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2019 health insurance reforms: Improving access to information about health insurance

A series of upgrades have improved access to information, making it easier to understand your level of cover.

Have you ever been unsure about what you are or aren't covered for? If you've ever found your private health insurance (PHI) policy confusing or complicated, you're not alone.

As part of a series of wide-ranging reforms, the Australian government has taken steps to make PHI simpler and easier to understand. The steps taken include making upgrades to the private health website, providing you with a new Private Health Information Statement and making product data publicly available.

What do the upgrades involve?

The government has launched a series of changes providing you with better access to information, making it easier to compare and understand both your hospital and general policy cover. These changes include:

  • Comparing products has become easier with the redesign of the Private Health Insurance Ombudsman (PHIO) website.
  • The old Standard Information Statements (SIS) has been replaced with a new, single info sheet called a Private Health Information Statement (PHIS).
  • Insurers must provide you with the following information, on request, rather than in annual statements:
    • A tax statement with details about your PHI rebate.
    • A Lifetime Health Cover Statement.
  • If you have Lifetime Health Cover, insurance providers are required to inform you at least once a year of how long your loading period will continue to apply.
  • Data about health insurance products are publicly available on the Private Health Insurance Ombudsman (PHIO) website and in downloadable format.
  • Information is available for you to access in a number of different ways. This means that consumer information can be provided via email, hyperlink or post, as long as it's provided according to regulated time frames.

How will these information upgrades make a difference to you?

In the past, there has been a lack of clear and concise information available to us. The changes that have been put into place are consumer-orientated. That means they'll primarily benefit you, while putting more pressure on insurance providers to provide clear and accessible information. They won't alter or affect your policy; the changes are simply about making things clearer and easier to understand.

Sometimes it's good to have some impartial help. That's what the improved private health website is all about. It cuts out the confusing jargon insurers sometimes use and helps answer those frequently asked questions you're struggling to get help with elsewhere. The website helps you decide which PHI products suit your health needs by making it easier to compare multiple products.

Everyone likes to get their information in different ways, be it by post or email. The changes let you choose how you receive information on your insurance. With policyholders ranging from teenagers to the elderly, this is a really important step towards making things simpler for us as customers.

Are there be any costs to you?

Although there's no direct financial benefit to these changes, they are among the ones most likely to help you keep money in your wallet. That's because they're providing customers with so much more assistance, making it easier for you to shop around and find the best possible coverage. Importantly, it'll stop your chances of misreading your policy or failing to know what you are and aren't covered for.

Why has it changed?

A major concern for you as a consumer relates to a poor understanding of PHI products, according to consultations conducted by the Department of Health.

Similarly, over 13 million Australians have PHI. This includes people from all walks of life, young and old. The previous set-up didn't adequately tailor insurance information to your needs or take into account the diversity of its consumers.

The changes provide people with simple and understandable information and give it to them the way they want it, not the way the insurer has decided to provide it.

When's it changing?

All of the changes regarding access to information are already in effect. However, insurers have until 2020 to rework their policies according to other regulations set out in the reforms. That means the number of policies you can compare on the PHIO will continue to increase as insurers roll out new policies.

What else is changing?

As well as these upgrades, the reforms include:

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