How Do Preferred Provider Services Work In Australia?

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Hello! My name is Tony and this is my new blog. I decided to start this blog while I was in the hospital recovering from an operation I had to have to remove a tumour from my body. My story had started a few months beforehand when I developed a cough which I couldn't get rid of. I had some test and the doctors discovered I had a tumour in my chest. I will be the first to admit that I haven't been as good as I could have been in terms of looking after my own health. However, since being diagnosed, I have been learning all I can about how to stay healthy.

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How Do Preferred Provider Services Work In Australia?

4 October 2017
 Categories: Health & Medical , Blog


Most people in Australia are registered with a particular health fund, and which one you're with depends on a number of factors. Some are related to particular industries or professions: if you're a teacher, for example, there's a good chance you're registered with Teacher's Health. Anyone who works in the transport industry is likely to use Transport Health, while members of the army, navy and police force also have their own specialised funds. Those who don't work in jobs that come with a health fund of their own may be registered with an international health fund such as Bupa, or a general discounted healthfund like onemedihealth.

Some of these funds offer what's called 'preferred provider services'. This means that you can only make claims for healthcare provided by specific service providers, but also means that those providers will be able to offer you heavy discounts and that your treatment will probably have less of an effect on your insurance premiums than it might otherwise.

Which services are covered by preferred provider programs?

The great thing about these programs is that they tend to only apply to specialist referral services. Your general, everyday healthcare will be available from your closest provider no matter which fund you're with--and you can find some excellent discounts on potentially life-altering treatments that are often considered less essential. This generally includes the following:

  • Chiropractic
  • Dentistry
  • Massage therapy
  • Optometry
  • Osteopathy
  • Physiotherapy
  • Podiatry

How can you check your fund's preferred provider list?

If you're interested in a specific kind of treatment but want to find it through your health fund, the quickest thing to do is to have a look on their own website or phone them to ask for a list of their preferred providers in your area.

If you already have a provider you'd like to use and would like to find out if your health fund covers it, you can phone the provider themselves and ask if they have a relationship with your health fund.

What about health funds without preferred provider services?

Not all health funds have preferred provider services. If yours doesn't, this might mean that you are free to access these specialised treatments wherever you like. However, they will usually be more expensive than they would be if your health fund had your chosen provider as a preferred service. In some cases, you may find that you are unable to claim for a particular treatment at all with providers who don't have these programs. Remember: you are free to switch health funds at any time, even if you are with one associated with the job you do.