Another step toward the end of preferred provider schemes

preferred provider schemes

In response to calls from the SA Legislative Assembly to prohibit the practice, the Australian Dental Association (ADA) has asked private health insurers to act now to fix the ongoing problems with differential rebates before they are forced to.

Congratulating Connie Bonaros MLC for putting the motion to the South Australian Legislative Assembly, ADA president Dr Hugo Sachs said health funds should take a leaf out of HBF’s book and end arrangements around preferred provider schemes and differential rebates which discriminate against many private health insurance policyholders.

“Private health insurance is sold as allowing consumers choice; but in reality, the current system offers differential rebates based on who provides that service and restricts that choice,” Dr Sachs said.

“If you hold an extras policy with a health fund then you should get exactly the same rebate as anyone else who holds that policy regardless of where you live or which dentist provides the treatment.”

Last week, HBF announced they would be ceasing the vast majority of their preferred provider scheme in WA in favour of a more equitable system which provides the same rebates for the same treatment to patients with the same policy regardless of which dentist they see.

The ADA has always maintained that preferred provider schemes are not in the best interests of patients or dentists and have called on all health funds to dismantle their schemes and pay the same rebate for the same treatment under the same policies.

This position was echoed in the findings of the Senate Inquiry into the value and affordability of private health insurance which recommended that Commonwealth legislation is amended to prohibit the current practice of differential rebates for the same treatments provided under the same product in the same jurisdiction.

“The SA motion reiterates the call for action at the Commonwealth level and I look forward to discussing this proposal in more detail in my next meeting with Minister Hunt,” Dr Sachs said.

“The ADA remains willing to work with individual health funds to create more suitable policy options for dental patients.

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