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Welcome to the Private Health Insurance Ombudsman on-line.
The Private Health Insurance Ombudsman is an Australian statutory body and its powers and functions are set out in Part VIC of the National Health Act 1953 (Cth)
The main role of the Ombudsman is to provide private health insurance members with an independent service for health insurance problems and enquiries. Hospitals, medical practitioners (including some dentists) and health funds can also approach the Ombudsman about problems with any health fund, private hospital or medical practitioner, although all complaints must be about a health insurance arrangement.
Other functions of the Ombudsman include:
providing advice about private health insurance to consumers;
providing feedback to health funds and Government about issues causing problems for consumers; and
dealing with disputes about prostheses arrangements
Private Health Insurance Ombudsman
All material © Copyright Private Health Insurance Ombudsman, 2001. All rights reserved. Please note the disclaimer that relates to use of this site, and our site privacy statement . Comments, problems with this site? Please report them to webmaster@phio.org.au Last modified: 2001-06-06 10:07:37
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Results from search: http://www.phiac.gov.au/
Private Health Insurance Administration Council (PHIAC)
This site was last updated
13 May 2002
What's been updated
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Health Cover and other
Incentives and Surcharges
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Find out about our
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Welcome to PHIAC
The Private Health Insurance Administration Council (PHIAC) is an independent
Statutory Authority that regulates the private health insurance industry.
Private health insurance policy is set down by the Australian Commonwealth
Department of Health and Ageing.
In addition, PHIAC:
collects and disseminates financial and statistical data regarding
health funds; and
collects and disseminates information about private health insurance
to enable consumers to make informed choices.
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Last modified:
13 May, 2002
Results from search: http://www.phahealth.co.uk/
PHA Health & Medical Insurance - Individual, Company, Group & Expat
PHA Medical & Healthcare Insurance
89 Station Road
Sidcup
Kent
DA15 7DN
UK
Tel: 0870 7700 942
Fax: 0870 7700 941
Contact Us
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If you feel like a mushroom -
in the dark about your healthcare !
We can help -
Health Insurance is a minefield !
With over 30 companies offering over 200 plans in the UK alone, how can you
be sure you buy the right plan?
You need
INDEPENDENT SPECIALIST ADVICE
PHA is totally independent of ANY insurer and will give you truly unbiased
free advice. Do remember that if you contact an insurer direct, or a "tied
agent" of an insurer, they will only be authorised to advise you on the schemes
run by that single organisation. Independent status allows a broker to
advise its clients on a wide range of policies and to select the best one
according to the clients' own circumstances. PHA hold over 30 insurance
agencies and explains in Plain English the
benefits of the plans so that you can understand what is covered and what
is not.
Health Care insurance is a complex product which is why you need specialist
advice from truly Independent Advisors such as PHA. We do not sell an insurance
plan from one Insurance company instead we advise you on the best plan that
suits your needs for the lowest premium from a whole range of insurers.
Here are some examples of monthly premiums for recomended plans.
Click Here for more details of the plan benefits.
Individual Examples
Click on each range (Comprehensive, Mid-Range, Budget or High Excess Option) for a benefit summary
* Including a £100 excess
** Includes a £2,500 excess
Age =
25
30
35
40
45
50
55
60
65
70
Comprehensive *
£42.17
£44.02
£46.96
£51.15
£56.54
£64.77
£76.64
£80.32
£107.15
£127.92
Mid-Range *
£24.00
£26.50
£29.26
£32.78
£38.93
£46.01
£53.34
£66.05
£84.31
£107.59
Budget
£20.09
£22.68
£25.94
£27.62
£28.34
£31.54
£33.86
£36.72
£44.49
£54.62
High Excess
Option **
£8.95
£10.96
£10.96
£14.98
£14.98
£23.77
£23.77
£35.04
£48.52
£63.62
Family (2 adults + 2 children) Examples
Click on each range (Comprehensive, Mid-Range, Budget or High Excess Option) for a benefit summary
* Including a £100 excess
** Includes a £2,500 excess
Age =
25
30
35
40
45
50
55
60
65
70
Comprehensive *
£105.42
£110.05
£117.41
£127.87
£141.35
£161.94
£191.59
£200.79
N/A
N/A
Mid-Range *
£59.09
£64.09
£69.92
£76.65
£88.96
£103.11
£117.77
£143.18
N/A
N/A
Budget
£60.00
£64.78
£71.30
£74.66
£76.10
£82.50
£87.14
£92.86
N/A
N/A
High Excess
Option **
£17.90
£21.92
£21.92
£29.96
£29.96
£47.54
£47.54
£70.08
£97.04
£127.74
The above policies have been chosen for their 'best value for money'
cover for a Comprehensive, Mid Range, Budget and High Excess policy. If you
find any of the premiums of interest, please specify on the
quotation form which one you require. Should you
require independent advice on a wider range of plans (not limited to the
recommended plans shown above), then please use the
application form accessible by clicking here .
A low-budget healthcare protection policy is available here -
Healthcare Hospital Cash Plan .
We are able to quote you for various categories of health insurance. If you
would like to learn a little more about the various classifications of
health insurance, click here to check
the Definitions of Types of
Healthcare Insurance You may be surprised at the number of different types
of cover that there are and which you might need.
To go to the relevant sections, click on the links here :-
Health Insurance for Individuals
Recommended Plans
Health Insurance for Companies/Groups
Critical Illness Insurance
Expat Health Insurance
Income Protection
Long Term Care
Hospital Cash Plan
Health Trust Fund
Free
Quote from:-
Quote
Options from:-
To go straight to the Medical Insurance Quotation request form please use the
links below according to whether you are an Individual or a Company/Group
administrator. We have specialist policies relative to these distinctions
and will be happy to provide you with a free quotation.
Recommended Plans
Individuals
Companies/Groups
PHA PROMISE TO KEEP YOU IN THE BEST OF HEALTHCARE
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Medibank Private Limited ABN 47 080 890 259 is a registered health benefits organisation.
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Private Health and Medical Insurance Online - Medibroker UK Independent Brokers
PRIVATE MEDICAL AND HEALTH INSURANCE UK
WHO ARE WE...?
Medibroker Online is a fully independent
intermediary and client Advisor for private medical insurance (PMI) and
permanent health insurance (PHI) across the domestic UK market and worldwide
to expatriates. We act exclusively on behalf the customer, as your consultant,
giving "best value" advice, when you choose to purchase such
insurance products. We deal with all the major health insurance companies
in the UK and many overseas. Thus we do not deal only with one insurer but
can offer you at least three quotations, more if requested. Medibroker can
place business for individuals, families, groups or small companies. We are
responsible for all the advice we give, being regulated by the General
Insurance Standards Council (GISC) of which we are a member.
WHAT CAN WE OFFER...?
With hundreds of healthcare plans
available from a wide range of insurers and product plan providers in
the UK, Medibroker have negotiated terms of business with the following
companies, where we can offer you a quotation and place your medical
or health insurance plans:
BUPA Healthcare UK
Bristol Contributory Welfare Association (BCWA) Healthcare UK
Capital Healthcare Optima
Friends Provident
Exeter Friendly Society
Health-on-line
Healthcare4Life
Legal and General
Medisure Health
Norwich Union
Permanent Health Company (PHC) Limited
PPP Healthcare
Royal & SunAlliance Healthcare
Secure Health
Standard Life Healthcare Plans
Swiss Life
Universal Provident Healthcare
WPA Healthcare
Medibroker staff review the market regularly, for the most competitive,
comprehensive, value for money PMI and PHI products and insurance plans. We
will keep you informed at renewal of your private medical insurance or other
healthcare plans, of premium changes and assist you and advise with any
legitimate disputes or delays you may suffer due to insurers. We can help
you define the exact product you require for the budget you feel best suits
you. We can explain the terms and conditions of medical and health insurance,
the ways to cut down premiums using deductibles or voluntary excesses on
claims. We can provide you with a Free Quote guaranteed to be Best Advice.
MEDIBROKER'S AIM IS TO BE THE CONSULTANT TO THEIR CLIENTS AND NEVER THE
SALESMAN OF ANY INSURANCE COMPANY. WE OFFER REAL CHOICES AND TRANSPARENCY
OF PRIVATE MEDICAL INSURANCE BENEFITS AND PREMIUMS OFFERED BY A RANGE
OF HEALTH INSURANCE COMPANIES IN THE MARKET
PRIVATE MEDICAL INSURANCE PRODUCTS AND PLANS
We can offer Best Value Cover at lowest premiums for Protection Insurance in:
Private Medical Insurance (PMI)
Critical Illness Insurance
Dental Insurance
Long Term Care
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Income Protection Plans
Evacuation Emergency Mortal Remains
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Worldwide Cover
Medibroker Online offers free online quotations on all above by
email ~ post ~ fax ~ telephone
FACTS ABOUT ILL HEALTH
Can you financially afford to be off work due to accident or illness for
one month, three months, a year, or even become permanently disabled? If you
need a non-urgent operation quickly, where can you go and can you afford it?
The disturbing facts of life are that in the UK
Each year over 130,000 people suffer a stroke and 80% of these survive at
least one year or more
One in three people will contract cancer sometime in their life
One in four healthy men in the UK between 20 and 40 will have contracted a
critical illness before age 65. For women, this is one in five and, of those
who develop cancer, 40% will survive 5 years or longer
One in six healthy men will suffer a heart attack before they reach 65 years
of age
WHEN ILLNESS STRIKES...
WHAT HAPPENS TO YOU?
Through no fault of your own, through unforeseen illness or accident, you
could be temporarily out of work (and income), disabled or needing long term
care. Who will pay for all this and provide your security and quality of life?
You could wait 8 months or more on the NHS for a simple hernia operation. A
medical emergency could be round the corner. Are you prepared and protected?
WHERE WILL THE MONEY COME FROM - WHO PAYS?
Who pays the bills when you are incapacitated due to illness or injury?
Private Medical Insurance, Income Protection and Critical Illness Insurance
can give you security and peace of mind concerning all of the above events.
If you plan for your financial future and security through a pension, you
also need to plan your health future too.
TYPICAL OPERATION MEDICAL COSTS
A hernia operation costs about £1,300 today in the UK whilst a hip
replacement costs in the region of £5,786. It surely makes sense today
to safeguard yourself and your family income, in the unforeseen event of a
medical catastrophe, accident or illness, no matter how serious it may be.
Private Medical Insurance is no longer a luxury, but an essential part of our
security.
Ask For A Free Quote
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Tyne & Wear, NE25 9DA, UK
Telephone: (0191) 297 2411
Fax: (0191) 251 6424
Email: advice@medibroker.com
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Results from search: http://www.demon.co.uk/dayco/pha.html
Private Medical Insurance, Health, Pets & Travel - online cover from PHA.
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CONFUSED?
Choosing the right insurance plan is a minefield!
With hundreds of plans, how can you be sure you buy the right plan?
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KEEP YOU IN THE BEST OF HEALTHCARE
PHA are specialist Healthcare Intermediaries
- with over 30 insurance agencies.
We find the right plan for you,
your family or company.
Check our site for Private Medical & Health Insurance (UK or Expat ),
Travel ( Trip , Long Stay , Annual etc.), UK Pets and similar.
PHA
89 Station Road, Sidcup,
Kent, DA15 7DN, UK
Tel: 0870 7700 940
Intl: +44 870 7700 940
Fax: 0870 7700 941
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OFFICES OPEN 6 DAYS A WEEK:
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Results from search: http://www.privatehealth.co.uk/
Private Healthcare UK
Private hospitals
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across the UK
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operating in the UK
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See what health screening services are available
The private healthcare industry
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Search for a consultant on-line
You can now use the
find a doctor facility to search the databases
of three leading UK private hospital organisations.
Laing and Buisson have
kindly given permission to provide key statistics
on the private healthcare sector. Laing
& Buisson publishes a wide range of information and statistics
on the independent health and social care sector.
The Princess
Grace Hospital in London has opened a new Snoring
and Sleep Apnoea Clinic .
The Portland
Hospital for Women and Children has set up a site dedicated to its
Cochlear Implant
Information Centre on the Web.
Surgicare
have extended their web site on cosmetic surgery and surgery for
varicose veins, cataracts, hernias and skin blemishes.
The Cromwell
Hospital has opened a new Gamma
Knife Centre within its Neuroscience Centre.
We also have a listing of those private
healthcare facilities that have a presence on the web. And if you're
looking for a nursing home or private
hospital , we have access to on-line databases.
Private Healthcare UK is provided by emseven
healthcare to help people find information about private healthcare.
As the site develops we will include information about health insurance,
private hospitals, nursing and residential care, health screening
and the private healthcare industry in general. It will provide
quick and convenient access to all kinds of information about private
healthcare services and the companies that are active in the UK.
We welcome comments and suggestions about
the site.
If you would like
information about how to develop a Web site for your private healthcare
service or facility, send an email to
sales@emsevenhealthcare.com or take a look at our
special offers for private healthcare providers.
If you have comments
or suggestions about the site please complete the
comments form .
You can telephone us
on 020 8752 2200 or fax us on 020 8752 2201.
You can write to us
at em:seven healthcare, Cambridge House, Cambridge Grove, Hammersmith,
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Early Release of Health Insurance Coverage Estimates: New Data from Quarter 3 of the 2001 National Health Interview Survey ( 03/06/2002, National Center for Health Statistics )
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Guide to Health Insurance (Health Insurance Association of America)
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Evaluating Access to Emergency Care Through Your Health Plan: A Checklist for Consumers (American College of Emergency Physicians)
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Guide to Long-Term Care Insurance (Health Insurance Association of America)
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Insure Kids Now: Find Your State (Dept. of Health and Human Services) - links to state programs for free or low cost health insurance for children.
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Can the Retiree Health Benefits Provided By Your Employer Be Cut? (Dept. of Labor)
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WISEWOMAN: Improving the Health of Uninsured Women 2001 (Centers for Disease Control and Prevention)
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Sorting
Out the Details of Private Health Insurance In
most cases, private health insurance comes through
your employer, who picks up the vast
majority of the premiums. Usually, you'll have some
choice as to the type of plan you have.
The job of choosing the coverage options is left to the employer. If
you're self-employed or work for a company that doesn't
offer health insurance, you can
buy it on your own. Taking that route isn't cheap.
You may have a wide range of plans and
plenty of coverage options to choose from, but the final decision will probably come down to what you can afford. In
1995, more than 60 percent of Americans under the age
of 65 had some type of private
health insurance. Many of us have the coverage, but
understanding the different kinds of
health insurance can be a challenge. No matter who pays the premiums, make sure you know what you're getting. Private
health insurance can be broken down into two broad categories: traditional and managed
care .
Within those
categories, there are four basic types of plans: Traditional
indemnity plans, which are now often called fee-for-service plans; PPO ,
or Preferred Provider Organizations; POS ,
or Point-Of-Service plans; and closed-panel HMOs , or Health Maintenance Organizations. No
one type of health care plan is better than the other.
It really depends on your needs
and preferences. Some people enjoy the autonomy offered
by fee-for-service plans, while
others prefer the low costs associated with closed-panel HMOs. Also, as health insurers compete for business, distinctions among the types of plans may blur. 'Traditional' Health Insurance Up
until about 30 years ago, most people had traditional
indemnity coverage. These days,
it's often known as "fee-for-service." Indemnity plans
are a bit like auto
insurance: you pay a certain amount of your medical expenses up front -- in the form of a deductible -- and afterward the insurance company pays the majority of the bill. Advances
in modern medicine increased the cost of providing
health care and made it possible
for people to live longer. Those advances caused many
insurance companies to look for ways
to reduce their costs of doing business, giving managed care the boost it enjoys today. Fee-For-Service For
years, indemnity or fee-for-service coverage was the
norm. Under this type of health
coverage, you have complete autonomy when it comes
to choosing doctors, hospitals and other
health care providers. You can refer yourself to any
specialist without getting permission,
and the insurance company doesn't get to decide whether the visit was necessary. You
don't, however, have complete autonomy. Most fee-for-service
medicine is managed to a
certain extent. For instance, if you're not already incapacitated, you may need to get clearance for a visit to the emergency room. On
the down side, fee-for-service plans usually involve
more out-of-pocket expenses. Often
there is a deductible, usually of about $200, before
the insurance company starts paying.
Once you've paid the deductible, the insurer will kick
in about 80 percent of any doctor
bills. You may have to pay up front and then submit
the bill for reimbursement, or your
provider may bill your insurer directly. Under
fee-for-service plans, insurers will usually only pay
for "reasonable and
customary" medical expenses, taking into account what
other practitioners in the area
charge for similar services. If your doctor happens
to charge more than what the insurance
company considers "reasonable and customary" you'll
probably have to make up the difference
yourself. Traditionally,
preventive care services like annual check-ups and
pelvic exams haven't
been covered under fee-for-service plans. But as the
evidence mounts that preventive care
can prevent more costly illnesses down the road, some insurers are including them. Fee-for-service
plans often include a ceiling for out-of-pocket expenses,
after which the
insurance company will pay 100 percent of any costs.
Needless to say, the ceiling is usually
pretty high. In
a nutshell, fee-for-service coverage offers flexibility
in exchange for higher
out-of-pocket expenses, more paperwork and higher premiums. Managed Care Managed
care has been around in one form or another since the
1930s, but it really took off
in the last 10 years. As it grew, it evolved, leaving
us with three basic types of managed
care plans. Today, the majority of people with private
health insurance have some type of
managed care. Although
there are important differences among the different
types of managed care plans,
there are some similarities. All managed care plans
involve an arrangement between the
insurer and a selected network of health care providers,
and they offer policy holders
significant financial incentives to use the providers
in that network. There are usually
explicit standards for selecting providers and a formal procedure to assure quality care. Preferred Provider Organizations (PPOs) One
step over the managed care border is the Preferred
Provider Organization. PPOs have made
arrangements for lower fees with a network of health
care providers. PPOs give their
policyholders a financial incentive to stay within that network. For
example, a visit to an in-network doctor might mean
you'd have a $10 co-pay. If you
wanted see an out-of-network doctor, you'd have to
pay the entire bill up front and then
submit the bill to your insurance company for an 80
percent reimbursement. In addition, you
might have to pay a deductible if you choose to go
outside the network, or pay the
difference between what the in-network and out-of-network doctors charge. With
a PPO, you can refer yourself to a specialist without
getting approval and, as long as
it's an in-network provider, enjoy the same co-pay.
Staying within the network means less
money coming out of your pocket and less paperwork. Preventive care services may not be covered under a PPO. Exclusive
Provider Organizations are PPOs that look like HMOs.
EPOs raise the financial
stakes for staying in the network. If you choose a
provider outside the network, you're
responsible for the entire cost of the visit. Point-of-Service
(POS) Point-of-service
plans are similar to PPOs, but they introduce the gatekeeper,
or Primary
Care Physician. You'll need to choose your PCP from
among the plan's network of
doctors. As
with the PPO, you can choose to go out of network and
still get some kind of coverage. In
order to get a referral to a specialist, though, you
usually must go through your PCP. You
can still choose to refer yourself, but it'll mean more hassles and more money coming out of your pocket. If
your PCP refers you to a doctor who is out of the network,
the plan should pick up most
of the cost. But if you refer yourself out, then you'll
probably have to deal with more
paperwork and a smaller reimbursement. You may also
have to pay a deductible if you go
outside the network. POS
plans may also cover more preventive care services,
and may even offer health
improvement programs like workshops on nutrition and
smoking cessation, and discounts at
health clubs. Health Maintenance Organizations (HMOs) Most
of the time, when you talk about HMOs, you're really
talking about closed-panel HMOs --
the least expensive, but least flexible type of health
plan. They also tend to be geared
more toward members of group plans than individuals. In
exchange for a low co-payment (or sometimes no co-pay
at all), low premiums and minimal
paperwork, an HMO requires that you only see its doctors,
and that you get a referral from
your primary care physician before you see a specialist.
If you can still pick up the phone,
you'll probably need to get clearance before you can visit the emergency room. An
HMO may have central medical offices or clinics (such
as those used by Kaiser
Permanente), or it may consist of a network of individual
practices. In general, you must
see HMO-approved physicians or pay the entire cost
of the visit yourself. HMOs have the best
reputation for covering preventive care services and health improvement programs. For
more in-depth information on auto, health, home and life insurance, visit insure.com .
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