Health Insurance & Preferred Providers
Health insurance has become a complicated and divisive issue. We believe health insurance is a great concept if it is right for you. Ancillary or extra however is a completely different situation all together. It is possible to have health insurance without the extras cover. Elite Perio encourages patients to do their research when it comes to ancillary health cover. Often people are paying a premium, but that premium does not cover the expenditure every year.
One of the biggest problems with ancillary health insurance cover is that if you spend $1000 on ancillary insurance cover for that year and you do not claim anything, you lose that money.
Elite Perio remains committed to providing the best dental treatment available and will NOT have any contracts or agreements with any health insurance.
Some health funds have introduced preferred or contracted provider schemes that claim to decrease your out-of pocket expenses.
At Elite Perio, we strongly believe that the contracted provider schemes are not in the best interest of our patients. For these reasons:
Health insurance companies direct patients to their preferred providers based on a business arrangement NOT in your oral health best interests. Health insurance companies know nothing about dentists or dentistry
Annual limits are the same with a “preferred” provider or a “non-preferred” provider. In fact if you see a preferred provider, your annual limit can be used up quicker, as you should get more back for certain codes. This means any complex treatment needed in a given year, once that limit is used and you will not be covered at all.
With annual limits patients will often forgo treatment until the annual limit renews or not have treatment at all. This can be detrimental to your oral health.
Dentistry should be based on your oral health needs, not codes, fees, preferred providers, annual limits or gaps between your rebate and cost of the appointment. All dentists should be providing you with the best treatment and options available period.
A preferred provider is selected by the health insurance solely as business decision, not on ability, experience, qualifications or any other reason
Health insurance is a business purely related to taken money and given it back – of course under its own terms. It is only interested in profit for share holder.
Some health insurance companies are now actually own dental business’s. This means now that you will pay to be member per year, and then pay them for the service every visit. The health insurance companies will then have all the employees paid by the same health insurance and, of course directing how the company should run. This is a clear conflict of interest
In recent years, health fund rebates have failed to keep pace with the rising cost of living and some services claimable in a calendar year have become more restricted. In fact between March 2012 and March 2017 health insurance premiums have increased staggering 38%. However rebates to patient only increased by 4% in the same period! See link from the ADA website: https://www.ada.org.au/rebates
At Elite Perio our advice would be to your research into ancillary/extras cover and carefully consider if it is really value for money. We would strongly recommend having health insurance WITHOUT the extras cover. The money you save every year can be put into your own bank account and not only will you not lose it, it will grow with interest.