My Private Health Cover 

The Gap

Dr. Jefferson’s fees are based on the rates recommended by the Australian Medical Association (AMA).  Regardless of your health fund provider, you will have out of pocket costs.  This cost is known as “the Gap”.  You are responsible for checking with your health fund to ensure you are covered for your procedure and we will provide you with your out of pocket costs.

Private health cover can be difficult to navigate.  We do our best to be clear and upfront with our patients regarding their private cover.

Disappointed With Your Rebate?

We have found some patients are disappointed by the rebates offered by their health fund.  While we do not endorse any particular fund, we know that funds vary greatly in what they offer their customers and we encourage those not happy with their coverage to compare funds and switch if necessary.  You can compare your private cover to other health funds here: www.privatehealth.gov.au

Many funds are run to benefit members, but some like NIB are listed companies, which have a legal obligation to maximise profits for shareholders. This can result in below-industry rebate ratios for their policy holders.

Switching Funds- What You Should Know

  1. Portability

The Private Health Insurance Act 2007 includes “portability” rules.  Portability means that when switching funds that there are no penalties or exit fees.

  1. Waiting periods are waived

If you are switching to a comparable policy, waiting periods that you have already served with your old health insurance policy are waived by your new health fund when you switch health insurance.

  1. Your new health fund does the paperwork!

Simply find and apply for the health insurance policy you want to switch to, and your new health fund will manage your transfer.  Once you give your new fund authorisation, they will cancel your old policy and retrieve your membership details.  Any portion of unused premium that you may have already paid to your old fund will be refunded to you.