Picking Private Health Insurance

People often ask us, what’s the best health insurance to get? Who is the best private health insurer? The answer is not simple or the same for every person.


The Australian Dental Association has been investigating private health insurance and has played a large role in the recent Senate Inquiry into private health insurance. Private health insurance premiums have increased much higher than the health CPI and rebates have not kept up.


““There is little evidence that consumers are getting adequate value for money when it comes to their private health insurance, yet taxpayers’ funds are underwriting the industry to the sum of $6 billion per annum in the form of the private health insurance rebate”, said Dr Hugo Sachs, ADA President.”


Even with the industry subsidy provided by the Australian Government, individuals are paying more out of pocket for dental health each year, to the tune of almost 60% annually according to the Health Expenditure reports released by the Australian Institute of Health and Welfare. Over the same period of time, the overall contribution by private health insurers to dental services has only increased from 14% to 18%.” ADA

So what should think about when considering private health insurance?


The insurer:


Not for profit funds vs for profit funds

Generally a not-for-profit health fund will offer better cover and the ability to choose your provider without preferential rebates.

Ability to choose your health provider

Many of the large insurance companies are opening their own practices as well as entering into agreements with dentists. This has been found to be inequitable and discriminatory as well as disruptive to the patient-dentist relationship. At Jamestown Dental we feel it is important for you to be able to choose your dentist and dental specialist without bias from health funds.


The Policy:


Do I need extras?

“Extras” cover includes dental services, physiotherapy, podiatry, optometry etc. Unless you use all these benefits regularly you may find that on average the rebate you receive back from your fund doesn’t add up to the cost of your cover and you may be better off simply putting money aside for these treatments. However you should consider your individual circumstances and if anything is likely to change for you in the near future. It is interesting to note that most Health Funds make the most profit for their extras policy holders.

What is covered?

Just because you have “dental cover” doesn’t mean that all treatments will be covered. Look into the fine print of what your cover will actually cover you for, some cover excludes dental procedures such as root canals, crowns, implants, dentures, periodontal treatment (gum disease treatment) etc. And even basic cover can vary from cover to cover, how many check-ups are included each year? Are x-rays covered? How many cleans are covered per year? Many covers also have limits and restrictions on these items.


So how do you pick a policy. Try looking at the private health insurance ombudsman website privatehealth.gov.au for a good place to start looking at different health funds and what their offer. The ADA has a great website Time2Switch with lots more information about private health insurance and a quick check system for your current health insurance. Check it out at this link: https://www.ada.org.au/time2switch/Home


And remember to check the fine print on your cover about any restrictions or waiting periods that may apply so you aren’t caught out with any surprises.


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Jamestown SA

08 8664 1204

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