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Health Insurance Frequently Asked Questions
What is the iSelect health insurance comparison service?
iSelect provide you with a service at no charge to you that has been established to help you choose a health insurance policy that meets your needs. Working together with participating health funds, iSelect aims to provide informed choices for consumers.
How does iSelect work?
When you access our website, you will be guided through a series of questions relating to your health insurance needs and requirements. This process may initially take you about 10 minutes. The requirements that you input are analysed by iSelect, and a ranked shortlist of policies from an approved product list are displayed. This is based upon the information that you have provided.
You may then examine the shortlist of policies and select the product that you believe suits your situation.Finally, you may join your chosen health fund quickly and easily through iSelect by completing the application form.
Or if you prefer, you can call iSelect on 13 19 20 to discuss your needs and requirements with a trained consultant.
Why do I need health insurance?
There are many reasons why people take out private health insurance. They are generally seeking peace of mind – the security of knowing they can get access to the right level of care and treatment they require while being financially protected.
Key benefits of private health insurance include:
- Choice of surgeon/doctor
- Choice of hospital
- Shorter waiting periods for hospitalisation
- Full ambulance cover in some states
- Broader health programmes that may also cover hospital substitute treatment by way of “chronic disease management”
- General Treatment Cover (extras) could include a range of services from dentists, physiotherapists, chiropractors, natural therapists, etc.
Additionally, consumers have also been encouraged to purchase private health cover by a range of government initiatives including Lifetime Health Cover, the Australian Government Rebate and the Medicare Levy Surcharge.
Read more: Why should I get Health insurance?
What if l already have health insurance?
iSelect may be able to recommend a policy that better suits your requirements. Simply complete the series of questions on this website and compare the shortlist of products with your current cover. Once you have made your comparison and if you find a more suitable match for your health insurance requirements, simply fill in the application form and iSelect will guide you through all of the paperwork.
Is it easy to transfer between funds?
Yes. You will have continuity of membership for the same or lower level of benefits when you transfer from one Registered Health Fund to another in most cases.
You must transfer within the stipulated period for your chosen health fund (this can be between 14 – 60 days). If you have not served all the relevant waiting periods to completion, you will have to serve the remainder of those waiting periods with your new fund. This would include any waiting period for any new services included in the policy with your new fund.
Extras benefits that accrue according to continuous length of membership with one fund are not automatically portable between funds.
If I am currently uninsured, will I have to serve Waiting Periods?
Yes. All health funds apply waiting periods for new members without current private health cover. Waiting periods are normally 12 months on obstetrics and related reproductive services, and pre-existing conditions. Other conditions requiring hospitalisation normally have between 2 and 12 months qualifying periods. Health funds may impose benefit limitation periods on certain services that are offered. For General Treatment services such as Dental and Optical waiting periods range from 2 to 12 months. Please read the policy carefully before you purchase.
What should I do if I have a dispute with my health fund?
In the first instance members should attempt to resolve any dispute directly with their fund.
You may also contact the Private Health Insurance Ombudsman – an independent body established to help resolve complaints and provide advice and information.
The Ombudsman can be contacted via:
- Telephone: 1800 640 695,
- Internet: http://www.phio.org.au, or
- In writing: The Private Health Insurance Ombudsman, Suite 2, Level 22, 580 George Street Sydney NSW 2000
Members can also contact their health fund to receive a copy of the Private Patients Hospital Charter.
Does the purchase of 100% hospital cover guarantee that I will not have any out-of-pocket expenses for a private hospital visit?
No. Health funds vary their level of benefits for hospital related costs and medical bills according to whether the hospital is or is not a designated Participating Hospital.
Prior to admission, members should contact their health fund to verify the status of the hospital they wish to use.
Medical expenses incurred in hospital are reimbursed to at least 100% of the Medicare Scheduled Fee – 75% refund from Medicare and 25% refund from your health fund to cover some or all the costs of:
- Hospital accommodation,
- Theatre fees,
- Intensive care,
- Drugs, dressings and other consumables,
- Prostheses (surgically implanted),
- Diagnostic tests,
- Pharmaceuticals, and
- Any additional doctor’s fees.
If a medical provider is a participant in a ‘No Gap/Known Gap’ scheme offered by your fund you may be fully covered for all admissible medical expenses. Members should confirm the extent of this cover with treating medical providers and their fund prior to admission.
If you use a non-participating hospital you may incur considerable out-of-pocket expenses. Contact your fund to enquire what they would pay at a non-participating hospital.
How do I keep my premiums low?
You could keep your premiums low by either increasing the excess that you are willing to pay if you are hospitalized, or through reducing your level of cover if it is sensible for you to do so.
Most health funds have policies that offer lower levels of cover through imposing restrictions or exclusions on them that in turn result in a lower premium.
You have the ability to take out a hospital cover with one fund and a general treatment (extras) cover with another fund.
We recommend that you shop around. There are many registered health funds and policy combinations in Australia, with an array of premiums for you to chose from.
We suggest that you tailor your health insurance to your needs so you aren’t paying for what you don’t need.
iSelect has recently reviewed what Australian’s are paying in additional tax related to private health insurance. A report released by the Australian Taxation Office has shown that people without private health cover are paying on average an extra of around $630 a year in tax through the Medicare Levy Surcharge. (Source: ATO Tax Statistics, 2007)