Dentists call for more clarity around private health insurance policies

The nations' peak dental body is calling for more transparency around the muddy waters of private health insurance policies to bring clarity to around 15 million Australian policyholders.

The call from the Australian Dental Association (ADA) comes hot on the heels of Private Healthcare Australia (PHA) applauding a new move for consumers to have guaranteed protection from unanticipated medical costs.

PHA CEO Rachel David applauded a move last week for specialist doctors to be obligated to disclose fees on the Government’s Medical Costs Finder website. She also called for tougher laws to protect consumers from surprise billing and clarity for patients around the cost of a procedure.

“Whilst PHA calls for more transparency in medical fees, the ADA calls for more transparency in health insurance products,” said ADA President Dr Chris Sanzaro.

“Our members and patients tell us there’s considerable confusion and uncertainty around the ‘extras’ element to many private health insurance policies.

“They sign up for policies believing these will make medical and dental care more affordable but say they don’t know what’s covered. The policy small print doesn’t even cover what’s included and what isn’t – hidden ‘business rules’ from insurers deny claims at the time they’re needed.

“Consumers have no visibility of this unless they take a quote in - which is not always achievable with urgent situations - or when they get denied at the time of claiming.

“The ADA and our 17,000 members want to see private health insurers providing more transparency and clarity on their fee and rebate structures, not least when PHI premiums are increasing at a higher rate than dental fees.
“By doing this and making their policies more easily understood, they may find it drives more consumers to take up PHI policies in future.”

Last month the Treasurer announced a 3.73% increase in PHI premiums from April 1, compared to 3.03% the previous year, and the highest annual rise in private health insurance premiums in seven years.

Dr Sanzaro added: “This is increase comes at a time when dentists have in recent years been keeping fees below inflation to assist patients.

“When added to the cumulative increases in other essential goods and services already stretching the family budget, it may well be a step too far for many households holding health insurance.

“This could be the cost of living blowout that sees people ditching their PHI and avoiding essential medical care including dentistry. By making policies clearer, at least people know exactly what they’re paying for when every cent counts.”