Putting members’ health before profit

hirmaa funds top AMA’s benefits report card

hirmaa funds among top providers of critical benefits, according to the Australian Medical Association.

The figures are in and Australia’s not-for-profit and member-owned health insurers have been proven to provide among the highest level of benefits out of all of the country’s health funds.

The Australian Medical Association’s (AMA) Private Health Insurance Report Card 2016, published on March 17, shows that insurers with the highest average benefits were not-for-profit, community based and member-owned funds.

As the peak body for 19 of Australia’s not-for-profit, member-owned and community-based health insurance providers, hirmaa has welcomed the AMA’s assessment of the industry.

“The AMA’s Report Card is a testament to the importance and value of not-for-profit health insurers,” hirmaa CEO, Matthew Koce said.

Not-for-profit insurers out-ranked their for-profit counterparts on common yet vital benefit areas such as cataract surgery, knee replacements, coronary bypass surgeries and stents.

“The AMA’s Report Card adds to the mounting evidence that bigger is not always better when it comes to choosing your private health insurance provider,” Mr Koce said.

As member-owned organisations, about 90 per cent of all premiums paid to hirmaa funds are invested back into improving benefits for policyholders. This is in stark contrast to for-profit insurers, which serve shareholders.

Mr Koce said that in addition to providing some of the highest levels of benefits and the lowest out of pocket expenses to policyholders, hirmaa funds are also leaders in providing the high standards of cover.

“Only around one per cent of all hirmaa fund policies comprise high levels of exclusions, restrictions and excesses, compared to the industry average of 23 per cent, according to 2015 industry figures.”

“Their not-for-profit business model, focus on providing superior benefits and coverage as well as outstanding customer service results in extremely high member satisfaction and retention rates, year on year.”

Mr Koce also noted that the AMA’s report card came just weeks after the 2016 premium round announcement whereby nine out of the 16 private health insurers that posted increases under the national average of 5.59 per cent were hirmaa funds.

“hirmaa funds consistently provide lower premium increases, averaging a rise of 5.2 per cent annually since 2012 compared to the industry-wide 5.78 per cent increase,” Mr Koce said.

“Consumers should shop around when it comes to their private health insurance and be aware that some of the larger, for-profits insurers are selling policies that exclude potentially lifesaving procedures or impose big and unpleasant out pocket expenses on unwary consumers.”

hirmaa is the peak industry body for 19 not-for-profit, member-owned and community-based health funds which together provide private health insurance for over one million Australians.