Representatives from the healthcare and insurance sectors are mulling over excluding mental health cover from cheaper health insurance policies as they work to simplify products as gold, silver, or bronze.
The idea is just one option proposed during the third meeting of the Private Health Ministerial Advisory Committee.
“There is definitely a model that doesn’t have those services covered in those lower tiered categories that has been put forward by health insurers. There is a model being built by government actuaries, based on work by insurers,” one source told Australian Financial Review.
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Government actuaries are modelling a series of options endorsed by the committee, with results to be released sometime in March. The committee will then make recommendations to health minister Greg Hunt.
Private Healthcare Australia (PHA), the Australian private health insurance peak industry body, said that while the sector is not pushing to remove mental health and palliative care from cheaper policies, it would not dismiss any exemptions on the lower categories.
“In terms of the specifics of what the committee is doing, all product levels except gold will have exclusions. But what those exclusions are has not yet been determined,” explained Rachel David, a member of the advisory committee.
“I can pretty much guarantee that the idea behind bronze is that essential services that you would expect to be covered by health insurance will be in bronze.”
Already, many health insurance policies, including from large funds like BUPA and Medibank Private, restrict cover for mental health patients, PHA revealed. It said that with the public system stretched, about 80% of costs for mentally ill patients in hospitals are covered by private health insurance funds.
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