Will your Australian health fund cover your overseas medical costs? Read on to find out.
Australian private health funds offer Australia-wide cover for a wide range of medical, hospital and healthcare expenses, but what about medical costs incurred overseas? For example, will your health insurance provide cover if you’re involved in an accident and suffer a serious injury while on holiday or if you’re planning a trip overseas to go under the knife for cosmetic surgery?
The answer is no. Health insurance does not cover overseas medical expenses, but there are some other cover options available to help you pay your doctor’s bills.
Does health insurance cover you overseas?
No. Australian private health funds only provide cover for medical and hospital expenses you incur in Australia. Private health insurance hospital cover can provide benefits for any medical service listed on the Medicare Benefits Schedule (MBS), but Medicare only provides cover for medical expenses incurred in Australia, not overseas.
The medical tourism industry is on the rise, with around 15,000 Australians heading overseas each year for a range of treatments from cosmetic surgery and breast implants to dental treatment and weight loss procedures.
And while the reasons are the same (much cheaper than Australia) and the risks are still there (hundreds of botched procedures every year), what’s now changed is that some Australian health insurers are getting onboard.
Does health insurance cover overseas cosmetic surgery?
The practice of going overseas for cosmetic surgery commonly referred to as medical tourism, is on the rise in Australia. However, health insurance doesn’t cover overseas cosmetic surgery costs for a couple of reasons.
The first reason is that Australian private health insurance will only cover you in Australia. The second reason is that health insurance only covers services for which Medicare pays a benefit, and Medicare doesn’t pay any benefits for surgery conducted for purely cosmetic purposes. So if you’re planning on going overseas to go under the knife, don’t expect your health fund to cover the costs.
What are your options for getting treatment abroad?
If you want to have an elective surgical procedure overseas, you can forget about looking to your health fund to pick up the tab. Firstly, they will only cover medical treatment performed in Australia and secondly, if it is a procedure such as a facelift or a tummy tuck, cosmetic surgery is not covered by health insurance either here or overseas.
Which leaves you with one of two options:
- Purchase a service such as the new NIB Options or visit a medical tourism travel agency and have your whole trip organised for you, from the surgical procedure to your flights and accommodation.
- Organise your overseas treatment yourself and insure it with specialised cover from a policy extension such as that provided by Go Dental.
How does NIB Options work?
NIB Options is not health insurance as such, but more of a fee-for-service offering. It provides those wishing to undertake cosmetic and dental procedures either in Australia or overseas with a safer and cheaper way of doing it.
In Australia, NIB recommends members of the Australian Society of Plastic Surgeons with a minimum of 12 years medical and surgical education and overseas registered, certified surgeons with at least five years postgraduate training and 12 years medical and surgical education.
NIB’s service covers every stage of the process from initial consultation through to travel arrangements, accommodation, the actual surgery and aftercare. And if patients suffer any complications they can have it dealt with in Australia at no extra cost for up to one year.
If you plan to organise your overseas procedure yourself, the Go Dental Tourism policy extension can be added to your Basic or Go Plus travel insurance. It includes cover for:
- Trip cancellation. Covers any costs incurred if you are forced to cancel or reschedule your trip due to circumstances beyond your control.
- Emergency overseas dental treatment. Covers the cost of any overseas emergency treatment for complications after your procedure.
- Additional transport and accommodation. Covers any additional transport and accommodation costs you incur if your complications prevent you from returning home immediately.
- Return travel and accommodation for remedial dental treatment. Covers the cost of returning overseas if your procedure is unsuccessful and you require remedial treatment.
Unfortunately, the vast majority of travel insurers will not provide any cover for elective cosmetic surgery overseas, as travel insurance typically only covers the unexpected medical expenses you incur while abroad. However, Go Insurance does offer a Dental Tourism Insurance policy, which covers trip cancellation costs, emergency dental expenses if there are any complications with your procedure, and additional transport and accommodation costs if complications mean you need to stay overseas longer than originally planned.
Travel insurance is the first port of call when looking for protection against the cost of overseas medical expenses. Travel insurance policies provide cover for emergency hospital and medical expenses you may incur while overseas, including things like hospital accommodation, surgical fees and even ambulance transport. Emergency dental costs are typically included as well. Travel insurance can also cover additional accommodation and travel costs that arise if you have to remain overseas for longer than planned due to medical reasons.
Many countries require you to take out an adequate level of medical travel insurance cover before you can gain visa approval, so it’s essential that you consider your cover needs before you go overseas.
Reciprocal Health Care Agreements (RHCAs)
The Australian Government has RHCAs in place with the governments of 11 other countries around the world. Under these agreements, Australian citizens visiting those countries can receive subsidised access to essential health care.
Australia has RHCAs in place with the following countries:
- The United Kingdom
- The Republic of Ireland
- The Netherlands
- New Zealand
Medical treatment overseas program
The Medical Treatment Overseas Program is an Australian Government program that offers financial assistance to Australians who suffer serious medical conditions and need to seek life-saving treatment overseas. As well as your overseas medical expenses, the program can cover travel and accommodation costs for you and a carer, travel insurance, and passport and visa costs.
You’ll need to satisfy a range of criteria in order to qualify for financial support under the program. For example, the medical treatment must not be available in Australia, and it must be deemed by the Department of Health to be “significantly life-extending and potentially curative”. Our guide to the Medical Treatment Overseas Program contains everything you need to know about accessing this potentially life-saving funding.
How can I pay for the procedure?
Around 15,000 Australians head abroad each year for medical treatments including cosmetic surgery, dentistry, reproductive and gender reassignment. In fact, in 2017 WorldFirst saw an increase of 22% in Aussie Dollars flowing to key medical tourism destinations in 2017 such as Malaysia, Thailand and the US.
If you use a service such as NIB Options, then you will pay an upfront fee which will include all of your costs. If you opt to go it alone, then be sure to factor in all the additional costs you will be liable for over and above your actual procedure and the cost of your holiday.
These can include pre and post-op consultation fees, lab work, medications, anaesthesia and aftercare, facility and surgeon fees.
You may need to pay many of these fees upfront, depending on the facility you are having your procedure at, so you will need to have some way of paying in local currency when the fee is requested.
Online money transfer and exchange services such as OFX or WorldFirst are one way to do this and give you the option of choosing a spot contract which allows you to make a payment now at the current conversion rate or a forward contract which lets you pay at some time in the future when the conversion rate is more favourable.