How will my cover change?

Your cover - moving to Frank

Private health insurance customers have received an email from health.com.au outlining the upcoming changes.

We have provided a recommended Frank product for you to move to - it’s the closest equivalent cover between the two funds. Any differences between your current health.com.au cover and recommended Frank cover are detailed in your email.

 

Will my premium change?
Recommended products have been matched as closely as possible between Frank and health.com.au to keep any premium changes to an absolute minimum. You will receive direct debit confirmation at least 14 days prior to 1 July 2021.

health.com.au currently allows payment of premiums up to 30 months in advance. With Frank, this will change to a maximum of 12 months in advance.

health.com.au policies receive a 4% direct debit discount, automatically applied to your policy. While Frank does not offer this direct debit discount, the difference has been factored into your new premium amount in order to maintain a similar premium to your current one.

 

Will I have any waiting periods?
Not if you move to the cover recommended in your email. If you choose to move to a different level of cover, standard waiting periods may apply.

 

Do I have to wait until 1 July to move my cover to Frank?
From 1 July 2021 you will automatically move to the recommended Frank cover. Should you wish to move across earlier, your change of product would be treated as a standard transfer between health.com.au and Frank (i.e. waiting periods may apply).

 

What other options are there?

If the suggested Frank cover isn’t what you were hoping for, please get in touch. There’s plenty of cover options available across both Frank and GMHBA - we’re sure we can find you a cover that suits your needs.

 

Extras cover 

 

Will my annual limits reset when the change happens?
No, your annual limits will still reset on 1 January each year with Frank, same as now. Any annual limits utilised in 2021 so far will carry across to Frank and count towards your new calendar year limit with Frank.

 

Does Frank have set/fixed benefits too?
Frank has both fixed benefits (same amount back each time you claim) and percentage back Extras cover options.

 

Can I claim with Frank for services I used while with health.com.au?
Yes. You'll need to submit any outstanding claims you have for us to process by 24 June 2021. There will be a short transfer period where we'll be unable to pay claims.

You can still claim on those services after 1 July 2021, as long as you are on the same level of cover and do not have waiting periods applied.

 

What's happening to Health Maintenance?

Exact changes will vary depending on your policy, so please check your email and policy comparison guide for the specific differences between your health.com.au cover and the recommended Frank cover. This first notice email was sent in April 2021, but if you can't find it you can also log in online to view a copy.

While changes vary cover to cover, these are the sort of differences you might see:

  • Health maintenance is called Health Management at Frank 
  • New inclusions may be Cancer Council UV Products, Flu Vaccinations, Melanoma Surveillance Photography, Nicotine Replacement Patches, Stress Management Courses, Exercise Classes, Disease Management Association Fees and Health Checks
  • New exclusions may include Swimming lessons for kids, Kids sport, Hypnotherapy and Relevant first aid courses.

 

 

Hospital cover

 

Emergency ambulance

Emergency ambulance will still be covered on all policies with Frank, except for those moving to Frank Basic Hospital 500 (Basic+). If this is you, and you would like to discuss moving to a cover with emergency ambulance, please get in touch.

 

What happens if I have a surgery booked?
If you have a hospital admission booked prior to 1 July 2021 (for an admission after 1 July 2021) for services no longer covered on your new Frank policy, you are still able to claim benefits for that admission. The admission needs to be booked with a hospital or day surgery facility prior to 1 July 2021. To confirm coverage, you must provide pre-admission paperwork or a confirmation letter from the hospital, or an eligibility check must have taken place before 1 July 2021.

 

Currently undergoing hospital treatment
If you are currently undergoing ongoing treatment in hospital, you will still be covered for any admissions for services no longer covered on your new Frank policy until 31 December 2021. After 31 December 2021, benefits will no longer be available for those services unless you upgrade your cover. Please contact us as soon as possible if this applies to you so that we can work through your individual situation.

 

How to ensure continuity of cover
If you decide to select a different policy than what has been recommended to you after 1 July 2021, the effective date of this change must be backdated to 1 July 2021 to give you continuity of cover. You will have until 31 August 2021 to make this change.


Will my excess change?
It all depends on what product you're currently on. Your customer email notice will outline any excess changes from your current health.com.au product to your new Frank product. If you're still not sure, please get in touch and we can confirm what your new excess will be.

 

Pathology and radiology services in Hospital
health.com.au pays inpatient medical benefits in line with the Australian Health Service Alliance’s Access Gap Cover scheme. Access Gap Cover does not cover the services provided by pathologists and radiologists, such as blood tests and imaging but health.com.au has additional agreements with pathology and radiology providers to cover this. Pathology and radiology services in hospital will not be covered from 1 July 2021 with Frank.

For ongoing treatment or hospital admissions booked prior to 1 July, Frank will continue to pay the same higher benefits paid by health.com.au for these services up until 31 December 2021.

Otherwise, for these treatments, Medicare will always pay 75% of the Medical Benefits Schedule fee and Frank will pay the other 25%. So, you’ll have to pay an out of pocket fee if your provider charges above this.

 

What is a restricted service?
Restricted services are hospital claims which are limited to a minimum (default) benefit – a minimum dollar amount set by the Australian Government for accommodation as a private patient in a shared room of a public hospital. A restricted service does not pay towards the cost of intensive and coronary care, or theatre fees in a private hospital or private day centre, therefore you may incur a large out-of-pocket expense.


What if my cover is currently suspended?
Your cover will remain suspended until your reactivation date. If your reactivation date is later than 1 July 2021, you will be automatically moved over to the recommended Frank cover on that date, but your suspension will continue. You are welcome to reactivate your cover earlier if you choose.

 

Will my Lifetime Health Cover (LHC) be affected?
No, your Lifetime Health Cover will not be affected unless you change to a different product than the one we have recommended to you (such as dropping your hospital cover to Extras only). You can learn more about LHC here.

 

Want to know more?

Learn more about the upcoming changes at health.com.au here