Painful cost fear if funds rejig cover

SUE DUNLEVY My HEALTH fund members could have to pay hundreds more to remain covered for heart attack, joint replacement, dialysis and cataract surgery under government reforms.

These conditions would only be covered under top-level gold policies under moves to simplify the system into gold, silver, bronze and basic policy bands from April 1, 2019.

Under silver policies, health funds would be able to exclude cover for 12 of 32 current key treatment areas, the health department website reveals.

These include heart and vascular conditions, cataract surgery, pregnancy, IVF, joint replacements, kidney dialysis, hearing surgery, weight-loss surgery, insulin pumps and sleep studies.

Patients who want to be covered for these will have to take out the top gold cover, which could cost up to an extra $300-$500 a year – for things this Wednesday, March 21.

The photographic feature provides a special keepsake for family, friends and the Prep students themselves to look back on fondly for years to come.

Don’t miss Wednesday’s Cairns Post for your copy of My First Year. they are covered for under the existing system.

Bronze cover would be able to exclude 22 of the 32 treatment categories and would only have to include cover for rehabilitation, mental health, drug and alcohol services, palliative care, brain procedures, broken bones, ear nose and throat, colonoscopies and chemotherapy or radiotherapy.

Analysis has found the most common policies pitched at families already have major exclusions and ban cover for cataract surgery, hip and knee replacements, dialysis, palliative care and psychiatry. Despite this families still pay $5400 to $5600 – and when combined with extras cover these limited hospital policies cost families almost $7400.

Australian Medical Association head Dr Michael Gannon said it was “clawing away at the value of health insurance”.

Medical Technology Association of Australia CEO Ian Burgess was concerned the proposal would reduce patient access to medical technology.

“These services already have extensive waiting lists in the public system and limiting them to gold cover will only exacerbate this problem,” he said.

Health fund membership is falling as premium rises continue to outstrip inflation. Families face an average 3.9 per cent premium increase from April 1.

Health Minister Greg Hunt said the Government’s reforms had just delivered the lowest premium change in 17 years and the new bands would give greater certainty to consumers.

“No final decision has been taken on what services will be included in each category,” his spokesman said.