A major overhaul is due for health insurance policies in 2019, with new rules set to simplify all hospital policies into four tiers of coverage. These changes could impact your current policy, making it a great time to check how you’re covered and consider whether you need to update it. Here are some of the top questions to ask yourself when deciding to update your health insurance.

Why 2019 is a good time to update your health insurance

Have you been wondering what the 2019 changes to health insurance are all about? The 2019 private health insurance reform will see all hospital policies categorised according to a four-tier system: basic, bronze, silver, and gold. Health funds can also offer basic plus, bronze plus, and silver plus categories, which will include minor upgrades to the base categories. The changes are designed to streamline the system and make it easier to compare different hospital policies. Insurers will have until 1 April 2020 to introduce the tiers.

So how do the changes work in practice? The changes include must-haves for the tiers, but insurers can offer more than the minimum must-haves specified for the tiers. For example, silver and bronze policies must have coverage for gynaecological services and ovarian and breast cancer treatment. In addition, younger people could have a discount for signing up for hospital cover early. Extras cover will no longer offer cover for naturopathy and some other alternative therapies.

Questions to ask yourself

So do you need to update your policy? With the changes in 2019, it’s even more critical to check if your health insurance needs upgrading. Things like lifestyle, family, and age should be considered considered against how your insurance coverage might be affected by the changes. Ask yourself the following questions.

1. Will this cover everyone in my family?

The changing tiers could mean certain hospital treatments are no longer included in your current policy. If you have family members who need coverage for specific treatments, you might need to upgrade to a higher tier to ensure full coverage.

2. Will my cover change significantly this year?

Any lifestyle or family changes could change your cover needs. For example, if you’re getting married or adding a new member to your family, you’ll have changing coverage needs, making it a consider upgrading to at least bronze, for which gynaecology is a minimum requirement. If you’re planning to have weight-loss surgery, keep in mind this is only a requirement for gold-level policies.

3. Do I need more comprehensive cover this year?

Hitting new milestones in your life, changing household arrangements, and lifestyle changes can lead to a change in the type of policy you need. If you or your partner is trying to get pregnant, you might want to update to a gold-tier package as pregnancy, birth, and IVF would be included.

4. Will this still cover my current doctor/optometrist/dentist?

The introduction of the tiers could mean certain services are no longer covered by your current health insurance policy or level of policy. Check to see whether you need to upgrade to another level to maintain coverage for your current healthcare providers, whether these are your GP, optometrist, dentist, or other professionals.

5. Are there family history factors I should take into account?

Consider anything that runs in the family when updating your cover. For example, if heart issues run in the family, you’ll want to ensure you (and possibly dependent children) are covered for heart-related surgeries. Being covered for family-history risks could give your partner extra peace of mind as well.

6. How might my age, health, and lifestyle impact my health insurance needs this year?

Australia has an ageing population. This has meant a rise in demand for palliative care services and a rise in rates of cancer and other chronic conditions. While we’d probably all prefer not to think about it, getting older might mean a higher risk of certain conditions and so changing need for coverage. As another year passes, it’s a good opportunity to think about increasing your coverage level. The new tier-based product categories make it easier to understand and compare hospital coverage, so take the chance to review whether you and your family could benefit from opting for a higher tier.

It’s also beneficial to consider your general health and any changes in lifestyle as the 2019 changes take effect. For example, if you’ve decided to take up a higher risk activity such as bike racing as a hobby, being covered at the right level could minimise the risk of not having appropriate treatment and quality care if you’re injured.

The 2019 health insurance package changes impact all hospital insurance policies, and so you’ll want to review your policy to see whether it will offer adequate coverage after the changes take effect. Consider lifestyle, household, age, and health factors in light of how your current coverage will change. By making an informed decision about updating your policy, you can ensure you get the right hospital treatment if you do need it and better protect the health of you and your family.

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