Home and away: does medical tourism pay?
Travelling overseas for expensive surgical procedures has little potential for stemming the rising cost of health insurance premiums, but "internal" medical tourism is being explored.
A report from health insurer Southern Cross has found that once travel and accommodation costs were included, the cost savings of medical tourism were not tempting for policyholders for any but the most expensive procedures. But flying policyholders around New Zealand in search of cost savings would be accepted.
Already many Kiwis are used to travelling for medical procedures – particularly those who live in rural areas – but as health insurance premiums have risen, many have switched to "shared cover" policies, under which policyholders pay a portion of the costs of each procedure. It is a trend that is increasing price sensitivity among policyholders.
Even so, according to the report, only 15 per cent of policyholders would consider travelling overseas for treatment.
The report, which was reviewed by Stephen McKernan of Health Partners Consulting Group, also found overseas travel costs would mean savings of around only 1% given New Zealand's geographic isolation from low-cost Asian countries such as India and Thailand.
But, McKernan noted, travel for procedures within New Zealand is a different story.
It is not yet known how much internal medical tourism could save in claims. Costs can vary dramatically around the country and in many cases there appears to be no good reason for those differences.
"In many instances, these cost variations reflect local service delivery circumstances; in others it is unclear why the cost variation is so pronounced," McKernan noted.
Just how much the cost of a single procedure can vary is shown by recent claims received from members for "intravitreal" eye injections which have ranged from $500 to more than $1200.
On complicated surgeries, the Sunday Star-Times understands, cost differences can run into five figures.
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Southern Cross is also encouraging policyholders to report anything that smells of price-hiking or overcharging for insurance claims, as well as enlisting the support of private medical providers in stemming costs. A roadshow around the country threw
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Who can purchase Australian Private Health Insurance ...
PHIO has received a number of enquiries recently from temporary residents who have been advised by health fund staff that they “can’t” purchase Australian complying private health insurance products (CHIPs) due to their residency status or their Medicare status. The inability to purchase a CHIP product has the potential to adversely impact on the member’s Lifetime Health Cover (LHC) and Medicare Levy Surcharge (MLS) status.
As part of their training, fund staff should be made aware that Australian private health insurers are required to sell complying health insurance products (CHIPs) to anyone who wishes to purchase them. As stated in the Department of Health & Ageing’s PHI Circular 60/09, “ This eligibility principle applies regardless of the colour and type of any Medicare card held by the consumer. It also applies even if the consumer doesn’t hold a Medicare card. ” The full text of the circular can found on the Department’s website.
Staff should also be aware that it is important to question new members about their level of Medicare benefits and not just their residency or visa status – while residency and Medicare status are usually closely linked, it is the consumer’s Medicare status that becomes most important when determining what benefits they will or won’t have access to when purchasing a CHIP.
Generally, temporary residents and new migrants may fall into one of the following Medicare eligibility categories in relation to CHIPs:
Full Medicare benefits : These consumers have full Medicare access and pay the Medicare Levy and (if applicable) the Medicare Levy Surcharge; generally they have a green Medicare card. They have the same level of benefits as people with full Medicare benefits, but on a time limited basis (usually until they become eligible for a green card). These consumers have full Medicare access and pay the Medicare Levy and (if applicable) the Medicare Levy Surcharge. They are eligible for the Federal Government Rebate and are liable to pay Lifetime Health Cover loading if they have passed their Lifetime Health Cover base day.
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Private Health Insurance Ombudsman - Wikipedia, the free ...
The Private Health Insurance Ombudsman[1] is an Australian Government agency but acts independently of the Government in dealing with complaints and reporting. ...
Private Health Insurance Ombudsman - australia.gov.au
The Private Health Insurance Ombudsman provides private health insurance members with an independent service for health insurance problems and enquiries. ...