Private Health Insurance Churning Challenges

I have been churning insurances for a couple of years or so and I have been pretty happy with how smooth it went as long as I've been churning between the major players such as Bupa and Medibank.

Early this year, I've decided to move to Frank Health Insurance, and that's when the nightmares began:

  1. Frank, first of all took almost 3 months to key in my information from the previous provider based on the clearance certificate provided, so for that duration I was completely out of pocket as they claims won't go through.
  2. They only cleared the 6 months of waiting as they said Bupa (previous provider) only provided 3 months of my coverage (where they had my 8 years of coverage) and the next 3 months were already been with Frank
  3. Upon checking with Bupa, they said they can't send my clearance certificate on email as per their policy so they will send it via post which I'm yet to receive and cross check, so I don't who f**kd me up in the first place.
  4. Now even after offering the whole clearance certificate with proper timelines from every previous provider, Frank says their systems are not equiped enough to sync that data in from multiple provider so my waiting periods will still won't be waived off and every time I want to claim an item I'll have to call in and they'll have to look at it from the beginning.

in short horrible experience from frank and I'm hearing even from HBF the same, they run lucrative offers to get a huge influx and then struggle to handle their membership and takes forever to get them up and running.

After Ombudsman, the Complaints Officer from Frank admitted in a 1500 words large email she sent, that they did a terrible job, and provided the correct information on in fact how it should have been done in the first place which their representative did not quite know of.

Edit: Another downside is if you are not with them for at least 12 months, the membership pause while you are travelling for a signifiant amount of time, is out of option as well.

Comments

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  • +8

    The hunter becomes the hunted.

  • +4

    You need to retain a copy of your own transfer certificates. here's how I do it: https://www.ozbargain.com.au/comment/15120488/redir

  • +3

    Try the Commonwealth Ombudsman.

    I had a similar issue with my wife's cover transferring to mine with a lot of confusion around sending the cerificate of currency and it being lost - fortunately, my health fund saw fit to waive all the waiting periods pending the receipt of the certificate.

    • I did it, but then I'm moved on from Frank as well as it was becoming unbearable, will need to do that again I guess if that repeats

      • +2

        Yes, you should follow the complaint process at the first sign of trouble. If timeframes are not met, escalate to PHIO.

      • -3

        Its called "Karma" my friend.
        It eventually comes back to haunt you.

        • Are you suggesting that the failed and antiquated business processes of Frank, GMHBA, and Bupa (and the health insurance industry generally) are the problem of the OP?

  • +3

    Frank says their systems are not equiped enough to sync that data in from multiple provider

    Frank lied. Whatever the case, that's Frank's problem.

    Frank is brand of GMHBA and uses GMHBA systems. I have never had an issue with GMHBA applying multiple transfer certificates.

    • +1

      That's what I'm preparing for lately, and obtaining all transfer certificates, I have all except Bupa as they are again hiding behind their BS policies of only sending it via post so I'll have to take pictures from that and store as a pdf.

  • +3

    OP, about 10 years ago I worked for one of the big health insurers for a few years. It wasn’t uncommon to get calls about waiting periods not being waived, and when we checked, there was no clearance certificate on file. Most of the time, the member would say their previous insurer had already sent it. We’d say we hadn’t received anything. Rinse and repeat. Honestly, it was a pretty poor process, and I’m surprised there still isn’t a more centralised or reliable system.

    Anyway, I went through the churn myself recently — Medibank → another fund (can't recall who, say xxx) → AIA.

    When I joined AIA, I noticed waiting periods had been applied and it turned out the clearance certificate issue had happened. Essentially, AIA had incorrect details, which stemmed from Medibank sending incorrect details to the fund I was with (xxx). It became such a mess that I ended up going to the Ombudsman to get it sorted.

    Now, whenever I switch, I ask the insurer to send me the clearance certificate directly. I check it myself to make sure all the details are correct, and then I forward it to the new insurer. Is it a bit more effort? Yes. But at least I know it’s been sent, and I can resend it immediately if for some reason they haven't actioned it.

    • Absolutely, I'm happy to go as far as I need, but then as one my points states in the post,

      Providers such as Frank says they won't be able to put multiple clearance certificate in their system as it only equiped to insert one from the latest provider, which is a lie obviously

      Other providers such as Bupa says they can't send my clearance over email as that is against their policy so that's one of the blocker as than you are required to take pictures and then send that pdf file across

      so all of these are making sure to make your life as difficult as possible.

      • +2

        Other providers such as Bupa says they can't send my clearance over email as that is against their policy

        This is annoying from Bupa. However, when pressed, they can use a secure file transfer service (which they have done for me).

        It's wholly unacceptable that in 2026 Bupa reverts to paper/post for transfer certificates.

        For a whole heap of reasons including poor customer service and processes, I try to avoid Bupa, Medibank, and NIB (and NIB-related brands). In years of churning, there's never been a compelling offer from NIB, so that saves me the trouble of having to consider it.

        so all of these are making sure to make your life as difficult as possible

        Agreed.

      • regarding: "Providers such as Frank says they won't be able to put multiple clearance certificate in their system as it only equipped to insert one from the latest provider, which is a lie obviously"

        So, when I worked in the health insurance field (again, this was a while back), we would only insert the latest clearance certificate provided to us. So, even if we received multiple (which to be honest, I don't ever recall happening), we would only look at the latest one and go by that. If there are cracks in the timeline (for example, Insurer A > Insurer B > Insurer C [incorrect details occurred here] > Insurer D), then the insurer who first broke it, needs to fix it and provide an updated clearance to the next insurer and then it goes down the line, so in the example above, A > B > C (has to fix their stuff up - and then provide a new clearance) > D (have to update their records).

        This is what happened to me last year with the Medibank fiasco.

        regarding: "Other providers such as Bupa says they can't send my clearance over email as that is against their policy so that's one of the blocker as than you are required to take pictures and then send that pdf file across"

        I did work at Bupa for a while, and back in those days, this was the case. However, from a customer service point of view, it was because there was no option to send it via email. Basically, you jumped into the system, and there was an option that asked along the lines of "send clearance certificate" and you would answer with Y or N - and it would automatically send via post. Again, this was a very long time ago, so unsure how the system works now, but even back then, the system was designed in such a way to not be customer friendly (and in-turn make it difficult).

        • we always went by the latest clearance certificate received

          Yes, some funds do it this way — and that's certainly fine when the policyholder was with the previous fund for an extended period.

          I have seen someone else post (can't recall when and where), that a particular fund would create a shadow policy that mimicked your previous funds' policies (based on the Private Health Information Statement). This would ensure that waiting periods were applied accurately.

          It seems that some of the larger funds in particular don't care for many of the waiting periods, particularly in relation to extras, and don't bother with having an accurate history.

  • Medibank didnt send my certificate to Bupa. I haven't made a claim yet, but i was hoping the claims still get paid. How annoying.

  • My churning journey over a 4 year timeline

    Frank -> Bupa -> NIB -> HCF -> HBF

    not sure where ill go next but i committed to the HBF 12 months for like 10 weeks free and a gift card ill stick that out and head to the next offer

    the ONLY one i had issues with was NIB - otherwise its been easy to churn and has saved me a lot of money

    • +1

      but i committed to the HBF 12 months

      Wow, that's certainly a commitment. There's no way I'd stay for 12 months.

      • They gave 4 weeks free the next 6 after 12 months

        The way i see it if i get 8-12 weeks free every year my PHI is well worth having over paying the levy

        • +1

          Why wouldn't you leave after the initial period of free weeks for another free weeks offer elsewhere?

          • @YesPleaseThankYou:

            Why wouldn't you leave after the initial period of free weeks for another free weeks offer elsewhere?

            Mix of factors some benefits require a minimum commitment

            There is also isnt always a good deal to jump on

            Lastly fear of 'over churn' there are only so many insurers if you burn them too quickly you might end up being stuck with shit ones ive has this issues with churning CCs in the past

            Im not saying you cant just keep churning but personally im happy to do a modest amount of churning

            • +1

              @Checkmate3023:

              There is also isnt always a good deal to jump on

              I haven't found that to be the case. Ever.

              Lastly fear of 'over churn' there are only so many insurers if you burn them too quickly you might end up being stuck with shit ones

              Health insurance is highly regulated. What do you mean by 'shit'?

              but personally im happy to do a modest amount of churning

              Fair comment. It's your right to change as often or as little as you want to.

        • @Checkmate3023
          Dumb question, I haven't churned before - but do you wait for a health fund to publicly offer up 'x weeks free' before churning, or do you call the health fund and ask for free weeks to have the pleasure of churning you across? I'm keen to save some money on health considering the ATO just sent me a fine because I didn't have family cover for my two kids. Didn't know that was a thing until I got the $1700 fine.

          • @dominator293:

            I'm keen to save some money on health considering the ATO just sent me a fine because I didn't have family cover for my two kids. Didn't know that was a thing until I got the $1700 fine.

            Wait, what?

            I knew there were tax advantages for you to take out a private health insurance policy, but didn't know it was compulsory - did think it was optional.

            How is it legal that you get fined because you don't have private health insurance for your children?

            Did they tell you the law? How do they justify that?

            • @Muppet Detector:

              How is it legal that you get fined because you don't have private health insurance for your children?

              Narrator: there was no fine.

              https://www.ato.gov.au/individuals-and-families/medicare-and…

              • @YesPleaseThankYou: So, he basically claimed for a surcharge tax benefit of $1,700, but didn't actually qualify to make that claim?

                Not a fine, he just didn't pay the amount of tax he was supposed to?

                (My kids were automatically included in my policy whilst they were dependents and now they're all still included via some kind of family add on (about $200 top hospital + top extras) until they turn 32 even though all are employed full time, some nolonger live at home and some not even in the same state as me)

                • @Muppet Detector: @Muppet Detector Yeah sorry, not a fine - wrong wording, they are just charging me the MLS because I claimed to have private health insurance (which I did for myself, but not my kids). You're right, no one I have spoken to know's about this apparent fact that if you have your dependents on your tax return, they must also have private health insurance or you get slugged with the MLS :-/

  • Bupa has an idiot working for them. I received an email from them, name supplied, that said they had received my clearance cert from HBF and would be changing my premium to a loading of 28%.. The cert clearly has a loading of 18%. I am so angry at the time wasted trying to sort this out.

    • +1
      • Submit complaint on Bupa website.
      • Screenshot this as email confirmation or reference number is not provided.
      • After a few days, submit a complaint to the PHIO.

      Please don't stress over it :)

      • I already wasted an afternoon on the phone, got nowhere, have submitted complaint, also left review. I even replied to the email they sent.Crickets

        • +1

          Yeah, never speak with them unless they are from the complaints team based in Australia. Otherwise, you will very likely be given incorrect information, and repeatedly placed on hold so they can scratch themselves.

          Sounds like it's time you submit a complaint to the PHIO. It takes a few minutes and will go to an escalation area within Bupa.

          • +1

            @YesPleaseThankYou: its only been a few days so I will contact soon

            • @screensaver: Rest assured that it will be sorted out any overcharged amount refunded. You could also ask for compensation for your wasted afternoon. You could receive a 'we don't admit anything' goodwill gesture.

  • Bupa has now sent me a ridiculous form to fill in to keep getting govt rebate, I have to return it! Bupa is now a pain in the ass

  • -4

    ADAPHICHS

    • +2

      woah toooo long

  • Legendary Bupa's transfer certificate arrived, but missed the details of rest of the family, only me on the certificate, so now is the time to go with the ombudsman thingy

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