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Premium Increase FAQ

 

PHI Reforms FAQ

 

Premium Increase FAQs (TBC)

Premium Increase FAQs

Why are you raising my premiums?

As a not-for-profit health insurer we are working hard to keep premiums as low as possible, although rising claim costs continue to have a substantial impact on benefits paid to Members. This has resulted in the need for us to raise our premiums.

 

My premium has increased more than the industry average, why?

The figure quoted by the Minister for Health is the industry weighted average which is calculated across all health insurers. The figure relating to Navy Health is the average across all products. Your premium change will generally depend on your cover type and location, with some members having increases below and others above the average.

 

Why are my benefits not increasing with me paying more for my premiums?

Navy Health is constantly reviewing its products and services to ensure its members are getting optimum benefits back and that we are up to date with new, beneficial services for all members.

 

Why does my new premium not reflect the discount when subtracted?

If you are subject to lifetime health cover loading, this is not represented in your base premium (‘non rebate’) when this calculation is completed. The calculation to work out your new premium is base premium – discounts – new rebates + lifetime health cover loading= new premium.

You may also need to take into consideration the change to the rebate levels the government has imposed. This increases your premium amount.

 

Can I pay in advance before April 1 to lock in at the current price?

You can pay your contributions in advance before the new premium comes into effect on 1 April 2019. The payment must be received by Thursday 29 March 2019, to allow enough time for processing and to take effect before 1 April 2019. The maximum allowable prepayment is 12 months.

 

I pay quarterly, half yearly or annually and I cannot afford to pay for my premium at the new rate, what options do I have?

Navy Health allows you to pay your premiums on a monthly basis if that is easier for you, alternatively we can look at your level of cover today and work out if there is a more appropriate level of cover with a more affordable premium for you.

 

What is my new rebate tier (from 1 April 2019)?

The rebate tiers remain the same however, the % will change as per below:

PHI Reforms FAQs

PHI Reforms FAQs

The Private Health Insurance industry is in the midst of significant Government initiated reform which are supported by Navy Health, to improve transparency and understanding for Members.

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 will have the following products that are categorised as Gold.

  • Premium Gold Hospital
  • Premium Gold Hospital 350
  • Premium Gold Hospital 750

Other products will be categorised by 1 April 2020 and members will be notified.
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.

 1 April 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.

 1 April 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

 From February 2018 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.

 1 April 2018 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.

 1 April 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.

 1 April 2019 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.

 1 April 2019 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:

  1. Affordability: Feedback from consumers has been consistent in that PHI is becoming unaffordable. Some to the reforms that have been announced i.e. prosthesis savings and the removal of natural therapies are designed to cost Navy Health less. Navy Health is committed to passing these savings onto our members, in full.
  2. Transparency: Having standard clinical definition and product categories will assist PHI consumers in understanding what they are covered for by making comparison simpler.

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.

Why are you taking some Natural Therapies off my extras policy?

  1. As part of the reforms, the Government has decided to remove services; Alexander technique, aromatherapy, Bowen therapy, Buteyko, Feldenkrais, herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, Shiatsu, tai chi, and yoga.
  2. The Government has removed natural therapies where there is no clinical evidence or efficacy (i.e. ability to produce a desired or intended result).
  3. Remedial Massage; Exercise Physiology; Chinese Herbal Medicine; Acupuncture will remain on your natural therapies cover.
  4. Navy Health will ensure any savings realised from this reform is passed to our members in their contributions
  5. Pilates/Clinical Pilates: The Department of Health does not differentiate Pilates from clinical Pilates and neither will be payable via Private Health Insurance regardless of the service provider – The Australian Physiotherapists Association supports this decision and has provided their constitutes with information on their website.

The Government has implemented reforms to assist in making Private Health Insurance affordable – where are my savings?

  1. In February 2018, the Government announced they had entered into an agreement with the Medical Technology Association of Australia to lower the price of SOME implanted prosthesis. The savings that have been estimated have been taken into consideration in our premium calculations and is estimated to be approx. $20 per membership for Navy Health members.
  2. When Navy Health is no longer able to pay a benefit on some Natural Therapies (as detailed in the table above) –these savings will be passed onto our members.
  3. The reform allowing for the increase in the maximum level of excess may also assist in making Private Health Insurance more affordable. Navy Health is conducting an assessment to understand how this will benefit our members.

Where can I get more information on the reforms?

More information on the reforms can be found at www.health.gov.au