Sleep studies may only be funded by the top level private health insurance Gold Cover under the new arrangements that come into force on 1 April.
According to the Australian Sleep Association, sleep studies are only listed under Gold Cover under the new government mandatory classification scheme to simplify explanation of consumer entitlements under private health insurance.
The lack of listing under mid-level Silver and Bronze policies and the low level Basic Cover “could restrict access to lab based sleep studies in private services and put huge pressure on the already struggling public system, further limiting access to sleep studies,” the ASA says.
In his latest newsletter, president Dr Peter Eastwood says the ASA leadership have met with staff from the Department of Health and also with the head of Private Health Australia, Rachel David, to raise concerns about the changes.
The ASA was advised that while it would not be mandatory for PHI companies to cover sleep services under Bronze or Silver many of the larger companies had indicated that they would continue to cover them.
The impact of the changes will be reviewed after about six months, and the ASA has gathered information from all public sleep medicine services about waiting times and services offered, and will be following up on this after 6 and 12 months to see what affect these changes have had.
“It is hoped that we will also be able to gather this information for private sleep services in the future,” he wrote.
The reforms introduced by Federal minister for health Greg Hunt are intended to make it simpler for consumers to understand what their private insurance cover must include.