What will insurance costs mean for you and your family?
Insurance premiums have been rising since 2014, and the Australian Consumer Law (ACL) has been introduced.
It requires insurers to offer “fair and reasonable” rates to people, with a cap of 10 per cent of the value of the policy.
The ACL provides some examples of what that means: your annual car insurance premium is capped at $7,500 and you’re entitled to a cap on out-of-pocket costs.
The rate you get for your policy is capped on the total amount you pay, but not by more than the maximum amount allowed by the policy, which is $15,000.
Your insurer is also required to provide you with a list of approved providers to ensure you’re not denied access to a provider because of your health condition or a chronic condition.
You’ll also be able to select between three or more different provider types, and you can only be offered one provider, but that provider is allowed to offer coverage in the same region.
You can also opt out of coverage at any time.
Insurance premiums are capped on a sliding scale, with more than 10 per, say, cent being considered “fair”.
But there are also caps on how much you’re allowed to spend.
“In some circumstances, such as where a person is not receiving primary care or nursing care, the insurer may be entitled to cover more than $15 per day in out-patient services,” the ACL states.
You’re also allowed to use up to 10 per day to use a doctor or specialist.
But insurers are allowed to cover up to $1,500 per day.
Some insurers will only cover certain types of medical treatment, such for cancer patients or people with a high blood pressure.
“These are very broad definitions of the terms ‘medical treatment’ and ‘health care costs’, which are subject to the ACL,” ACL’s chief executive, Peter Smith, said.
“If your policy covers a specialist in surgery, it will cover up for up to two hours of surgery per week for the life of the coverage.”
Insurance premiums can be quite expensive, especially for people with very expensive medical conditions, like diabetes, heart disease or cancer.
If you’re covered, your insurer is expected to cover at least half of the total cost of the plan.
The ACCL limits your coverage to a maximum of $15 a day in a hospital, $10 in a GP office and $5 in an outpatient clinic.
But you can also pay more for services like dental or vision, if you have more than four of these covered.
For example, if your health insurance covers the cost of a dentist for the first four months of the year, but only pays for one visit at a time, you could pay $1.50 more per visit than you would with the ACCL caps.
In addition, some insurers require you to pay out-pays or co-payments when you’re sick.
If your insurer covers out-pocket expenses for you or your family, it may charge you for this out-penalty if you don’t pay in full.
But if you’re uninsured, you won’t have to pay this out of pocket if you pay it in full or have an out-payment to your insurer, but your insurer doesn’t cover it.
“This means you can have a very different picture of the impact on your health care costs from the one you might get with a policy with no out-payment or co, and therefore it’s worth checking the out-door health cost coverage you’re being offered,” Mr Smith said.