Rural and regional health insurance

How can Aussies in the country benefit from having private health insurance?

Health insurance for Aussies in rural and regional areas has always been a tough sell. Of the approximately 2.8 million Australians that call regional and rural Australia home, less than half (1.3 million) have health insurance.

And those figures have their own geographical divide, between those in inner regional areas and those living in outer regional or remote communities. About 50.1% of those in the more populated inner regional areas have health insurance, which walls to around 47.7% for those further out. By comparison, 53.9% of the population had some form of health insurance as of 31 December 2018.

In order to provide rural members with more value, the Australian Government announced that as part of its range of reforms, health funds can now offer travel and accommodation benefits as part of their hospital policies.

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What are travel and accommodation benefits?

Basically, travel and accommodation benefits allow you to claim a certain amount towards the cost of you having to travel to and from the hospital. This means that in addition to claiming for your treatment while in hospital, those living in remote and rural areas can recoup some of their costs towards travelling for treatment.

The type of costs you'll have covered generally include a dollar amount per kilometre travelled and a per night dollar amount for your accommodation. For example, all eligible HCF policies provide:

  • Travel benefit: 30c per kilometre travelled in a round trip
  • Accommodation benefit: Accommodation is capped at $50 per night, including the night before and after admission

Best of all, you can claim these benefits for both yourself and your carer.

How do you claim these benefits?

To be eligible to claim these benefits, members will need to:

  • Serve the waiting period
  • Have a policy that provides this benefit
  • Be travelling for a hospital treatment covered by your policy
  • Travel more than 200km for your treatment

You'll also need to make sure you keep all your receipts to submit along with your claim. Other info you'll need to provide includes petrol receipts, documentation supporting the necessity of your admission and the dates of your treatment.

What about non-hospital treatments?

Well, this will depend on your policy. If you're travelling for an appointment with a medical specialist and only have travel and accommodation benefits through your hospital policy then you won't be able to claim.

However, if your travel and accommodation benefit is provided through your general (extras) policy, you will be able to claim.

Why were these reforms needed?

Prior to the health insurance reforms, health funds offered travel and accommodation benefits only through their general (extras) policies. What this would mean was that in effect those living in rural and regional areas would need to take out both hospital and extras policies, with neither returning much value because of where they live.

By allowing funds to offer these benefits through their hospital options, it should at least ease the burden on those wanting cover for travel and accommodation benefits without the need to take out an extras policy that doesn't provide them with cover for many services in their immediate area.

How else can regional Australians benefit from health insurance?

In addition to travel and accommodation benefits, Aussies living in the country may be able to benefit from cover from health funds that offer telehealth benefits. Basically, telehealth services allow clinicians to visit with patients face-to-face through video conferencing services.

While these services have been popular in the US for some time, they're starting to find their feet in Australia, with some of the bigger health funds including Bupa, Medibank and HCF all exploring the space.

You also might want to look for a health fund that has agreement hospitals or dental facilities that are in your immediate area. While you're at it, if it'd make you feel more at ease you could even look for a fund that is used to looking after people from your region such as Queensland Country Health Fund or Cessnock District Health Fund.

Bottom line

Of course, members living outside of major metros can benefit from a range of services covered by health funds such as dental, hospital and optical. However, if you do live in a regional or remote area and are worried about the value provided by your health fund, be sure to check:

  • If they offer benefits for travel and accommodation services
  • If that cover is provided as part of their hospital or extras policy
  • If they offer telehealth services
  • If they have agreement hospitals or dental facilities in your area

Picture: GettyImages

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