Georgia Dixon
Caring

Doctor's outrage over health insurer's policy change: "It's a disaster"

If you’re with Bupa health insurance, you’re about to experience some big changes to your policy, and according to one doctor, they’re not good.

Doctor Fred Betros from Toowoomba, Queensland, took to Facebook recently to warn Bupa customers about the upcoming changes to its Medical Gap Scheme, which could leave them with sky-high hospital bills.

“Incredibly, BUPA has now announced that it will not cover patients equally, depending on the hospital they choose to attend,” Dr Betros wrote.

“If a doctor wishes to provide private care for a patient under a gap cover scheme (that is avoiding out-of-pocket cost doctors’ bills), after August 1st, they will now only be able to do this for BUPA patients at BUPA contracted hospitals.

“If a patient is admitted to a non-contracted hospital (and this includes ALL PUBLIC HOSPITALS!), the patient will have to receive bills from all treating doctors and be highly likely to incur out-of-pocket costs. Many of us who work in the public system are very happy to provide private care to patients in public hospitals via this scheme but BUPA is taking that option away from us.

“At present, there is no other insurer in Australia that has taken this step. All other insurers continue to offer practitioners a gap cover scheme to ensure there is an option to avoid unnecessary bills to patients.

“We are extremely lucky to have a private health system that allows us to choose our own doctors and hospitals if we wish. With the changes BUPA propose, it means to keep your costs to a minimum, you can only be treated by doctors in a BUPA contracted facility. Therefore if you aren't treated by a doctor under BUPA's preferred terms, you have to pay a potential difference, even if the doctor wants to use a no-gap scheme. This includes patients who become unwell quickly and are taken to public hospital emergency departments.”

Dr Betros warned that if customers aren’t careful, they could end up with US-style healthcare, which could leave them with medical bills of tens of thousands of dollars.

“It is a disaster over there and they want to bring it here. Trust me we don't need or want that problem in Australia. We have enough problems with our current system thank you very much!

“If you are with BUPA, I would encourage you to make sure you completely understand the impact of what staying with their policy after August 1st will have on you. If you do not like what you see, you have the right to change to any other health fund you wish, without having to serve new waiting times for similar benefits and policy inclusions.

“I'm a doctor, but at times both me and my family are patients as well. I always want to have a complete choice and I don't want a non-medical person deciding what is best for me. I was a BUPA customer until yesterday.”

However, in a statement on its website, Bupa claimed the changes will NOT lead to an American-style health care system. “Any claims that Bupa is moving towards a ‘US style system of managed care’ are completely incorrect, and scaremongering by a select group of people whose interests are probably more self-serving than customer centric.”

The insurer also implied that Dr Betros and other doctors were only upset about the changes “because it means the out-of-pocket costs they choose to charge their customers will become very obvious”.

“It also means if they choose to send you to a non-contracted facility, potentially one they have an interest in, customers will be aware of the additional charges they will be faced with, as a result of the doctor’s decision.”

Tell us in the comments below, what do you think about Bupa’s changes? Are you a customer with them? Will you be staying after the August 1 changes?

Tags:
doctor, health insurance, insurance, Bupa, health