The ‘For Profit’ Health Insurance Industry are our friends right?  They want us to be all shiny and healthy just like on their ads. I mean, when I think health insurance I think sandy white beaches and fluffy dogs too… right? It’s just seems all a little bit too good to be true. 100% Better and all that? At what price?

For Profit Health Insurers – For example, BUPA, Medibank, NIB and HCF are private companies and their purpose is to make a profit. Their ideal customer is one who pays their premiums regularly and claims as little as possible. Just like those Gym membership we’ve all taken out and never used (Yep, guilty there too.)

‘Extras’ Health insurance covers things like Dental, Optometry, Podiatry, Physio and Chiro services. All bundled together into a single blob.

When you call a Health Insurers about Extras Cover, it’s not like taking out Car insurance.   When you take out Car insurance you expect to be asked a million questions. How old are you? What make and model of car do you own? Where is it garaged? A million and one questions – all very necessary, so that the Insurer can determine your and therefore – their risk.

But let’s take a look at insurance for your dental health. In order for you to get the best value for your dollar, the level of cover you purchase should logically be based on a risk assessment. Has your health insurer ever carried out a dental health risk assessment?

When it comes to dental health, you are almost 100% in control. It’s not like driving a car where the insurer has to take into account all the other variables on the road that you  and they cannot control. There are a few really easy habits you can develop that will effectively lower your risk for things like dental decay (and therefore the need for fillings for example), or gum disease, or tooth discolouration.

When you are low risk, you need less treatment.  It’s a win: win.  You see the dentist less.  And you save money on dental health insurance you never needed in the first place.

Authorities as diverse as the ex Chief of the ACCC, the CEO of the Private Health Insurance Commission and Choice spokesman Tom Godfrey have all recently criticised health insurance with Choice saying

“Extras cover doesn’t make any sense. Unless you are confident of receiving more in benefits that you’re paying in premiums, you should consider dropping your extra’s insurance. Our analysis of extras cover shows low average payout rate and savings of up to 45% available to consumers who drop it” – Choice Magazine, March 2016.

When it comes to transparency, there seems to be a real problem. For example, Medibank is currently being investigated by the ACCC for misleading customers. They reserve the right to change your Policy’s Terms and Conditions each year and you may not be fully informed of the changes.

Some Health Insurers also contract practitioners in schemes known as ‘Preferred Providers’’, or ‘Members Choice Providers’.  These health practitioners have entered into a contractual arrangement with the Health Insurer.

Under these contracts, your rebate will be affected. If you receive a more generous rebate when you see one of their contracted providers, this means you will reach your annual limit sooner.

What’s becoming clearer to me is that the more confused the customer is,  the more fatigued you become with having to wade your way through the reams of items numbers,  rebates and premiums, the more you fear that your dental health is not predictable and   NOT under your control, the more of a sitting duck you become.

I am passionate about helping my patients to become as low risk as possible and saving them money. The less I have to do to teeth the happier I and my patients are.

It is entirely possible to lower your risk of dental disease to the point where all you need is an annual checkup and clean. At the moment, at Your New Dentist, that will cost you $185.00 annually.  That’s $3.50 / week. In contrast, Medibanks Top Extras Cover for a 25 year old single at the moment costs  around $60.00 a month, or $720.00 / year. Read the fine print to find out what a great deal this is.  The devil is in the detail.

For me, Insurance is about having some back up in the case of an unforeseen event.  It’s different for everyone. Especially when it comes to your health.  We all seem to be being sold ‘bundles’ of all sorts of things these days. I am beginning to feel that today’s ‘ bundles’ are just yesterday’s ‘wool over the eyes’’…

Top Tips

  • If you can, self-insure for extras.  Pop a few dollars away in a savings account each week to cover the costs of ‘Extras’
  • If you need health insurance because you are in a higher risk category – let’s say you play footy. Then check out the Not For Profit Health Insurers.  Search ‘Members Own Health funds’
  • Top Hospital and Ambulance cover is really all what most people need.
  • Put your dental health in the hands of someone who is committed to helping you reduce your risk for dental problems and save you money.

I don’t know about you but my life looks nothing like a Medibank commercial.  I am not very good at running on the sand and my lily white Irish complexion makes me fry in an instant.  My dogs are a bit wonky and slightly badly behaved.  But then again, I am a real person.  I am not perfect but I like asking questions and I like having the choice to control my bank account and my health destiny.


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