Private Health Insurance..thinking of cancelling

[Jordy]

We have been in Australia for almost 10 years now and have had private health insurance since day 1. It costs us currently about $2800 a year for a family of five. We have basic hospital with extras and a $250 excess on hospital stays. We have hardly used it. But recently I had an emergency five day stay in hospital. The doctor refused to book me into the private section of the hospital because the public section (in the same hospital) was closer to his offices. It was a shared room but cost me absolutely zero. The care I received was equal to a private hospital in South Africa. Now I have to go for a day procedure and am booked into the private hospital for 3 hours. The pre-visit with the surgeon cost me $220 for a 6 minute consult (got $75 back from medicare and zero from health insurance), the anesthetist cost me $460 (got back $275), the hospital excess was $250. So all in all for a simple day procedure I paid $575. This is in addition to the $2800 I pay per year to Bupa. If I had of gone public it would cost me zero, but I would have had to drive 200kms return trip to the nearest public hospital.

 

I am wondering to myself if private health insurance is really worth it.... 

 

Choice has designed a neutral website to give guidance...

 

https://www.doineedhealthinsurance.com.au/

 

 

[BobSA]

Just look into the implications of the loading (LHC) should you ever need to get back onto Private care and take into account the taxes/levies based on your family income. All in all if you take out base hospital cover without extras it still should be 'cheaper' then the Medicare Levy Surcharge. (IF APPLICABLE)

 

https://www.ato.gov.au/Individuals/Medicare-levy/Medicare-levy-surcharge/

 

 

Edited June 26, 2017 by BobSA
Error

[Jordy]

Here is the original article that got me thinking:

 

https://www.choice.com.au/money/insurance/health/articles/how-to-pay-the-lifetime-health-cover-loading-and-save

 

As the article says,"If you're paying for health insurance you don't use, or you're considering buying it "because it will cost more later" – this is required reading."

 

I think I may be better off by just paying the Levy. It is costing me more to avoid it. Anyway the point they are making is that Health Care Companies use the Levy in clever marketing to scare you. 

[Nev]

The point for me is the insurance component, medicare can have really long waiting times for non-life threatening items, So you land up in an accident and stuff up your legs, you could sit in a wheelchair for a year on the waiting list, then have a couple long more waits if there is a part 2 / 3 / 4

 

What private hospital gets you is insurance that you can jump the queue, Read this article, sometimes you die from non-life threatening requirements

http://www.dailytelegraph.com.au/lifestyle/health/patients-are-dying-before-they-get-surgery-as-public-hospital-waiting-lists-explode/news-story/62fb238e4f7632260c51d7d5b95012f4

 

For me it is insurance, get the lowest reasonable hospital, Medibank medium hospital only was the one I picked as it covers joints, then know that you won't die in line or spend a long time in a wheelchair when it can be fixed

[Nev]

A more direct example that I keep forgetting is when my wife had breast cancer, she went from detected to surgically removed in 6 days, in public that process can take 3-4 weeks as each part has a waiting component

 

We had a scare recently and tried public, from trying to get a booking to an indication of the expected result date (And then we would need to book and wait for surgery) was expected to take 3 weeks, so 4-5 weeks to surgery if the cancer had come back.

 

I phoned our private doc and ghids had the results in 3 days, not cancer, but if it had been she would have been in surgery within 6 days of initial detection

 

Private medical is a worthwhile insurance

[Mara]

I would certainly not be without it!

[Jordy]

Thanks for the replies. I guess that is the nature of insurance. We complain that we have to pay for it when we don't use it, but are grateful to have it when there is an emergency. 

[Karools]

Am I understanding this correctly: You may have private hospital cover, but for procedures for which waiting isn't an issue you may use the public health system and avoid any excess or specialist payments?

 

Also, if we stay in a town that only has a public hospital and we have private hospital cover, are we allowed to use the public hospital and still skip the waiting times or must we go to a private hospital for that? 

Edited September 29, 2017 by Karools

[Mara]

@Karools I doubt you would find any procedure for which there is no waiting time in a public hospital EXCEPT in the situation where your life is immediately at stake! In this instance, they will attend to you first and ask questions afterwards.

 

You can be a private patient in a public hospital, that is not a problem.

 

Most private medical insurance companies have a list of approved private hospitals that you should consider if you want to ensure that you stay within the limits of your insurance. They make arrangements with hospitals to do so.

 

If you go to emergency, it will usually be to a public hospital, they will ask if you have private insurance, in case you have to be admitted. I have also been asked in the past, whether I wish to remain at the public hospital or go to a private hospital, it is then your decision.

[Jordy]

5 hours ago, Karools said:

Am I understanding this correctly: You may have private hospital cover, but for procedures for which waiting isn't an issue you may use the public health system and avoid any excess or specialist payments?

 

Also, if we stay in a town that only has a public hospital and we have private hospital cover, are we allowed to use the public hospital and still skip the waiting times or must we go to a private hospital for that? 

 

To add that public and private hospitals are often in the same building but are merely different wings of the same hospital. Private wings have carpeted floors and public wings have vinyl floors.  Same doctors.  Same standard of care. 

 

For the birth of our two sons we chose public which cost us exactly zero for two Caesarians. We were in a two person room but when you don’t pay a cent, we could live with that. 

[Nev]

@Karools

You can choose to also use a public hospital and go as a private patient, thereby skipping the waiting list and not having to pay in due to there being a gap,

Private medical is simply an insurance against waiting lists with the ability to go to private hospitals and pick your doctor / surgeon, however that may result in having to pay in

 

[Gya]

Someone correct me but I think there is a way it adds up on your annual medicare levy on your tax with time; that's if u don't pay for the private health insurance (like myself) 

[new2forum]

The private health insurance here is different to SA….

Even if you have private health insurance here you still have to be seen by the public emergency system. For some procedures, there is some benefit in using private health insurance. Hip surgeries, cataracts wait times can be months if not years.

Even if you have private health insurance, specialist dental services have a maximum threshold of $1k.

So , just like us if you’re a member for 10+ years for a family of 4, that’s about $5K a year, so in 10 years we paid maybe $50K in premiums, but if I have to have periodontal treatment which costs about $4000 for a few teeth, I would only get back $1000!

[Gya]

33 minutes ago, new2forum said:

So , just like us if you’re a member for 10+ years for a family of 4, that’s about $5K a year, so in 10 years we paid maybe $50K in premiums, but if I have to have periodontal treatment which costs about $4000 for a few teeth, I would only get back $1000!

This is the calculations I made and it never made sense! I left it 

[new2forum]

A chalk and cheese comparison but in reality It’s a far cry from the medical aids in SA.  The same with motor vehicle and property insurance here. The only benefit if you’re health is that of the tax benefit.  If you have to have a procedure done, if you pay cash upfront for the procedure that might be of greater value.

[Nev]

To add on the above, 

 

Dental is not hospital insurance, it is extras, (As is optometry....etc) basically out of hospital services

 

I don't take extras as they are a real rip, all of them have max caps and the amount you get back doesn't cover the full amount of what you get done, if you do the maths it is really hard to get your money's worth, and essentially you pay more per year than you will ever get back

 

Get a medium Hospital, and ignore the extra's

[new2forum]

True. I guess with medium cover as well they still ensure they make a profit. The cost of labour/living is sky high here. The taxpayer foots the bill for a good economy but services that we used to take for granted in Sa is really costly in australia