Research report

2016 State of the health funds report

24 Mar 2017

The information used in the report in order to compare health funds is based on data collected for regulatory purposes. This information is the most appropriate, independent and reliable data available.

The report is intended to help you to decide which health funds to consider, though it won’t necessarily indicate which of the fund’s policies to purchase. Virtually all funds offer more expensive policies that can be expected to provide better than average benefits as well as cheaper policies that provide less.

The State of the Health Funds Report The State of the Health Funds Report (SOHFR) compares how health funds perform across the following criteria:

  • Service performance;
  • Hospital benefits;
  • Medical gap schemes;
  • General treatment (extras) benefits;
  • Financial management; and
  • Health fund operations

You can use the information contained in this report to identify possible funds to join, or to assess your existing fund’s performance if you’re reviewing your current needs.

You can use the range of indicators included in this report as a menu to choose the factors of most importance to you — not all factors will be of equal importance to every individual or family.

For instance, if you prefer to do business with a health fund in person, then you should consider the availability of retail offices to be an important consideration. However, if you prefer to do as much of your business as possible over the internet, the range of services available through the funds’ websites will be more important.

More information about particular indicators is provided in the explanations preceding each of the tables in this report.

If you’re considering taking out private health insurance for the first time, the Ombudsman suggests you use this report to identify a number of funds — preferably at least three — for further investigation.

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