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Private healthcare vs Medicare


Kangabok

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I am still a bit shellshocked after getting results of medical tests today. I am up for a BIG operation and possible radiotherapy afterwards etc. We are on Medibank private, the best option with all the extras. Just with all of this tests, scans, Drs visits etc of the past weeks we had to pay a lot of out of pocket expenses. As we will have to rely on only my hubby's salary from now on, we will not be able to afford it in the longterm.

My question is: wont it be better for just myself to go onto Medicare and quit being a private healthmember (hubby can stay on Medibank) and then get the treatment in the public hospital? It seems that the nature of my operation might only be done in public anyway! If only on Medicare, I will not have all of this out of pocket expenses as at persent and we then might be able to survive on one salary. My head is spinning...

Any advice or experience to this regard please?

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Hi Kangabok

Firstly, my heartfelt sympathy for the situation you find yourself in, I sincerely trust and pray that you have a good outcome!

I have some experience in this area. Many years ago I had to have a emergency hernia operation, this was done at a government hospital. I had no problem with the operation, but the aftercare was dreadful, to me, anyway. I ended up in a six bed room, surgical ward, three men and three woman, all sharing a bathroom. I Could not handle it and went home far to early, so ended up with an unsuccessful operation. I immediately went onto a private medical and four years later had the same operation (only bigger this time) done privately. Wow, what a difference, doctors of my choice, whom I felt comfortable with, private room with bath, meal menu's etc. We are on HCF Medical, but only 100% hospitalisation, and that is what it was, not a cent for me to pay whilst I was in hospital.

Now for the other side, I have a hereditiary heart condition, for which I have to see my cardioligist twice a year, and for the sake of this explanation, I have to admit that last year July I ended up in hospital with a heart attack. As the heart attack happened on a Saturday afternoon, I ended up at emergency at a government hospital. This happens to be the same hospital where my cardioligist sees his government patients. He has his private practice across the road. When he was called in to see me, he asked me if I wanted to be moved across the road to the private hospital, I then asked him what he thought I should do, his immediate answer was that he thought I was better off where I was, because, if I deteriorated, or there was another emergency, they were better equipped to deal with it in the government hospital than in the private one. So I stayed, but because of my private medical aid, I elected to stay as a private patient, and managed to have a room to myself, although the bathroom was a shared one. I must admit though, that if I elected to be a Medicare patient, I would not have any control over the cardioligist I see, it would be the one on duty, and not always the same one.

So, in answer to your question, I think it all depends on the treatment you are going to need. For instance cancer is almost always treated in the government hospitals and not privately. Also, it is up to you whether or not you claim for your treatment on your private medical, you are not required, by law to tell the hospital that you have private medical cover, as you are entitled to be treated under the Medicare system. Please just remember, their idea of urgency will not necessarily be yours...regardless of the situation, they can sometimes drag their feet terribly to get you the urgent care that you need.

For myself, whilst I can afford it at all, I will keep my 100% hospitalisation, because for me, if I need drastic treatment, I also need a decent aftercare situation. I know this will differ from hospital to hospital.

I hope this information has helped you a little.

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Hi

If you do not have private medical cover your husband will pay the medical levy on his salary. I think it is 1% of gross income. therefore it is worth taking a private medical hospital cover without the extras. If you do decide to go back on a private medical aid you will pay a penalty for each year you were not on one. You must also ask your medical cover for discount if you pay a year in advance. I got one month for free.

Ajvr

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Thanks Mara, really good advice, I too understand it better now :-) We have a full plan with Medibank and I am thinking about changing it to a 100% private hospital plan only... the extras they offer is not worth the extra premium in my opinion.

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Thanks very much Mara for the kind words and all of you for the replies. Like you say Mara it seems to depend on a few roleplaying factors and based on that you sort of have to make the decision.

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If you do not have private medical cover your husband will pay the medical levy on his salary.

The Medicare Levy Surcharge is an additional 1 per cent surcharge of taxable income. For the financial year of 2009-10 it will be imposed on people who earn more than the thresholds of $73,000 (single) or $146,000 (couple/family) but who do not have an appropriate level of private health insurance hospital cover (hospital cover).

The Medicare Levy Surcharge is in addition to the normal 1.5% Medicare Levy.

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Kangabok, no comment on medical aid, just want to say so sorry to hear about your medical problems and I pray for good medical treatment, great doctors and a speedy recovery.

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Thanks Eva!

I always feel grateful and blessed to be in Australia, but so much more since I fell ill. All the care and treatment I received up to now was excellent! I saw a WONDERFULL urologist and immediately felt I am in the best hands I can ask for. But my rough ride is still ahead...

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