What your health cover can do for you during COVID-19
COVID-19’s impacting every area of our lives. This (understandably) includes the way we access health care and use our health cover.
In an evolving situation, it can be hard to stay across the facts. So here we answer some key questions you may have about your Hospital and /or Extras cover. We also address another hot topic: the cost of your cover – now and in the future.
I can’t access all of the services I’m covered for during COVID-19. Why should I keep my Hospital cover?
We appreciate this situation is frustrating. Especially if you’d planned surgery that’s been postponed. There was some good news on 21 April though, when the government gave private hospitals the go-ahead to carry out certain elective surgeries.
It’s also important to know that there are many non-elective surgeries (heart-related, cancer treatment, obstetrics, accidents and more) that are still happening and can be done in a private hospital, with your chosen specialist.
When COVID-19’s over there’s likely to be a significant surgery backlog in the public system, making wait times even longer than usual. Which is unlikely to be the case in the private system.
Am I covered if I’m admitted to hospital because of COVID-19?
Yes, whichever level of Hospital cover you’re on, you’re covered for COVID-19 hospital admissions.
What other value can I get from my Hospital cover during COVID-19?
You may not be aware of the great work the Teachers Healthcare Services team does. They help eligible members* with Hospital cover access a range of support services, including Care Coordination and Mental Wellness programs, and Hospital Substitute Services.
They also provide access to the New Family Program, which is available to more members during COVID-19 (see below).
Can I access the New Family Program?
The New Family Program is an (online and phone) support program for expectant and new parents. Usually, the program’s a once in a lifetime benefit for members with Hospital cover. Women can enroll when they're 36 weeks pregnant, up until their baby's three months old.
As many families may need extra support during social isolation, we’ve opened the program up to women from the 14th week of pregnancy, and those who've accessed the New Family Program before. These measures are in place until 30 September 2020.
*These programs are brought to members through Teachers Healthcare Services, an initiative of Teachers Health to support members’ health and wellbeing through quality, evidence-based health management programs and services. To be eligible for a program you must be a member of Nurses & Midwives Health and have Hospital cover with all relevant waiting periods served. Additional eligibility criteria may apply. Eligible members are connected with a dedicated Teachers Healthcare Services care coordinator who supports them on their personal journey.
What services can I claim for using my Extras cover during COVID-19?
There are lots of services that haven’t been affected by COVID-19, including:
- Emergency dental treatment
- Glasses/contacts (online orders with a current script)
- Healthy Lifestyle programs (we recently added 28 by Sam Woods and TIFFXO to the list of approved programs and are looking to add more)
- Artificial aids and appliances
- Home nursing
- Emergency ambulance
- Childbirth education.
What you can claim for depends on your level of cover (and remaining limits). Check your cover
There’s also a wide range of telehealth services you could claim for during COVID-19 (see below).
What telehealth services can I access through my Extras cover?
In response to the current restrictions, we’ve expanded our coverage of telehealth services (it was previously limited to psychology).
Depending on your level of cover (and remaining limits) you could now claim for:
- Dental – item 919 (until 30 June 2020)
- Speech therapy
- Occupational therapy
- Exercise physiology
- Lactation nurse.
These measures are in place until 30 September 2020, when they’ll be reviewed.
If your provider's still offering face-to-face services (like physio or chiro) you can claim as you usually would.
The cost of health cover
I’ve heard health funds are making record profits during COVID-19. Is that true?
It’s a good question. There are two parts to the answer, as far as Nurses & Midwives Health is concerned:
- We’re a not-for-profit health fund. This means the money you pay in premiums is used to look after you, our members, not provide shareholder payouts. So, our wins are your wins!
- There haven’t been any savings, yet – and it’s unclear if there will be. No one knows how long COVID-19 will last, how many elective surgeries will be delayed, how many COVID-19 hospital stays we’ll be covering, and how many urgent elective, emergency and obstetrics services will be paid for by health funds in coming months. So, it’s way too soon to call this one.
If you end up paying out less in claims during COVID-19, will you pass the savings on to members?
Yes – absolutely. As we said, we’re a not-for-profit fund, which means you’re our priority.
First, we’ll need to establish what these savings are, if they happen. We’ll also have to offset the financial impacts of member-support measures like:
- Postponing the planned 1 April premium increases to ease members’ financial stress
- Enabling members who’ve lost income due to COVID-19 to temporarily suspend their memberships.
So, as above, we just don’t know how this will pan out. Please bear with us, as you will benefit if our balance sheet is healthier than projected down the track!
Why shouldn’t I just drop my cover for a while to save money?
Unlike cover suspensions, dropping your cover means re-serving waiting periods when you get health insurance again. If you’re struggling financially it’s much better to suspend your cover so you can start claiming again as soon as you reactivate your membership.
Dropping your cover could also mean you’d be liable for the Medicare Levy Surcharge (if applicable).