Members Own health funds

Members Own refers to a group of not-for-profit health funds, including both open health funds and some restricted health funds, dedicated to reinvesting profits back in its membership. What this means is that Members Own branded organisations pay a larger proportion of premiums back to members in the form of benefits and claims paid.

What's the difference between for-profit funds and not-for-profit funds?

• For-profit funds. While all health funds are obligated to remain financially viable so they can honour claims made by customers, this fund type also needs to deliver profits to the business owners, which may include another health fund or overseas corporation.
• Not-for-profit funds. Like the name suggests, these funds transfer a larger share of the profits to members and are also required to maintain transparency so everyone can see where the money goes. This fund type is typically able to offer lower premiums or additional benefits to members as a result.

How well do Members Own health funds perform?

According to data from the Private Health Insurance Ombudsman, the Australian Prudential Regulation Authority (APRA) and the Private Health Insurance Administration Council (PHIAC), on average Members Own health funds give more back to their members than the major commercial health funds in relation to premiums paid. However, the benefits of Members Own health funds might be even better evidenced by the lower rate of complaints and a higher retention rate, suggesting that they might do a better job of satisfying customers with both price and service.

Members own funds vs commercial funds

• Plain text version: Members own funds vs major commercial funds

  Performance statistic	Members Own funds	Major commercial funds
  Benefits paid to members relative to premiums	86.8%	84.6%
  Percentage of member complaints	10.5%	63.2%
  Member retention rate	86.8%	83.9%

Which health funds are Members Own or not-for-profit?

There are 19 participating Members Own health funds in Australia. Many are restricted to certain occupations or groups, and their families, while others are open to all Australians. In addition, there are also nine not-for-profit funds that exist outside of the Members Own network. You can learn more about all of them by making a selection below:

• Members Own funds
• Not-for-profit funds

• What are restricted funds?

  Restricted funds limit membership to certain occupations or industry groups, such as teachers or former members of the Australian Defence Force. In most cases, the family of eligible persons are also able to join.

Are not-for-profit health funds better?

The ideal health fund is one that can deliver the right benefits and the right value. Because all health funds are different it can be worth comparing all the options, both commercial and not, and nonprofits within and without the Members Own network. Commercial health funds, for example, will often be larger than the non-profits, and able to deliver a scale that non-profits might not. For example, a frequent traveller might benefit from the larger private hospital networks maintained by commercial health funds.

Picture: Shutterstock