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Health Funds Surplus Should Waive Harsh New-Member Rules

A $343 million surplus for the private health insurance industry should be used to waive harsh rules for new members on pre-existing illnesses, according to the AMA's Federal President, Dr Kerryn Phelps.

Dr Phelps was commenting on a report by the Private Health Insurance Administration Council showing private funds had reaped massive profits through new memberships since the introduction of government incentives - including Lifetime Health Cover and the 30% rebate.

"This is a great opportunity for the funds to sort out some of the confusion and worry about waiting periods and other membership restrictions.

"Many new members still do not understand that they face a 12-month waiting period before they are covered for any pre-existing ailments.

"This is way too harsh and we are calling on the funds to waive the 12-month wait.

"Some funds also have a very wide definition of 'pre-existing ailment' and are rejecting many claims.

"There should be simple explanations for new members of what constitutes pre-existing illness," Dr Phelps said.

Dr Phelps said the AMA would like to see the funds expand member benefits to include cover for out-of-hospital services such as GP house calls and to provide adequate funding to private hospitals in the wake of the surge in numbers of privately insured patients.

"The AMA will shortly be releasing a checklist on private health fund products to help patients make educated choices on their private cover," she said.

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