A loophole allowing insurers to subsidise GP telehealth consults between a doctor and a patient who have never met face-to-face has attracted a second major health fund.
Health insurer Medibank claims its pilot GP telehealth program, which exists thanks to a loophole in Medicare rules, is drawing an increasing number of patients – but that it is not intended to replace regular primary care.
Medibank’s entry into the telehealth sector makes it the second major Australian health fund to do so.
Launched in June, the Amplar Health Online Doctor program allows eligible Medibank members with hospital cover to access three online telehealth consults per year for no out-of-pocket fee.
Amplar Health is wholly owned by Medibank and includes the Better Medical and MyHealth Medical Group GP chains.
Medibank owns 169 GP and medical clinics nationally, making it the biggest corporate GP chain in the country.
Under Australian law, health insurers are forbidden from subsidising services for which there is already a Medicare rebate.
Crucially, though, there is no Medicare rebate for GP consultations via telehealth if the patient and doctor have not met face-to-face over the previous 12 months.
The face-to-face rule was originally put into place in mid-pandemic, in an attempt to address the rise of online-only single-issue telehealth clinics.
Bupa was the first to identify the loophole, and launched a digital healthcare platform in October 2024 which allows its members to access three free video GP consults per year.
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According to Medibank, its virtual doctor program has been popular; appointments increased by 34% between July and August, reflecting what it called “increasing demand from customers seeking convenient, timely access to healthcare”.
“The increase comes as Australians continue to face challenges accessing primary care, particularly in regional and rural communities and amid ongoing GP workforce pressures,” the insurer says.
Medibank Group Medical Director and GP Dr Shona Sundaraj says the service is not intended to replace a patient’s regular doctor.
“Primary care remains the foundation of a strong health system, but Australians are telling us they want more ways to access that care,” she says.
“By combining virtual health services with traditional healthcare pathways, we can help more people get the right care at the right time.
“Whether it’s a parent managing competing priorities, someone in a regional town or a customer who simply needs medical advice quickly, virtual GP services are helping remove barriers and making healthcare more accessible.”
Over the last several years, private health insurers have shown an increasing interest in funding general practice, with both Bupa and Medibank now owning a large chunk of the country’s clinics.
In all, insurers now own around 15% of Australia’s general practice chains.
While no major rules have changed, some interpret the moves from private insurers as a threat to the integrity of general practice.
Speaking at The Medical Republic’s Burning GP conference on Saturday, Director of Bupa Medical Scott Beattie told delegates that the rules against funding general practice directly mean health insurers have to “think differently” about supporting prevention.
“There are good and important safeguards around funding patients, funding doctors, and I think we’re not actually trying to change the dynamic,” he says.
“I don’t think that in 2033 you’ll turn up and there’ll be an extra payment from health insurer, I can’t see it happening.
“But there might be coordinated care programs or navigation programs which health insurers fund for their members, which might be models of care to maybe prompt the government to think more about it.”
