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Curious About How Your Health Fund Performs?

With the deadline fast approaching, the Private Health Insurance Ombudsman (PHIO) will be finalising the ‘report cards’ of over 35 registered health insurance providers which will be released at the end of March 2010.

The fifth annual State of Health Fund Report will provide information on private health insurance performance and service of delivery, comparative to industry results.

Coverage per state is a key performance indicator for the report. It will show the scope of your health fund from 1 July 2008 – 30 June 2009, in the following categories:

  • Percentage of Hospital Related Charges Covers
  • Percentage of Medical Services with No Gaps
  • Percentage of Medical Services with No or Known Gaps
  • Percentage of Extra Treatment Covered
  • Number of Private Hospital Agreements
  • Number of Day Hospital Agreements

In addition to coverage, the report also investigates the percentage of health fund’s management expenses as well as their share of complaints on benefits and services lodged with the PHIO.

For existing consumers, this report is a valuable resource for reviewing current health cover policies and make decisions about future membership.

For new consumers, it will give an overview of the different services available from individual Australian private health insurers and how they fared during the last financial year.

Will it provide you with the best overall fund? No but it does provide you with a list of factors that may be important in your decision to take out health insurance.

The best cover is one that caters to your budget, needs, wants and circumstance. As Acting Ombudsman Samantha Gavel recommends, health funds must be reviewed year on year. Use this time to figure out what factors are important to you and whether your health fund is still able to meet your changing needs for the coming year.