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How the Private Health Insurance Reforms Affect Travel and Accommodation for Treatment
If you’re one of the 33% of Australians living in a regional area1, you may be wondering how the recent changes to private health insurance may affect you.
When you live in regional Australia, it’s possible that you may need to travel to a metropolitan area for some health services that aren’t available locally. These changes mean that you may be covered for travel and accommodation costs if you stay in hospital for a medical procedure.
Travel and accommodation for hospital stays
Previous legislation allowed insurers to provide travel and accommodation cover as part of extras/ancillary policies, which can also include dental, optical, physiotherapy, chiropractic, and other services. From 1 April 2019, insurers will also be able to offer cover for travel and accommodation for in-hospital treatments, as part of hospital cover rather than extras/ancillary cover)2.
Do insurers have to provide travel and accommodation cover to regional Australians?
No, it’s not mandatory for insurers to provide these benefits. That’s why, if this is something which may be of value to you, it’s a good idea to shop around and find the right insurer who will be introducing these features.
Do most insurers offer this kind of cover?
According to the Australian Government’s Department of Health, only half of all private health insurers offer benefits for travel and accommodation for members who need to travel for a stay in hospital (as part of extras cover)2. Generally, only the top levels of extras cover offer travel and accommodation cover.
What kind of travel and accommodation costs will be covered?
This can vary between insurers. Generally, you may be covered for some or part of the cost if you need to travel for medical hospital treatment. The benefits are designed to help reduce your costs if you need to travel for medical reasons.
Therefore, accommodation, petrol, public transport, or flight costs may be totally or partially covered. Insurers typically have criteria about when they will cover travel and accommodation costs including:
- Whether the in-hospital patient treatment is medically necessary
- If the treatment is not available locally
- Limits on the distance travelled that will be covered, usually up to 200km
What exclusions apply to travel and accommodation cover for regional Australians?
Benefits vary around accommodation, some funds will cover a hotel stay before and after treatment, and others will only provide cover for a hotel stay on the day a patient is released from hospital.
Who is covered:
Typically, only the patient is covered, so if you have a friend or relative staying with you to help your recovery, their travel and accommodation costs may not be covered. However, in ‘life or death’ situations some insurers provide cover for the patient’s next of kin to travel with them.
What is covered:
Because funds only cover medically necessary surgeries, cosmetic treatments such as breast augmentation (except after a mastectomy) are not covered. Also, laser eye surgery, dermabrasion, and eyelid reduction surgery is considered optional surgery and is generally not covered.
Typically, health insurers will cap the total amount of rebates they will pay in relation to travel and accommodation expenses. For example, an insurer might give you a certain amount of money per day to cover costs, capped at a maximum amount.
Most funds provide travel and accommodation cover for parents travelling with children under the age of twelve, though limits and exclusions do apply.
Who will benefit from these health insurance reforms?
If you live in a regional area of Australia, you may need to travel to access health care at some point in your life. These reforms make it more affordable for Australians living in rural areas to cover the costs of medically necessary hospital treatment. More broadly, providing quality healthcare to regional Australians is an important priority for the Australian Government.
How can I find out which insurers will be offering these travel and accommodation benefits?
Because the changes don’t come in to effect until April 2019, there is still some time to wait until you’ll be able to access these features. If your insurer chooses not to provide these features (as they are not mandatory), it could be a good opportunity to compare policies and providers, and see if you can get a better deal.
How will this make private health insurance premiums cheaper?
According to the Australian Government Department of Health, the priority for this reform is to make private health insurance more valuable for Australians living in regional areas2.
Other reforms, such as increasing excesses, discounts for younger Australians and a $1.1 billion reduction in prostheses costs, may help make private health insurance more affordable for all Australians3.
Want to learn more about finding the right health insurance for you?
When it comes to health insurance, at iSelect we try to take the confusing and make it simple. Finding the right private health policy doesn’t have to be overwhelming, and with iSelect you can easily compare plans side by side, and select the right one for your needs and budget.
Start comparing plans online today, or call us on 13 19 20.
iSelect does not compare all providers or policies in the market. Not all policies are available at all times.