Though not as much fun as a traditional New Year celebration, or as well-known as the end of financial year – the 1st of April marks the start of another ‘private health insurance year’ in Australia, and as always, it brings about changes to health insurance premiums, benefits and products that consumers need to be aware of.

This year in particular is one I could liken to our industry’s version of the ‘Y2K’ year – because this year the Government’s much talked about ‘Private Health Insurance Reforms’ (Reforms) properly come into effect.

The Reforms include;

  • Private Hospital insurance being categorised under a new tiered system as either ‘Gold’, ‘Silver’, ‘Bronze’ orBasic’
  • A new, standardised list of 38 ‘Clinical Categories’ defining the minimum standards for services to be covered under each tier of hospital cover.
  • The removal of some natural therapy treatments, such as naturopathy, homeopathy and aromatherapy, which will no longer qualify for benefits as part of a complying health insurance product.
  • An upgrade to the privatehealth.gov.au website, coupled with an increase in powers and resources for the Private Health Insurance Ombudsman.
  • A new format for the old Standard Information Statements (SIS) which will be renamed as the Private Health Information Statements (PHIS) and be designed to make comparing policies easier.

Now you’ll all remember that ‘hold-your-breath’ fizzle that we all experienced at midnight in 2000 when the world didn’t come crashing to an end? Well much like the preparation work that prevented Armageddon in 2000, I’m confident that Police Health & Emergency Services Health Members at least, will be well sheltered from any chaos the Reforms stir up for consumers, because in many ways, the Reforms are creating industry standards that align with the philosophies and practices we’ve been championing for over 80 years.

I’m talking about;

  1. Cover that’s simple to understand – so you don’t get caught out by exclusions, restrictions or co-payments.
  2. Cover that provides real value for money for consumers
  3. Practices that put the health and wellbeing of fund members first.

For instance, while some insurers are making significant changes to their products to align with the Reforms’ new product classifications of Gold, Silver, Bronze & Basic - we’ve always provided the ‘Gold’ standard of hospital cover so our existing hospital cover maps directly over. The only change is in our product name, which will soon include the word ‘Gold’ for added clarity.

When it comes to value, Gold is the only level of cover we offer because we don’t believe there’s any value in being ‘under insured’, especially not when it comes to your health. By sticking to just one top level product and avoiding the ‘pick and choose’ cover abomination the rest of the industry has spiraled into over the past decades (in an effort to sell cover at any cost), our Members don’t get caught out paying fees year in year out only to be left with huge out of pocket costs when the time comes to ‘cash-in’ because they didn’t accurately predict which health issues would arise.

But perhaps most importantly, Members have always come first for us. We understand and hold the upmost respect for our Members, what they and their families sacrifice for the betterment of our community, and the health impacts and concerns that are specific to the lives lived by our police and emergency services community. Members are at the centre of everything we do – not shareholders or overseas investors, as may be the case for some of the big name for-profit insurers.

So while most of the industry appears to be approaching the year of Reforms with the same apprehension as those who had everything to lose in 1999 if Y2K had become a reality… We’re experiencing our highest levels of growth in years within Police Health at a rate of 7.7 times the national average, while Emergency Services Health can claim the highest percentage of growth of any health fund, albeit from a small base, as drawn from APRA’s latest quarterly statistics (Sept 2018). So we’re definitely punching above our weight!

Given all of the above, if you’ve got eligible friends, colleagues or family members who aren’t yet with us – tap them on the shoulder and tell them to give us a call. We’d love to welcome them into the fold so they too can breathe easy coming into this new private health insurance year.

Happy 2019!


About Scott Williams, CEO of Police Health & Emergency Services Health
As the son of a Cop, (a Registered Nurse by background), and 20 years of experience overseeing the clinical and managerial administration of public and private hospitals both in Australia and abroad (including 4 years as the CEO of the North Eastern Community Hospital in Adelaide) – Scott is an ideal fit to lead Australia’s only private health funds exclusive to the Police and Emergency Services community respectively. Connect with Scott on Linkedin to learn more.