The Right to Change Health Insurance Cover

There is a wealth of health insurance providers in Australia, with each insurer offering a unique range of policies and benefits. Choosing which fund and policy to choose can be a complex and difficult decision.

When you first enter into a fund, it is important to adequately balance your needs against the cover the insurer can offer you. However, over time your situation or the health insurance product you have can change. It is therefore crucial to regularly review your private health cover to ensure your needs are still being met.

If you find your policy is no longer suitable, or you are unhappy with changes to benefits or premiums enacted by your health fund, you may be wondering what your options are.

Fortunately, if you find yourself in this position you have the power to make a choice - changing your policy or provider.

Changing policy

If your private health insurance product has recently been changed, you have the right to switch to an alternative policy within the same health fund if something more appropriate is available.

This could include if your situation changes and you require additional benefits or need to add a dependant to your policy. You may also wish to reduce the cover you receive if you find you no longer require certain services - such as pregnancy cover for a woman going through menopause.

In some cases, your health fund will be able to offer an alternative policy better suited to your needs. However, it is important to remain aware of potential waiting periods and limitations you may have to complete before your new cover comes into action.

If you are seeking a new policy with your existing health insurance provider, you should request all relevant information regarding waiting periods, restrictions and cooling-off periods to ensure you are not surprised by an unexpected gap in cover.

Changing health fund

If your existing fund does not offer a policy suited to your change in situation, or you are unhappy with your provider's behaviour regarding claims, premiums or benefits, you are able to switch to a more appropriate health fund.

In some cases, the general waiting periods of benefits will not apply to your new policy, so long as the new policy offers the same benefits to your old cover. If you are switching to a fund that offers new benefits some restrictions may still apply.

To efficiently switch fund with minimal gaps in cover, it is important to follow correct procedures. This includes making sure your premium payments are up to date on your old policy and asking your previous fund to provide a 'clearance certificate' as soon as possible.

Your old provider is required to send you this certificate within two weeks of you cancelling your product and requesting the paper. Once you have received this document, send it on to your new provider while keeping a copy for yourself.

Making the switch

There are many reasons why a person may want to change fund or policy, including increasing premiums, a change in health or evolving family situations.

When you have decided to switch cover or provider, it is important that you apply the same care and research to choosing your new fund that you did when taking out health insurance for the first time.

Ideally, you will investigate all products on the market to find the policy most suitable to your needs and situation. However, this can be a complex and time-consuming process.

Instead, consider utilising the services of a health insurance broker, such as HICA.

HICA offers specialist advice and guidance to help you choose the right health fund and cover, including a comprehensive health insurance comparison to save you the time and inconvenience of having to compare health insurance products on your own.

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Michael van Schaik

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