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The Private Health Insurance (PHI) industry is in the midst of significant Government initiated reforms. Navy Health supports these changes as they provide transparency and PHI easier for you to understand.
Below is a table which outlines the reform and the action Navy Health has taken.
Reform | Timing | Impact on Navy Health members |
Product categorisation
All health insurers will be required to classify their products into new tiers. The tiers are gold, silver, bronze and basic and there are set minimum hospital services which need to be covered within each product tier. |
From 1 April 2019.
Must be implemented by all health insurers by 1 April 2020. |
As of 1 April 2019, Navy Health have
the following products that are categorised as Gold.
As of 13/01/2020, Navy Health will have the following products that are categorised as Silver Plus.
As of 13/01/2020, Navy Health will have the following products that are categorised as Bronze Plus.
|
Natural therapies
The Government has legislated that from 1 April 2019, all health insurers will no longer be able to pay a benefit on the following Natural Therapies; Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, herbalism, Western herbalism, homeopathy, iridology, kinesiology, naturopathy, reflexology, Rolfing, shiatsu, tai chi, and yoga. The Government has made this decision to exclude therapies that based on evidence do not demonstrate evidence of clinical efficacy. |
Completed 01/04/2019 | Navy Health members will still be able to claim on Acupuncture; Remedial Massage; Myotherapy; Exercise Physiology and Chinese Herbal Medicine. |
Standard clinical definitions
All Health funds will need to use standard clinical or medical definitions, which means the language used will be consistent and easy to understand across all policies. |
Completed 01/04/2019 | This should make it easier for members to compare what is and isn’t covered, in different policies, across private health funds. |
Prosthesis list changes
Prostheses or medical devices are items such as pacemakers or replacement hip joints. The price for these items are set by the government. The government will reset the price for these devices, reducing the amount Navy Health pays for each device |
Ongoing | Navy Health will be passing on these savings onto our members in the next annual premium calculation, due to be announced in April.
Any future prosthesis changes that result in savings will also be passed back to our members. |
Mental health
Members with limited mental health cover will be able to upgrade their cover to access in-hospital mental health services without serving a waiting period. |
Completed 01/04/2019 | Members with minimum benefits for mental health cover will be able to upgrade their cover to access full benefits for in-patient hospital psychiatric treatment without serving the 2 month waiting period.
Members will be able to use this exemption, from the existing 2 month waiting period, only once in their lifetime. |
Excess levels
Health funds will be able to offer higher levels of excess. The maximum excess will be increased to $750 for singles and $1,500 for couples or families. |
Completed 01/04/2019 | Navy Health’s Premium Gold Hospital product will be available with a $750 single excess and a $1500 family excess. |
Regional and rural travel and accommodation benefits
The government will give health funds the option to offer travel and accommodation benefits under hospital cover for members living in regional and rural areas. |
Being monitored | Navy Health has not currently implemented this reform. Navy Health will continue to monitor this reform and review this decision periodically. |
Discount for Young Adults
Health funds will be able to offer a discount of up to 10% on Hospital coverage to people aged 18 to 29. |
Being monitored | At this stage, Navy Health has decided not to implement this reform. Navy Health will continue to monitor this for suitability. |
Why has the government decided on these reforms for Private Health Insurance?
These reforms have been decided on for numerous factor outlined below:
Why is Navy Health making changes to my products?
Navy Health is making the changes in response to the government imposed reforms that were announced in October 2017. Navy Health is required to make these changes to ensure our products are compliant with legislation and they support our member’s needs.
Will the cost of my policy increase?
The cost of your policy will be considered later this year as part of the annual premium review process, and may be adjusted from 1 April 2020. Navy Health will communicate to you separately should your premium be changed.
The Government has implemented reforms to assist in making Private Health Insurance affordable – where are my savings?
Where can I get more information on the reforms?
More information on the reforms can be found at www.health.gov.au
Is Saver Bronze+ Hospital 500 and/or Saver Bronze+ Hospital 500 & Extras 65 different from my current Saver Hospital or Saver Plus?
The services below are currently partially excluded and will be covered on an unrestricted basis | The services below are currently partially restricted and will be covered on an unrestricted basis | The services below are currently covered and will be excluded | The services below are currently restricted and will be excluded |
Brain & Nervous system
Eye (not cataracts) Bone, Joint & Muscle Male reproductive system Gynaecology Pain Management
|
Lung and chest
Ear, Nose & Throat Digestive System Miscarriage and termination of pregnancy Plastic & reconstructive surgery (medically necessary) |
Insulin pumps
Sleep studies
|
Pregnancy & Birth
Heart & Vascular system
|
I have Saver Hospital and am booked into hospital after 13/01/2019, for a service that is no longer covered (Heart & Vascular, Pregnancy & Birth & Sleep studies)?
Will I be subject to re serving my waiting periods?
Is my policy cost increasing?
Is Core Silver+ Hospital 500 different from my current Core Hospital?
The services below are currently partially excluded and will be covered on an unrestricted basis under the new policy | The below services are currently partially restricted and will be covered on an unrestricted basis under the new policy | The service below is currently restricted and will be excluded under the new policy |
Eye (not cataracts)
Bone, joint & muscle Male reproductive system Gynaecology
|
Ear/Nose & Throat
Digestive System Miscarriage and termination of pregnancy Heart and Vascular system Lung & Chest Plastic and reconstructive surgery (medically necessary) |
Pregnancy and birth |
I have Core Hospital 200 and am booked into hospital after 13/01/2019, what excess will I pay?
Will I be subject to re serving my waiting periods?
Is my policy cost increasing?
There are no immediate changes to the cost of your policy, however, please note, your policy may be impacted by the yearly Private Health Insurance rate rise effective 1 April 2020. Navy Health will communicate to you separately should you be affected. For members on Core 200 , as you have been transferred to a higher excess product the cost of you policy will decrease.
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