AMA (NSW) welcomes Bupa policy reversal

AMA (NSW) President, Dr Kean-Seng Lim, is welcoming the policy reversal by Bupa on changes to its health insurance products that would have limited patient choice.

“It’s important that when someone buys something like health insurance that it can be used when they need it, under the treatment of the doctor they choose, and at the hospital of their choice.

“With the Ombudsman’s report today and Bupa’s announcement to reverse many of its planned changes, this should send a clear message to everyone that health insurance needs to do what it says on the tin,” Dr Lim said.

“The issue at hand was Bupa’s plan to restrict the use of its health insurance policies in public hospitals for non-booked procedures – like emergency treatment – and at private ones that aren’t part of Bupa’s medical gap scheme.

“Doctors and patients need to have certainty about how health insurance can be used and Bupa altering the way its product worked under specific circumstances undermined that.

“This change would have left both doctors and patients in very uncertain territory,” Dr Lim said.

“That said, Bupa has not yet reversed its position on restrictions patients will face on using their health insurance at non-Bupa-contracted private facilities and the AMA will continue to work with the insurer to resolve this issue,” Dr Lim said.

“No-gap arrangements under insurers’ medical gap schemes are commonly used in NSW but are not the only billing arrangements in place.

“Patients can check with their doctor if he or she is part of their insurer’s medical gap scheme.

“There are a variety of reasons doctors may opt out of these schemes and charge above no-gap agreement rates – the recommended AMA rate, for example, is often higher.

“Doctors, like people in any other professions, need to be able to charge a fee that reflects their expertise, experience, and expenses,” Dr Lim said.

Media contact: Lachlan Jones 0419 402 955