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Private Health Insurance Premiums Up Again On April 1st.

29 March 2016

Now really…. What the heck is going on?????

The government has just approved another round of Private Health Insurance (PHI) premium increases. Depending on the fund, some are going up by 5 – 10%, the average increase being well over 5%. This represents 3 – 5 time the rate of inflation.

What is not going to happen and I can assure you is that rebates will not increase by the same amount…. Actually they are unlikely to go up at all.

How can I be so sure? Because the government has approved premium increases almost every year and to date I can’t remember rebate increases anything like the premium increases.

So why do we have health insurance premium increases?

It’s got nothing to do with the cost of glasses going up, or orthodontics treatment fee increasing, or even the costs of a crown on a tooth going up or physiotherapist fees rising.


Don’t ever think different….even the so called ‘not for profit’ funds are putting their fees up!!!!

So the Modus Operandi of the PHI’s is to charge higher premiums, give you back less when you claim…. Then tell you that you should see “one of OUR dentists” or “one of OUR optometrist” if you want a better rebate.

What ever happened to freedom of choice when it comes to seeing a health professional.

Who are the dentists, optometrists, podiatrists, physios etc. that are working for PHI????

These are hardworking health professionals whose practices are struggling to attract patients. They have been squeezed so hard by the Private Health Funds and Corporate Owned Practices that the only way they can remain in business is to sign ridiculous contracts with a health fund and then charge lower fees in exchange for patient referrals…….unfortunately that’s the only way a lot of them can remain in business.

Now let’s think about this scenario. A dentist or optometrist who is struggling with his/her overheads signs a contract with a health fund. He/she is forced to reduces their fees and as a direct consequence needs to cut back on their expenses. They probably buy cheap and inferior materials and equipment in order to help maintain some of their operating margin, and then need to see more patient’s every day in order to keep their practices afloat…… to me it’s all a little scary.

It’s also important to remember that your ancillary insurance rebates are capped… at sometimes ridiculously low levels. In addition to the capping, PHI’s thru their ‘business rules’ restrict the number of services that are covered in a particular time period, so it is almost impossible for a person to get back in rebates the amount that they have paid for in their premiums. Then of course you must pay an ‘out of pocket’ balance for the service provided anyway.

THE ANSWER is simple.

Give up Private Health Ancillary Cover (keep top ‘Hospital Cover’ with the highest excess to reduce the premium)!!!!! Ancillary cover makes up the bulk of your premium and it pays you the least back, with patients almost always left with significant ‘out of pocket’ costs.

I suggest to people that they should create a ‘Self Insured’ Fund. Put the ancillary premium into a separate private bank account and use these funds to pay your health bills. I tell my patients that by doing this, a lot will have funds left at the end of the year to help with their Xmas shopping……. And BTW, I like Pinot Noir!

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