Health insurance evolution: free doctor consults starting for some

Private health cover is changing, with fresh benefits for members to ease the strain on GPs and hospital emergency departments.

Private health insurers are offering fresh member benefits. Picture: iStock

Millions of Australians with health insurance are being urged to check their policy inclusions as intense competition in the sector delivers mini financial windfalls to many members.

Despite the cost-of-living crunch, private health member numbers and profits are growing as the insurance evolves from being a simple emergency fund for hospital treatment into preventive medicine such as health checks and other consultations.

The nation’s second-largest health insurer, Bupa, will soon offer 2.2 million members three free telehealth doctor consultations each year. It says this means a family of four could have 12 free consults and potentially save hundreds of dollars annually in gap payments.

“The pandemic accelerated demand for telehealth services, which has remained in recent years, Bupa clinical director Simon Benson said.

“This is about making medical care accessible and affordable 24/7 while taking some of the pressure off hospital emergency departments in the after-hours period,” Dr Benson said.

Bupa says its free doctor telehealth consults are an Australian first. Its competitors offer their own benefits beyond standard hospital cover, with Medibank providing a 24-hour nurse phone service, and HCF and nib giving members access to discounted GP consults.

Figures from financial regulator APRA show the number of Australians with private hospital cover rose 2.4 per cent last financial year to 12.2 million, and one million more people have taken out this cover since mid-2020.`

Separate APRA numbers show health insurance profits were $800 million in the March 2024 quarter, up from $382 million in the September 2023 quarter, at a time many private hospitals are struggling financially and cutting services.

Patients are also facing rising gap payments when visiting doctors.

On Thursday the Royal Australian College of GPs said early findings from its Health of a Nation 2024 report showed out-of-pocket costs now were an average $36.86 for a 20-minute consult, up almost $2 from $34.91 in 2023.

The RACGP has asked for a 20 per cent increase in Medicare rebates and wants the federal government to encourage more homegrown doctors into general practice.

Comparison website iSelect’s spokeswoman, Sophie Ryan, said health funds had been rolling out incentives to align with the increasing popularity of wellness, mental wellbeing and prevention.

“Some funds are trying to lure customers by launching new health and wellbeing programs and digital platforms,” she said.

“We’re also seeing free telehealth consults or rewards for customers who complete regular health checks.”

Ms Ryan said almost 14.9 million Australians had some form of private health cover – either hospital, extras or both – and this was up 1.3 million since 2019.

Sophie Ryan from iSelect says private health products are better-tailored.

“Significant membership growth and continuing household financial pressure has prompted many insurers to transform and better tailor their products,” she said.

Health insurers say competition in the sector is “red hot”, and separate research from the Private Health Insurance Intermediaries Association shows people are holding onto their policies despite rising living costs.

Some have been choosing cheaper base-level cover rather than ditching their health insurance altogether, because households on average incomes or higher are penalised by higher government taxes if they fail to hold hospital cover.

“Switching private health cover can be well worth it, especially when new research has revealed almost three-quarters of Aussies surveyed who switched their private health insurance in the past 12 months saved money on their premiums, with an estimated average saving of $1151,” iSelect’s Ms Ryan said.

Originally published as Health insurance evolution: free doctor consults starting for some