Changes To Private Health Insurance Impacts In Portland

Friday, 22 May 2015
Changes to private health insurance policies could impact on people seeking treatment at Portland District Health (PDH).

PDH CEO Chris Giles said some private health insurance companies had changed their policies, tightening what they will fund for private patients in a public hospital such as PDH.

This includes opting out of no-gap agreements with pathology providers and only funding shared room accommodation in a public hospital.

Patients insured with GMHBA and Medibank Private may now incur out-of-pocket costs for inpatient pathology tests at PDH. This means private patients insured with these funds can expect up to a $390 bill for pathology tests undertaken during a hospital stay.

Medibank Private, BUPA and NIB no longer pay the public hospital single room rate, which means people may not be eligible for a single room in a public hospital even with top hospital cover, but will= be covered for a shared room.

All funds have different rates of cover for doctor gap payments, however at PDH many local specialists do not charge any gap fees above what the health funds pay.

Ms Giles says it is vital that local residents with private health insurance are aware of what is covered to fully understand how much a hospital visit may cost and what level of room accommodation they are entitled to. People should carefully analyse their health fund policies and understand each time a fund makes a change how that might impact on their individual health care costs in the future, she said.

Insurance companies have tightened what they will and won't fund. The changes mean that some people who come to PDH for services may now have to pay a gap fee.

Ms Giles said local residents should shop around and find the insurance that suits their budget and in hospital needs. If you're not sure ring up your fund and ask or give us a call at PDH prior to admission if you can, she said.

Remember it's OK to ask, if your are not happy with the answer shop around till you find the right fund for you and your family.

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