grouped under the AHSA brand, come in a close second.
They have the best payouts for knee replacements, coronary artery bypass, cataract surgery, coronary stents, skin cancer removal, hernias and haemorrhoidectomy and gall bladder surgery.
Mildura Health Fund and GMHBA provided the lowest benefits for 19 of the 22 procedures that were compared.
There was not a single procedure among the 22 surveyed where the nation’s largest health fund Medibank or NIB had the best payout.
The analysis shows if you need surgery some funds pay out $330 less for cataract surgery than the best fund, $737 less for a hip replacement , $794 less for delivering a baby.
AMA president Professor Brian Owler said the size of the payouts by health funds would give consumers a hint of which funds would leave them with the smallest gap payments if they had surgery.
The AMA says its Private Health Insurance Report Card 2016, has a clear message to consumers — know your product.
“The AMA wants Australians to know their insurance product — and know it thoroughly,” Professor Owler said.
“With the cost of private health insurance constantly rising, and with private health insurers regularly changing what is covered and not covered by their products, the AMA believes it is important that families and individuals are better informed about the health insurance cover they are purchasing.”
The AMA is also taking aim at health fund comparison sites like Compare the Market and iSelect which charge health funds commissions to be part of their business.
Some health funds are not members of these comparison sites so consumers may not be getting the best deal as the sites only compare policies that pay the broker a commission.
Compare the Market says it charges health funds a uniform 27.3 per cent commission on the first year’s premium when it joins up a new member to the health fund, these costs are adding to premium rises because health funds have to recover them.
“These comparator sites — which are marketed as ‘free’ comparison sites — can earn exorbitant fees per sale from the insurers,” Professor Owler said.
“The AMA wants the government to demand a greater level of transparency from the comparator sites wants them scrutinised by regulators.”
Meanwhile, more than 63,000 Australians have joined the Big Health Insurance Switch in pursuit of more affordable cover. The campaign began 12 days ago and aims to use “people power” to extract a group discount from a major health insurer.
To join the Big Health Insurance Switch go to www.onebigswitch.com.au
* There is no obligation to take up any offer. This masthead’s publisher News Corp Australia and One Big Switch will earn a commission from any accepted deals. News Corp Australia is a shareholder of One Big Switch.
EMAIL:sue.dunlevy@news.com.au
TWITTER:@Sue_Dunlevy
Originally published as Australian Medical Association reveal the best and worst of health funds
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