Private health insurance reforms
Understanding reforms
In 2019, the Australian Government introduced a range of reforms for the private health insurance industry with the aim of making health insurance simpler and more affordable.
These reforms were designed to:
Choose a higher level of excess to make your premium more affordable
Enhance the visibility of out-of-pocket costs for members
Make private health insurance easier for Australians to understand
Introducing new product tiers and clinical categories
Two of the reforms impact the services that hospital cover includes and how this information is presented to members.
- Product Tiers
- Clinical Definitions
Product Tiers
The first reform introduces mandatory product tiers for hospital cover. Private health insurers must ensure their hospital policies fall into one of four tiers: Gold, Silver, Bronze or Basic. Below you will see an example of GU Health’s product tier stamping.
Each product tier has a minimum list of services that must be included. This reform is designed to reduce the confusion members may face when choosing a cover and when they wish to compare that cover to other covers.
Product Tiers
The first reform introduces mandatory product tiers for hospital cover. Private health insurers must ensure their hospital policies fall into one of four tiers: Gold, Silver, Bronze or Basic. Below you will see an example of GU Health’s product tier stamping.
Each product tier has a minimum list of services that must be included. This reform is designed to reduce the confusion members may face when choosing a cover and when they wish to compare that cover to other covers.
Changing coverage for some natural therapies
Following a review that found that there was no clear evidence demonstrating the efficacy of certain natural therapies, the Australian Government made the decision that the Private Health Insurance rebate will no longer apply to 16 services previously covered within the natural therapies/health management categories.
Information provision
This reform gives health funds the flexibility to provide product information to members in a variety of formats so that the member is able to select how they want to receive it.
Making your cover easier to understand
As a result of the hospital product categorisation reform (Basic, Bronze, Silver, Gold), consumers will benefit from a consistent approach across the health insurance industry. Included and excluded benefits will also be communicated in the same way with new clinical categories, helping members understand what they are covered for.
Consistent experience for all GU Health members
GU Health has adopted the same approach for our Overseas Visitors Covers to ensure a consistent experience for all our members, especially when transitioning to a resident cover.