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Private health cover: who is eligible?

9 August 2011 - 1:59pm

The Private Health Insurance Ombudsman (PHIO) has responded to queries from temporary residents about whether or not they are able to take out complying private health insurance products (CHIPs).

Many are confused about their eligibility due to their residency or Medicare status and are worried that this will impact on their ability to claim the Medicare Levy Surcharge.

PHIO has advised that all private health fund staff should be informed as part of their training that they are required to sell CHIPs to anyone who wishes to buy them.

The Department of Health and Ageing's Private Health Insurance Circular states: "This eligibility principle applies regardless of the colour and type of any Medicare card held by the consumer. It also applies even if the consumer doesn't hold a Medicare card."

Private health insurers need to inquire about a person's residency and visa standing, but also need to pay particular attention to their Medicare status.

It is the Medicare grade which determines what level of CHIPs they can purchase, whether or not they will be eligible for the federal government rebate and if they are liable to pay Lifetime Health Cover loading.