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Not-for-profit health funds

Where to find not-for-profit health funds in Australia

In a recent finder.com.au survey, participants were asked if they would be more likely to choose a not-for-profit health insurer over a for-profit one. Not surprisingly 36.4% said yes, but more interestingly, 27.4% said they didn’t know there were not-for-profit health insurers out there.

So with such a large percentage of people unaware of their existence, we thought we’d provide a brief rundown on not-for-profit health funds in Australia.

What are not-for-profit health funds?

A not-for-profit health fund is a health insurer whose premiums are paid back into the fund solely for the continued running of the business and to pay benefits to its members.

This is unlike a for-profit health fund, which is owned by outside interests and makes a profit out of members’ premiums to provide a return to its owners and/or shareholders.

A not-for-profit health fund can be open to anyone to join or it can be a restricted fund where members and their families must be aligned with a particular employment group or professional association.

List of not-for-profit health insurers

According to privatehealth.gov.au, these funds report as a mutual organisation that operates on a not-for-profit basis:

The list of restricted not-for-profit funds which limit membership to certain groups includes:

Note: Doctors' Health is a for-profit fund that is owned by the Avant Mutual Group, a group that operates on a not-for-profit basis.

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Source: http://www.ombudsman.gov.au/publications/state-of-the-health-funds-report/2017-state-of-the-health-funds-report#sec6

What are the differences?

There are several differences between not-for-profit and for-profit health funds.

  • They have different business structures – a not-for-profit is a mutual organisation, while a for-profit is often a corporation with owners and shareholders.
  • Not-for-profit funds generally have lower premiums – because they exist solely to benefit members, they return a higher percentage of funds to their members in the form of cheaper premiums.
  • Not-for-profit funds often have better benefits – because all monies are returned to the fund, any surplus is spent on improving member benefits.
  • Not-for-profit funds can have more flexible terms – conditions such as excesses, waiting periods and pre-existing conditions are sometimes reduced or waived altogether.

Is a not-for-profit fund right for you?

Before you rush out and look for a not-for-profit health fund to join, you should keep the following things in mind:

  • While most restricted funds are open to family members, this may be limited to immediate family only (ie, spouse and dependent children).
  • Previous employment in an industry can go back a number of years, so you may be eligible to join a restricted fund even if you haven’t worked in an industry for some time.
  • Membership of a restricted health fund can sometimes also give you access to other member benefits like industry super and life insurance.
  • Cheaper premiums should only be one consideration when looking at not-for-profit health funds. You also need to ensure the level of cover on offer is adequate for your needs.

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