A guide to preferred health providers
From dentists to optometrists, it’s nice to build a relationship and enjoy that personal touch. But is it worth the added expense?
Choosing a health fund with a health insurance preferred provider network can help you save on your treatments. Here is an overview along with a list of health insurers that have agreements in place.
Key Points
Preferred providers usually result in lower out-of-pocket costs to save you money
Some health funds have their own dental and optical centres
Preferred provider schemes are designed to reduce your out-of-pocket costs and aren't necessarily a reflection of the quality of the care.
What are preferred health care providers?
Preferred providers are health practitioners that have a special relationship with a health fund. This can also include a fund’s dental or optical centre.
Assuming you have appropriate cover, getting treatment through a fund’s preferred provider means you may receive a discount on the service as well as your health fund benefit.
Preferred providers include:
Dentists
Optometrists
Physiotherapists
Chiropractors
Osteopaths
Massage therapists
Podiatrists
What’s a preferred provider agreement?
This is an agreement between a health fund and a service provider or hospital that contains the fees and health fund rebates for health services provided.
What’s a non-preferred provider?
This covers any provider that doesn’t have an agreement with your health fund. If you want to continue seeing your favourite practitioner – your family dentist for instance – keep in mind your out-of-pocket cost may be more.
Which funds have preferred providers?
Apia
Unihealth
However, it’s always best to check with your health fund directly to see if they do have preferred health providers.
Can hospitals and doctors be preferred providers?
Yes. Health funds have agreements in place with doctors and hospitals, also known as agreement hospitals. To avoid significant out-of-pocket expenses, you need to be treated at participating hospitals that have an agreement with your health fund.
What are the pros and cons of preferred providers?
Pros
Your treatment may be cheaper
You may get a higher rebate
Claiming should be quick and easy
You’ll often know the treatment cost beforehand
Cons
You may not be able to choose your favourite provider
It may be harder to build a long-term relationship
You might need to travel further
Preferred providers may not necessarily offer the best care for your particular needs
Take the time to compare policies as some will be better value than others. And make sure your policy includes everything you need with no hidden out-of-pocket expenses. Once you determine your specific needs, you’ll be in a good place to understand which fund is best for you.
We saved Australians an average of $300 when they compared* and switched their health insurance with us over the last five years^. Why not see how much you can save?
This guide is an opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.
^Based on 136,746 customers between 1 Jan 2018 - 23 December 2022.
#We compare selected products from a panel of trusted insurers. We do not compare all products in the market.
