Overseas Visitor Health Insurance Complaints Spike By 50%

Each year the Private Health Insurance Ombudsman receives complaints from health insurance policy holders in Australia. In 2013/14 the ombudsman reported that complaints from overseas visitor health cover (OVHC) and overseas student health cover (OSHC) holders was up 50% from 138 to 207.

The Worst-Performing Health Funds

The table below shows that BUPA received by far the most complaints (42% overall). Last financial year BUPA had relatively few complaints, but this number increased by 280% in 2013/14.

Another spike was seen for IMAN (nib) with complaints rising by 127% to an overall total of 25 for last financial year. Medibank and Allianz round off the ‘top 4’ most complained-about funds for their OVHC (eg 457 visa health insurance) & OSHC policies.

It should be noted that for Australian Unity and HIF, the total number of complaints was very low despite their strong market presence. This may highlight strong customer service by the two Australian health funds.

When reviewing these results it is important to consider that different Australian health insurance companies hold different market shares which remains relatively steady each year. While in part this may explain why some funds receive more complaints than others, it does not explain why some health funds received spikes in the number of complaints last financial year compared to the previous year.

What Are Health Policy Holders Complaining About?

There are four key complaint areas for overseas visitor health cover and OSHC policy holders:

1. The waiting periods set by the health fund in relation to any pre-existing condition they may have (or that the health fund claims they have)
2. Service delays (such as delays on getting approval to conduct a treatment)
3. Delays in payment (from claims)
4. The ability to cancel existing health insurance membership

Unlike Australian citizens, overseas visitors do not have the public health system to fall back on if treatment options are not provided by their Australian health cover (such as 457 visa health insurance), which can lead to many complaints. When a visa holder is refused cover for a treatment, they can either pay the full hospital or doctor’s cost, or return to their home country for treatment. In some cases, moving back to the home country for a set period can lead their employment and visa status in Australia to be lost, so it is often a difficult decision to make. What can make this worse is many providers (such as hospitals) charge full fee-paying patients more than they would charge to Medicare for the same treatment.

Summary For Overseas Visitors To Australia

While all the overseas visitor health insurance policies compared on this site meet the Department Of Immigration And Border Control’s condition 8501 requirements, they can differ dramatically based on price, policy features and customer service. Visa applicants and holders should be aware of spikes in complaints for certain health funds and consider if the fund is right for them. While health cover complaints are just one aspect, they can highlight larger issues in the specialist overseas visitor health cover areas of the market for students and working visa holders.

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