Finding a provider for a certain procedure When selecting a provider for a certain procedure, participants varied in their responses. Some used their referral or recommendation, others made their own choice or asked friends / family / doctor’s colleagues, and some consulted the list of preferred providers. insurer’s The majority of participants were aware of the existence of preferred provider lists, but only few had used them, usually motivated by cost. These participants gave mixed reviews as to the outcomes. you use a preferred provider you get as much Female, 53 years, private health “If don’t don’t back.” – insurance less than 12 months don't feel pressure but I get more money back so it's a preference for the point of “I me… What's having insurance if I'm going to use providers that I'm not covered Female, 34 years, private for?” – health insurance for 8 years In general, most participants felt empowered to make their own choices of providers. wants to be told they have to go to a certain doctor or dentist. You build an intimate “No-one relationship with these Female, 48 years, private health insurance for 5 years people.” – don't think we should be match-maker between insurance companies and health care providers. “I This is just not Male, 49 years, private health insurance for 5-9 years right.” – preferred provider might not be my preferred Female, 35 years, private health “Their provider.” – insurance for 5-9 years it comes to my health it's important for me to go to the doctor I have most confidence “When in.” – Male, 26 years, private health insurance for 5-9 years Experiences of expectations not met and challenges encountered Participants spoke about their expectations not being met due to inconsistent information, which largely resulted in them incurring unexpected costs for services and procedures due to not being covered and believing they were, and not receiving the rebate they were expecting. Unexpected costs experienced by participants included: Costs for anaesthetists and additional specialists / assistant surgeons; Emergency hospital admission fee; Private hospital excess; Co-payment; Tests;
Finding a provider for a certain procedure When selecting a provider for a certain procedure, participants varied in their responses. Some used their doctor’s referral or recommendation, others made their own choice or asked friends / family / colleagues, and some consulted the insurer’s list of preferred providers. The majority of participants were aware of the existence of preferred provider lists, but only few had used them, usually motivated by cost. These participants gave mixed reviews as to the outcomes. “If you don’t use a preferred provider you don’t get as much back.” – Female, 53 years, private health insurance less than 12 months “I don't feel pressure but I get more money back so it's a preference for me… What's the point of having insurance if I'm going to use providers that I'm not covered for?” – Female, 34 years, private health insurance for 8 years In general, most participants felt empowered to make their own choices of providers. “No-one wants to be told they have to go to a certain doctor or dentist. You build an intimate relationship with these people.” – Female, 48 years, private health insurance for 5 years “I don't think we should be match-maker between insurance companies and health care providers. This is just not right.” – Male, 49 years, private health insurance for 5-9 years “Their preferred provider might not be my preferred provider.” – Female, 35 years, private health insurance for 5-9 years “When it comes to my health it's important for me to go to the doctor I have most confidence in.” – Male, 26 years, private health insurance for 5-9 years Experiences of expectations not met and challenges encountered Participants spoke about their expectations not being met due to inconsistent information, which largely resulted in them incurring unexpected costs for services and procedures due to not being covered and believing they were, and not receiving the rebate they were expecting. Unexpected costs experienced by participants included: Costs for anaesthetists and additional specialists / assistant surgeons; Emergency hospital admission fee; Private hospital excess; Co-payment; Tests;
ACCC%20Consumer%20Survey%20Private%20Health%20Insurance%20Final%20Report.docx