Private Health Insurers pre-approval process

Private Health Insurance – pre-approval process

It has been long established that if your surgeon recommends that you undertake a procedure and a Medicare item number exists for that procedure then your private health insurer will cover that procedure.

Some major insurers are introducing an American-style managed care system that requires you to obtain pre-approval from your private health fund despite you being entitled under the terms of your policy for the particular procedure to be covered.

This new process undermines the doctor-patient relationship and threatens the effectiveness of the Australian health system.

Some private health insurance policies exclude all plastic surgery procedures so it is important to look closely at your insurance policy and, if necessary, change your policy or your insurer.