The Issue

If you're like most people, signing up with a health fund is largely driven by a desire to give yourself additional healthcare options not offered by Medicare. But Government policies are also a strong motivator, so much so that approximately 50% of Australians now have some form of health insurance cover.

But do you have the right kind of policy, particularly when it comes to extras cover? Determining that can feel like a near impossible exercise with over 20,000 policies in the marketplace (according to the ACCC), all of which come with restrictions and exemptions, which differ from fund to fund, potentially complicating and obscuring the decision-making process.

The ADA is seeking to highlight this perceived lack of transparency with Time2Switch. While the Standard Information Statements which funds are obligated to supply for each policy provide a reasonable amount of detail, the restrictions and exemptions are not consistent from fund to fund, making direct policy comparisons problematic.

Further, while premiums are rising, the ADA believes that the extras rebates you receive from your insurer for dental services have not kept pace. Few insurers cover the full cost of a treatment, with many people left to cover the gap between the premium they pay and rebate they receive.

Insurers are also increasingly in a position to potentially influence how treatments are delivered. Their ownership and operation of dental and medical practices to which they might refer you with the promise of higher rebates can lead to a tiered system for customers, meaning that while you might pay the same premiums as everyone else, you may not receive the same rebates.

The objective

The aim of the Time2Switch campaign is to create a more workable balance between the profession, our patients and the health funds.

It is envisaged that this will be achieved by encouraging dental professionals and patients to lodge complaints with the Private Health Insurance Ombudsman, and by persuading patients to complain about and compare their existing policies, with the intention of intiating reform in the private health insurance sphere.

ADA accuses private health funds of misusing patient data

The president of the ADA Dr Rick Olive has warned a Productivity Commission Inquiry into expanded data sharing, that private health insurers that own dental surgeries are misusing HICAPS-sourced information for commercial benefit.
ADA and ACCC: health insurers are misleading consumers

The Australia Dental Association (ADA) has mirrored the concerns of the ACCC regarding the advertising of health insurance. In particular, the ADA is concerned that insurers are misleading the majority of Australians to believe that they will receive a tax benefit when none will be forthcoming.
ACCC warns against misleading claims by private health insurers

The Australian Competition and Consumer Commission is warning Australians to be alert to potentially misleading claims about the tax benefits of obtaining private health insurance.
ACCC Submission on Private Health Insurance

Unless action is taken to address issues about PHI conduct in regards to consumers' out-of-pocket costs, their ability to access quality healthcare and open competition in the delivery of dental health care, consumers will continue to be adversely impacted.