Health funds are charging more for Silver policies than for Gold. Picture supplied.
Health funds are charging more for Silver policies than for Gold. Picture supplied.

Is your health insurance ripping you off?

Health fund members are being charged up to $1,700 a year more for second-rate Silver policies than for top cover Gold products in a newly uncovered scam.

Consumer group Choice has identified 215 Silver policies - which exclude cover for care like pregnancy and joint replacements - where the premiums are higher than for Gold policies, which cover all categories of hospital care.

"The worst offender nationally is Frank (GMHBA) Health Insurance with the most expensive Silver Plus policy (Their "Top Hospital" cover) in every state and territory," the consumer group says.

 

 

 

Frank's Silver Plus policy exempts cover for insulin pumps, weight loss surgery and pain management devices but is more expensive than some Gold policies covering everything.

Major health insurers such as Medibank, Bupa, HCF, HBF and NIB are also engaged in the scam of charging more for Silver care than for Gold cover, Choice said.

The Silver policy scams follow the introduction of the government's new Basic, Bronze, Silver and Gold system in April this year that was meant to simplify the job of comparing health funds.

As private health insurance membership plunges, Choice is calling for the government to hold a Productivity Commission inquiry into the industry, claiming it has lost the trust of the public.

 

 

Silver products can exclude knee surgery Picture: istock
Silver products can exclude knee surgery Picture: istock

The Choice comparison included single policies with a $750 excess, but families and couples can use the comparison table by simply doubling the single premiums.

Choice found the cheapest Gold Cover health fund policy in ACT, NSW, Queensland, Tasmania and Victoria was provided by Mildura Health Fund and cost $182 per month.

In South Australia, the cheapest Gold policy cost $180 per month; in the Northern Territory $99 per month and in Western Australia $163 per month.

In NSW and the ACT, Choice found 32 Silver and Silver Plus policies that were more expensive than the cheapest Gold policy.

The worst offenders included Frank's Top Hospital (Silver+), Australian Unity's Advanced Hospital (Silver Plus), RACQ's (MyOwn) Silver Plus Premium.

Health funds are charging more for Silver policies than for Gold.
Health funds are charging more for Silver policies than for Gold.

Health fund members who switched from these Silver products to Gold could save up to $725 on their premiums every year and be covered for more procedures.

In Victoria, Choice found 34 Silver policies that were more expensive than the cheapest Gold cover. The worst offenders were Frank's Top Hospital (Silver+), Australian Unity's Advanced Hospital (Silver Plus), CUA's Premium Non-Obstetrics (Silver Plus).

Health fund members who switched from these Silver products to Gold could save up to $927 on their premiums every year and be covered for more procedures.

As private health insurance membership plunges, Choice is calling for the government to hold a Productivity Commission inquiry into the industry.
As private health insurance membership plunges, Choice is calling for the government to hold a Productivity Commission inquiry into the industry.

In Queensland, Choice found 33 Silver policies more expensive than the cheapest Gold policy. The worst offenders were Frank's Top Hospital (Silver+), Australian Unity's Advanced Hospital (Silver Plus), RACQ's (MyOwn) Silver Plus Premium Hospital.

Health fund members who switched from these Silver products to Gold could save up to $834 a year on their premiums every year and be covered for more procedures.

In South Australia, Choice found 22 Silver policies that were more expensive than the cheapest Gold policy.

The worst offenders were Frank's Top Hospital (Silver+), Australian Unity's Advanced Hospital (Silver Plus), RACQ's (MyOwn) - Silver Plus Premium Hospital.

Health fund members who switched from these Silver products to Gold could save up to $831 a year on their premiums every year and be covered for more procedures.

In Tasmania, Choice found 30 Silver policies that were more expensive than the cheapest Gold policy. The worst offenders were Frank's Top Hospital (Silver+), Australian Unity's Advanced Hospital (Silver Plus), RACQ's (MyOwn) Silver Plus Premium Hospital.

 

Obstetrics can be excluded from silver policies.
Obstetrics can be excluded from silver policies.

Health fund members who switched from these Silver products to Gold could save up to $931 a year on their premiums every year and be covered for more procedures.

In the Northern Territory, Choice found 40 policies more expensive than the cheapest Gold policy. The worst offenders were Frank's Top Hospital (Silver+), TUH's Silver + Family Hospital, Latrobe's SilverPlus Hospital.

Health fund members who switched from these Silver products to Gold could save up to $1723 a year on their premiums every year and be covered for more procedures.

Choice's health campaign manager Dean Price said it was "outrageous" that funds were charging people more money for less cover.

"People already find health insurance high cost and low value. This investigation uncovers more reasons why people don't trust the companies offering these expensive policies," he said.

Choice say it’s outrageous that people are being charged more for less cover. Picture: istock
Choice say it’s outrageous that people are being charged more for less cover. Picture: istock

Choice said its investigation shows how the health insurance industry is profiting from the confusion the new Basic, Bronze, Silver and Gold system created.

Under the changes Gold policies must cover all 38 categories of hospital procedures while Silver policies can exempt up to nine types of procedures.

Procedures that can be excluded from Silver policies include cataract surgery, joint replacements, dialysis for kidney failure, pregnancy and birth, IVF, weight loss surgery, insulin pumps, pain management and sleep studies.

Private Healthcare Australia chief Dr Rachel David said the fact Choice had been able to produce the comparison table showed the new Gold, Silver and Bronze and Basic system was working.

"People have a clearer idea about what is covered and they are better able to compare," she said,

Previously different health funds had seven different names for weight loss surgery and they had various names such as premium or premier or top for their most extensive coverage, she said.

Choice members can find the best values health fund products by visiting their website.


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