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1 in 2 Aussies lie about their health cover to avoid out-of-pocket expenses

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A new survey suggests that almost half of Australians with private health insurance have likely lied to health professionals about being insured to avoid paying ever-increasing out-of-pocket expenses, which amounted to $181 million[i] during the final quarter of 2015 alone.

The survey of a nationally representative sample of 1200 Australian adults was commissioned by leading health insurance comparison website comparethemarket.com.au and conducted by an independent research agency[ii]. Almost half (48%) of privately insured respondents confessed to choosing the public health system in order to avoid out-of-pocket expenses, with almost 90% of respondents believing out-of-pocket expenses are becoming more expensive.

Out-of-pocket expenses include refer to an upfront excess or co-payment towards the cost of hospital accommodation and treatment, as well as  the gap between a doctor’s fee and the benefit payable by Medicare and a private health fund.

“With pressure on household budgets, and the cost of health insurance increasing well above the rate of inflation, it is not surprising that people are hesitant to use their private cover if they don’t know how to avoid-of-pocket expenses. Especially when almost 20% of respondents already spend between three and four thousand dollars on their health each year,” says comparethemarket.com.au spokesperson Abigail Koch.

“An easy way to manage costs is to seek healthcare providers that have a gap cover agreement with your health fund. Don’t be embarrassed to ask for a detailed breakdown of costs from your doctor or your health fund before you commit to a procedure, remembering to include any additional fees such as that of anaesthetists. This will give you a clear idea of what expenses you could be facing, and more of an opportunity to avoid or reduce them by choosing alternative healthcare providers.”

The high proportion of those choosing not to use their private health insurance was fairly evenly spread across age brackets and gender. However, survey results show that women are more likely to resort to the public health system over their private health insurance (49%) and the 18-24 age bracket are marginally more evasive about having private health (59%) than the 35-44-year age bracket (57%). The demographic most likely to use their private health insurance despite increasing  out of pocket expenses were over-65s, where only 29% used the public health service to avoid additional costs.

Among respondents who felt out-of-pocket expenses were more expensive, it was females who most felt the pinch (91% of female responses), compared with 88% of males.

Abigail says the survey results were interesting, particularly when comparing those who found out-of-pocket expenses difficult to afford, with the number of people who didn’t look for alternative policies: “With such dissatisfaction about how much people pay on top of their insurance, it was really surprising to see that only 39% of respondents had used a free comparison service like comparethemarket.com.au to seek better value health insurance, and that 32% of people had not bothered to look at all, as they were worried the alternatives would not be any better, and may possibly leave them without the right cover,” she says.

“Some insurers do have higher out-of-pocket expenses than others, and with the annual premium having increased by 5.9% on 1 April this year, the figures will not improve anytime soon.”


For further information or to arrange an interview:
Hannah Twiggs, PR Assistant, comparethemarket.com.au
Tel: 07 3377 8879
Email: hannah.twiggs@comparethemarket.com.au

About comparethemarket.com.au
Comparethemarket.com.au is a comparison website making it easier and quicker for Australians to compare and buy products and services they rely on in their everyday lives. Whether you’re looking for a good deal on your car insurance, health cover for you and your family, the lowest fuel prices in your area, or an energy provider that suits your needs, then go to comparethemarket.com.au. It’s a completely free service and enables Australians to make purchasing decisions with greater knowledge, confidence and savings. 

[i] http://www.apra.gov.au/PHI/Publications/Documents/1602-MedGap-20151231.pdf
[ii] A Pure Profile survey

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