Family Health Insurance · A practical guide

New treatments: check the cover, not the headline.

How to approach claims about access to new medicines through private insurance.

Private availability does not mean insurance cover

A treatment being available privately does not mean your insurer will pay for it. Clinical suitability, licensing, policy exclusions and the insurer’s approval all matter.

Be careful with disease-specific promises

Cover for ongoing chronic conditions is generally limited or excluded under personal private medical insurance. Do not assume a new policy will fund treatment for an existing diagnosis, including dementia.

Ask before arranging treatment

Discuss medical suitability with the treating clinician and obtain a clear coverage decision from the insurer before incurring costs. We do not present earlier news about a medicine as a current guarantee of access.

A little clarity goes a long way

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