For those unsure about Australian health insurance, the processes required to join a fund or make a claim can be overwhelming and confusing.
A lack of understanding of the complexity of products or miscommunication from providers can ultimately lead to the idea of private health insurance being abandoned altogether.
Additionally, the difficulty of choosing the right policy from the vast range of products and services available coupled with not knowing which questions to ask or information to provide to insurers may cause many Australians to prefer the risk of staying uninsured rather than potentially end up with inadequate or unsuitable cover.
So, if you're feeling overwhelmed trying to understand the private health insurance system, who can you turn to for help?
Private Health Insurance Ombudsman (PHIO)
The PHIO is an organisation formed under the Financial Management and Accountability Act 1997.
The agency's role is to protect the interests of private health insurance consumers, which it does through assisting members to resolve disputes with providers, investigating underlying problems in the health insurance system and advising consumers and government bodies on issues and methods to help improve the performance of the sector as a whole.
PHIO has also assumed a function as an advisor, providing consumers with important information and advice regarding their health insurance choices.
Health fund members are free to submit complaints to PHIO on any matter related to private health cover.
This includes complaints directed at a health fund provider, broker, hospital, medical professional or other practitioner – as long as the complaint is focused on private health insurance.
Complaints about quality of service or treatment should be directed to your local health care complaints body.
A health insurance broker is completely on the customer's side. Their role is to find the best insurance policy for each member's needs.
Working on a case by case basis, a broker will assess the customers needs and budget then compare health insurance policies and funds to source the products that best meet the member's requirements.
But they don't just help you compare cover, your broker will be your health insurance advocate to ensure your specific needs are being met.
This care continues beyond the initial sign-up. A broker should regularly monitor your private health cover to make sure it remains the most appropriate and valuable option available to you while also keeping you up to date with changes to your policy, provider and the overall health system.
If you would like to work with a reputable health insurance broker with more than 25 years experience helping Australian health fund members, speak with the team at HICA today.