Getting the Most out of Your Private Health Insurance

Let’s face it: private health insurance isn’t cheap. At the same time, depending on government health services limits your choices and although there are many excellent doctors in public hospitals, you may not always have access to immediate care. How can we make sure that we get the best possible value from that expensive private insurance?

What Does the Health Plan Offer and What Does it Exclude?

Health insurance plans are not created equal. You need to take an in-depth look at what your insurance plan offers. Make sure that you know what exclusions and benefit limitations are applicable to your insurance plan so that you don’t end up getting a nasty surprise when you have to pay all or part of the bill for certain procedures!

For example, some plans don’t even offer cover for cardiac care or dialysis. Make sure that your broker gives you a full list of what is covered, to what extent it is covered and what is excluded. Getting a bit of professional advice from someone who isn’t trying to sell you insurance can be helpful!

The ombudsman regularly gets complaints from people who thought they were covered only to discover that their insurance plan doesn’t cover the procedure that they need. That comes from not reading the fine print! Even if you read everything through, you might miss something since buying health insurance isn’t something you do every day. Getting advice from someone who understands medical insurance is important.

Common areas that are excluded in many plans are dentistry, psychology and alternative medicine. Consumers should also check for items such as ambulance cover, hearing aids, joint replacement surgery and blood glucose monitors. You might be young and in excellent health, but your insurance plan must cover as many eventualities as possible.

A lot of insurers keep premiums down with partial coverage, co-payments or coverage up to a certain limit. Be sure that you know what these limitations will mean to you in the event of a medical emergency or chronic illness

Where Are You Covered?

Some health insurance plans cover you if you are in a certain geographical area only. If you don’t travel around much, that can be an advantage in cost-savings, but if you’re always on the road, it might not work for you. Check if your health insurance provider has entered into agreements with specific service providers and if this translates into better coverage for you. It often does and it’s good to know you can get higher pay outs depending on the health care provider you choose.

Check Out Gap Cover

Most medical funds will only cover expenses up to a certain point. What should you do about the ‘gap’ between what you’re insured for and what your problem ends up costing? Make sure you investigate the option of taking out gap cover in order to limit your out of pocket medical expenses especially since these could be substantial depending on the nature of your health issue.

Got Extras – Use Them!

Many people with extras on their health insurance policy are often unaware of the services they have access to. They may also be unaware that if you don’t use the allocated rebate for those extras each year, they don’t roll over to the next. This really is a case of use it or lose it! Some savvy individuals determine what they are entitled to receive back from their health fund for services such as acupuncture, naturopathy and massage at the start of each year and then plan to use as much of their plan as possible. This is actually a great idea, you might discover that you can have a massage every month throughout the year and receive a rebate from your fund. That is, of course, provided that the therapist is acutally registered with your health fund! You can check out the list of health funds Body Kneads Massage works with here.

Don’t Just Do Your Homework Once

You should check out your health insurance every year in order to see if it’s still right for you and if you can’t get better cover or additional features from other insurers. That means getting the list of benefits every year and checking it against other offerings on the market.