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Confused with the options of private health


KirstyS

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So I have been here for almost 3 months now and am looking at private healthcare insurance now. 

Its confusing. I know about the loading if we don't get it within a year. And I know about the tax - although not sure if the tax reduction is then made negligible by the policy premium. But on looking at the hospital cover and extras cover and what % you can claim it seems like it really isn't that beneficial. I was particularly looking at orthodontics and speech therapy optical and wisdoms teeth benefits. Any advice on anyone who has good or bad experiences or has learned how it all works? In SA I only had a hospital plan so am used to paying all my own day to day medical bills. TIA

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I cannot really comment on the extras - we have a pretty basic plan and I think we kind of break even with the extras taken dental costs. You don`t have to take extras, it is only the Hospital section of the plan that counts towards the medicare levy. 

 

For us I calculated that it was not worthwhile joining until the end of the 12 months, but at the end of the day I think we paid as much extra tax in the first year as the basic private health plan would have cost (bad math or under estimated our earnings in the first year :)). So at the end of the day our out of pocket expenses would have been roughly the same, but we would have had private medical. 

 

Go to www.paycalculator.com.au can give you a quick idea on the medicare surcharge if you enter your salary.  Something like: 

"You have a Medicare levy of $2,283.11. In addition, if you do not have a private health fund you will be liable for an additional Medicare surcharge of $1,426.94 . The calculation on the Medicare levy assumes you are single with no dependants"

 

Alternatively you can do the full calculation here taken your partners pay and number of children in account:

https://www.ato.gov.au/Calculators-and-tools/Comprehensive-tax-calculator/

 

Generally I think you are better of taking private medical aid, the government added the surcharge as a way to encourage people to join the private medical aid so the cards are stacked against you.

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We are with HCF and we have a 100% cover for hospitalisation only. The annual limits for "extras", after investigation, I honestly did not think it was worth it. I have to add though, that hubby and I are both 67, so we did not have to worry about kids. As far as dental especially is concerned, the costs are so high, that you would probably quickly run out of your annual limit. It costs around $200 to have a simple filling done, $180 to have a tooth extracted, and if you have to have root canal treatment with a tooth to be capped afterwards, that could be upwards of $4000 per tooth. So we decided to open a savings account and put something in it every week, to allow for the "extras". I have well used my 100% hospitalisation over the years. As long as you go to a hospital on their list, they cover 100% of the costs. Some years ago, I was in hospital for around six weeks, $70,000 later and three visits to the theatre in that time, all I ended up paying was my daily charge for the tv rental in my room, which they did not cover! From this month the two of us will be paying $320 per month.

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Thank you both for the information. Are the private hospitals much better here? Are only somethings covered at the public hospitals? 

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@KirstyS Private hospitals, I cannot say the are better or worse, as I guess it would depend on which hospital you go to. I live in Melbourne in the North West, however, I was living in the North East 16 years ago when I was diagnosed with a hereditary heart condition. The doctors I see are all still in the North East and I prefer to keep on seeing them. I go to the Austin hospital emergency (government teaching hospital) when I need to. My cardiologist will see me there and he will usually ask me whether I wish to stay there or go across the road to the Warringal private hospital. On one occassion he actually said that he would prefer me to stay at the Austin, as the equipment needed, should I have a problem, was better suited. When I opt to go to Warringal, it is because I can go into a private en suite room, I do not like sharing. If I stay at  the Austin, I can either stay as a Medicare patient, or a private patient. If I stay as a Medicare patient, I have to stay where they decide to put me. If I stay as a private patient, I can request a private room, however, their private rooms have two beds, so they will put me in there on my own, however if the need to use the other bed, they will put someone in there. So hope that explains the difference. It is not that one is better than the other, I think they are pretty equal, and it is best to depend on the knowledge of the doctor treating you.

 

All things are covered at the public hospitals, especially the big teaching hospitals. There are some of the smaller public hospitals that I would not care to go to, but at the teaching hospitals, they are all pretty good and even though you are initially cared for by students getting to the end of their medical degree, there are highly qualified doctors that will assist them if they have questions. In my case my cardiologist is actually one of the cardiac section's teachers. I hope that has cleared this up for you.

 

Should you have further questions, I am happy to try and explain.

 

In Melbourne, to my knowledge, none of the private hospitals have an emergency section, so you will go to a government hospital for emergency treatment and transferred to a private hospital if you need to stay, if you so wish, once your doctor has arranged this for you.

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  • 1 year later...

Should one be opting for an insurance that includes doctors visits and so on? Is OCT medication or prescribed meds covered on Medical Insurance there? 

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A lot depends on which visa you are coming to Australia.

If you are on PR, then NO private medical will cover doctor's visits or medication, as this is covered by Medicare. You can choose whether you take out only hospitalisation or whether you wish to add extras to it, like dental, physio, etc. It all depends what your needs are.

If you are not on PR, and not covered by Medicare, then you have to take out "VISITORS MEDICAL INSURANCE" on which everything should be covered, including doctor's visits and medication, just like the private medical insurance you had in RSA.

Edited by Mara
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