New changes to private health insurance categories are aimed at making it easier for consumers to compare insurers and easily determine which packages best suit their needs.
This overhaul to the systems means many changes for all health care consumers, including those living with chronic pain.
The minimum coverage requirements for product tiers provide a progression of service coverage across products in a way that reflects the existing health insurance market.
Each product tier will now have a consistent set of clinical categories required as minimum coverage. There are two clinical categories for pain management.
Pain management that does not require a device or prosthesis will now be a minimum requirement for all PHI policies, while pain management that does require a device or prosthesis will be a minimum requirement for Gold policies.
Importantly, insurers will not be prevented from providing cover for any treatment in any of the product tiers. For example, they could choose to provide cover for pain management that requires a device under a lower tier product than Gold. In addition to the specific pain management categories, there are other clinical categories that may be relevant to treatments for pain (e.g., a back, neck and spine category will cover procedures to treat back pain, which will be a minimum requirement for silver hospital treatment insurance products).