Health funds should reimburse COVID-19 windfalls to members, says CHF

Funds must level with their members and return what they save on the shutdown of elective surgery.

health insurance concept image

Health funds must level with their members and eventually return the funds they save as a result of the COVID-19 shutdown of elective surgery, urges the Consumers Health Forum.

“We welcome the commitment by health funds to reimburse windfall gains to members. Independent estimates put at billions of dollars the surpluses the funds are expected to generate in coming months,” said the forum’s chief, Leanne Wells.

“The bottom line is that, particularly, at this time of financial hardship for many consumers, it is members who should be the beneficiaries. It is, after all, their money, paid in ever-escalating premiums.

Ms Wells says the fund would already know roughly how much they will be in the black as a result of the shutdown.

“They have sophisticated business modelling and would already know the pattern of claiming in a normal year, so they should be able to come up now with a reasonable estimate of their expected profits.

She says funds need to do more than give unspecified promises of returning surplus funds sometime in the future, and that there needs to be some definitive undertaking to do so now.

“The industry would retrieve some credibility if it adopted a consistent and transparent approach. The ad hoc responses taken by the industry in response to the realities of COVID-19 show yet again a failure of funds to give priority to the best interests of their members,” said Ms Wells.

“If private health insurance in Australia was not previously under existential threat, it certainly is now.”

Would you expect your health fund to reimburse you for any savings it makes?

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    To make a comment, please register or login
    10th Apr 2020
    Dont hold your breath! I am with Medibank Private and they only deferred their premium price hike when I put it on Facebook, wrote to Sco Mo, the Health Minister and finally sent MBP an email from HBF saying no price hike until end of 2020. Keep on them and they finally do what their members want.
    10th Apr 2020
    Just so refreshing to hear from someone who actually DOES
    something instead of whining away.
    Thank you Missskinnylegs.
    10th Apr 2020
    Yeah it was all you! Haha

    It was announced by Private Healthcare Australia Limited that ALL health funds would be deferring their increases for 6 months.

    This had nothing to do with your email, what rubbish.
    10th Apr 2020
    I expect my health fund to refund the portion of my premium associated with services they are unable to cover now such as hospital care for elective surgery, extras for ancillary services etc. By my reckoning they should refund 100% ........................I won't hold my breath though.
    10th Apr 2020
    So don't you think that when services return to normal there will be MORE surgeries to catch-up, costs overall won't be much different.
    10th Apr 2020
    Will our PM. make this come about time will tell.
    10th Apr 2020
    I have been in private health over 40 years and they well and truly have benefitted from our lack of use. We accepted that we were insuring for a just in case scenario.
    now that we can’t have the assurance of that coverage I’d appreciate a refund especially as they will not have to be paying anyone for ‘private’ services used.
    11th Apr 2020
    Will not happen unless mandated...these leeches will cite "C19 pressures" on staffing, off site set up costs etc and pocket the "windfall". I am with a Not For Profit fund ( 50 yrs ) and they have 100's of millions in the Bank...every Annual Report shows a profit...go figure
    12th Apr 2020
    Medibank Private. We pay for extras. I cannot use jthe extras services due to covid 19. But they take our payments. We want to see a full refund of the costs of all non available services during the government stated closedown period. I also contacted the Prime Minister re the price increase as I believe did a multitude of members. They were shamed/forced into suspending the increases. It was a government directive. So in reality they gave us nothing. Now those of us with top cover are paying the costs of thoes with lower levels of cover. Stinks. The government needs to make it mandatory to refund unused fees taken from members.

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