Health Insurance - AMA Urges Waiver on 12-month Waiting Rule
The Australian Medical Association today called for an urgent, temporary rule change to allow new health fund members to use their private cover straight away.
Reports today indicate that some new fund members, unaware of the 12 month waiting rule, have been left with big bills after entering private hospitals in the past few weeks in the belief that they were covered.
AMA Federal President, Dr Kerryn Phelps, said that the 12-month rule was in place to stop what the health insurance industry call 'hit and runs', those with a pre-existing illness who would take out private cover, seek immediate treatment, and then drop their insurance.
"The rule is a sensible one in normal circumstances. However, in the past few months we have seen hundreds of thousands of new members sign up because of the 30% rebate and the lifetime cover rule.
"There are reports that a man in Melbourne was presented with a $20,000 bill after recent treatment for heart attack. He had sought private care believing he was covered under his new health insurance policy. And a woman reportedly diagnosed with kidney stones two weeks ago was on a public hospital waiting list after being told her newly acquired private insurance would not cover her.
"There appears to be significant confusion about what's covered and what isn't. Some funds have waived waiting periods, but only for 'extras', such as dental care.
"The AMA calls on the funds to explain in simple, clear language exactly what is covered and what isn't. We also call for an across the board, temporary rule change to allow the new fund members to use their new cover straight away.
"It's up to the funds to ensure their products are value for money if they want to retain their new members and attract more in. We also need to see simple explanations of what constitutes 'pre-existing illnesses'.
"It is important the new fund members have positive experiences with private health insurance - not hassles over fine print," Dr Phelps said.