Is it time for your annual health fund checkup?

Private health cover gives us reassurance that we can get treatment for our health when we need it. But it can be expensive, and it often seems that how much we pay for it goes up every year.  How can we be sure that we’re getting the best value for our health dollar? There are some easy steps to take to check the health of our Health Funds.

  1. Annual Health fund check up.

    The Australian Private Health Ombudsman  recommends checking your health insurance policy at least once a year. Compare it to other policies provided by your current health fund, and even other health insurers.  Does the cover meet your needs? Do you need glasses, obstetrics, joint replacement or cardiac surgery cover?

  2. Know your Limits.

    Different health funds calculate limits on “extra’s” benefits, in different ways. They may pay a set dollar amount or a percentage.  Check that the extra’s that you are paying for are extra’s that you need.

  3. Bali or Barcelona?

    If you’re planning a big sabbatical or gap trip overseas for longer than three months, you need to manage your health fund. Health insurance won’t help you overseas, you’ll need travel insurance.  Some health funds will allow you to suspend your cover, and return without waiting periods. Others will impose waiting periods for certain treatments. If you don’t suspend your insurance policy, you’ll need to maintain payments while you’re away.

  4. Baby shower, 21st or swinging single?

    Relationship and family circumstances change from time to time through everyone’s life.  Check how appropriate your fund is if you find yourself in a new relationship, your child becomes eighteen or leaves home or you are planning a baby.  You’ll need to revisit your fund if you are newly separated.  Contact your health fund as soon as possible when your family or relationship circumstances change.

  5. Happy New Year, EOFY or April?

    Knowing when your extra’s cover resets can allow you to get best value from your current cover.  Some funds reset their extra’s cover at the start of the financial year; others reset it with the New Year fireworks in January.  Knowing your reset date allows you to plan physio, podiatry and optical treatments to get the most from your health fund.  April is also a good time to review your cover, as this is when the annual premium increase takes place.

  6. Any discounts?

    Some funds may offer discounts if you’re able to pay more than one month in advance. Typically this is likely to be a year in advance.  You may be able to negotiate a discount, or at least stop your premiums from increasing in this period.  

  7. Preferred Provider?

    A few of the larger funds have Preferred Provider schemes, offering less Gap to pay when you see these providers. Insurance companies promote that their Preferred Providers go through vetting. In Australia, you can be reassured that all Physiotherapists and Podiatrists must meet rigorous standards to attain and maintain our registration with Australian Health Practitioner Regulation Agency.  Preferred Provider vetting is about payment rules and how many practitioners are in a particular suburb.  You may even find that using a Preferred Provider can deplete your extra’s fund more quickly.  Check that the allied health provider is experienced in your health problem, listens well to your concerns, and is open about their fees.  We encourage you to check the status of any health professional at AHPRA


Checking the health of your insurance is a fabulous step in taking charge of your own financial and physical health.  




Pilentum Physiotherapy and Wellness Clinic

‘at Pilentum we keep you moving’