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Health Insurance: Victoria

Jonathan August 13th, 2015 0 comments

When you shop for health insurance, it is helpful to understand how the market works.  Throughout Australia, there are more than 30 companies providing some type of private health coverage to policyholders who want broader coverage for health expenses than is offered by Medicare.  A total of 55 percent of Australians have purchased some type of general coverage policy to pay for things like optical care and dental treatment while 47 percent of the population has purchased private hospital cover. There are over 11 million Australians with private hospital insurance and almost 13 million Australians total with Extras cover.

Although some insurers offer policies to clients throughout the entire country, there may be major differences in insurance markets from state to state. Residents of Victoria should be aware of the market conditions in their home location so they can make informed choices when comparing policies and shopping for coverage.

Who Are the Biggest Insurers in Victoria?

Within Victoria, there are over 20 open membership funds providing health cover and there are 10 restricted membership funds.  However, there are only two insurers which have a substantial portion of the market share.  BUPA has 24.3 percent of the local market share within Victoria and Medibank has 35.2 percent of the market share.  HCF, AU, GMHBA, and NIB each have somewhere between 5.7 and 8.1 percent of the market share. All other open membership fund providers have less than one percent of the share of the market.

Big insurers can provide broad and comprehensive coverage, but some small insurers have almost all of their business focused within Victoria and may also have large local networks within the state. For example, almost 85.5 percent of membership in MDHF was within Victoria in 2015.  You should carefully comparison shop among both large and small insurers in order to determine which coverage is best for you.

How does the cost of health insurance in Victoria compare?

In Victoria, the average annual premiums a family paid for health cover for both hospital and extras coverage in 2015 was $4,366 with obstetrics services and $3988 without obstetrics.  This package price was one of the highest of any Australian state, with only  Tasmania and SA having a higher average.

While the costs in Victoria may be higher on average, than for people in other states, this does not mean individual policies have to be expensive. Shopping around and comparing policies among different insurers can help you to get the best overall deal, so you get the most bang for your buck.

How Does Ambulance Cover Vary?

Ambulance coverage varies substantially from state to state. For example, in Queensland, the government provides ambulance cover to residents. In Victoria, however, coverage must be obtained through Ambulance Victoria or through a private health fund if you wish to ensure you have your ambulance ride paid for in the event of an emergency.

How Profitable Are Insurers in Victoria?

In Victoria, the gross profit margin for hospital treatment was 9.6 percent and the gross profit margin for general treatment was 21 percent for 2013/14 according to a comprehensive 2015 report about Competition in the Australian Private Health Insurance Market. While for-profit insurers need to make money, larger profit margins can sometimes mean consumers are being charged too much or insurers are underpaying claims.  When you shop for an insurance coverage provider to offer you health insurance, be sure the insurer has a good reputation for responsiveness to the needs of those who are covered and that the insurer has a good reputation for paying covered claims.  By looking for a policy with expansive coverage and reasonable premiums, you can have the peace of mind of knowing your family is taken care of whenever health issues arise.

Disclaimer: The above information is correct and current at the time of publication.

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