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Private Medical Cover - is it needed?


Mara

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The question is often asked whether or not you have to take out private medical cover... if you have Medicare. Apart from the problems when you turn 31, that ATO will charge you a higher percentage for your Medicare contribution, I received this information the other day... and it was news to me... as we have always said that in an emergency, you will be covered by Medicare... that is still the case, but it now appears that Medicare's idea of an emergency and our idea of an emergency, may well be miles apart.

 

DID YOU KNOW THAT YOU COULD WAIT UP TO 30 DAYS FOR URGENT SURGERY, ON MEDICARE?

 

 

Hi

Put your hand up if you think that elective surgery means “surgery you choose to have”? Unfortunately it doesn’t.

Elective surgery is a term used for non-emergency surgery which is medically necessary, but can be delayed for at least 24 hours. For example - If you have a heart attack you may be taken to a public hospital and treated for the heart attack BUT if you require further surgery, like a by-pass or a stent, you could wait on a public wait list

Why is that important for you to know?

People needing Urgent Elective Surgery – the classification with the highest priority – can still wait up to 30 days before they are operated on.

Now imagine you or your loved one has had a heart attack and the doctor says you require urgent surgery, which you need to go onto the public waitlist for and possibly wait up to 30 days at your home for the surgery.

This is why so many Australians WITHOUT private health insurance are paying up to $38,100* for a heart bypass in the private hospital system. Because when it really matters, they want treatment immediately.

 

 

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So I believe new entrants have up to a year to get themselves onto private medical before the levy kicks in (even if you are over 31).  Which ones would you guys recommend?

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@ChrisH I will be keen to see answers as everyone has a different opinion based on their experience. I was interested in Australian Unity, until I google searched reviews. But then people are always quick to complain so maybe we only ever see the negative.

Anyway. We will leave all this for a while as we have time to decide.

If you are keen to compare on the various websites be warned that iselect hound you constantly. I had not even completed my details and they phoned me. I will not make that mistake again, 3 weeks and they are still calling even though I said thanks but I am not going to decide until a later date. (You HAVE to give a number before you can compare in the site.)

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I will not recommend Australian Unity based on personal experience.  They're like the 2nd hand car salesmen of Health Insurance.  Everything looks pretty good but then it soon all falls apart...

 

We are with Bupa (since 2008 when they were still HBA) and I must say apart from the occasional frustration (paying for massages but would not pay for a prescribed knee brace after a meniscal tear for instance)  we're pretty well covered. I often get a surprised look when the receptionist realise the tiny amount I have to pay in. I've never seen a hospital bill - 100% covered.  We pay only about $17 for dental checkups and about $7 for physio. We've been with NIB between Australian Unity and HBA/Bupa and we had a pretty good run with them too. I can't comment on the others.

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7 minutes ago, Riekie said:

We are with Bupa

Which package are you on if you don't mind me asking?

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Corporate Cover - Not sure of the exact name, but I can check on a statement at home. 

 

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It's actually printed on my card:

Corporate Hospital Cover Level 1 + Corporate Extras 90

 

This would probably equate to the top cover under hospital and extras.

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I am with HCF, I do not have extras, just 100% hospital cover with no upfront payments. Since taking out this cover, around 17 years ago, I have been hospitalised numerous times, many operations, one of which the bill came to around $72,000 after 5,5 weeks. They paid for everything, all specialists, all doctors, private room with en-suite, all laboratory work, all medications, all x-rays, ct scans and mri's. I can honestly recommend them. I have never bothered with extras, I am happy to fund that myself, when the need arises.

 

https://www.hcf.com.au/

 

 

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21yearsoutofrsa

There are some tax considerations. If you have private cover you  get a reduction in your medicare level surcharge. So very high earniners may find the reduction in the surcharge more than pays for their private medical insurance subscriptions, in which case it's a no brainer.

 

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

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RedPanda
On 24/09/2017 at 0:50 PM, 21yearsoutofrsa said:

There are some tax considerations. If you have private cover you  get a reduction in your medicare level surcharge. So very high earniners may find the reduction in the surcharge more than pays for their private medical insurance subscriptions, in which case it's a no brainer.

 

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


If I remember correctly then the Barefoot Investor said the rule-of-thumb figure for that decision is about $90k annually. So if you're over that it's cheaper to add private, if under, it's cheaper not to. Of course this doesn't address anything other than just the bare monetary considerations.

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  • Mara pinned this topic
  • 1 year later...

Mother pleads with WA government to fix waiting times to prevent daughter from losing hearing
https://www.9news.com.au/national/2018/11/19/21/48/perth-mother-calling-on-state-government-to-improve-waiting-times-in-perth-childrens-hospital

 

Medicare seems to be great for emergencies, not great for anything with a wait time. 


 

Sent from my iPhone

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  • 5 months later...
On 9/24/2017 at 9:27 AM, Mara said:

I am with HCF, I do not have extras, just 100% hospital cover with no upfront payments. Since taking out this cover, around 17 years ago, I have been hospitalised numerous times, many operations, one of which the bill came to around $72,000 after 5,5 weeks. They paid for everything, all specialists, all doctors, private room with en-suite, all laboratory work, all medications, all x-rays, ct scans and mri's. I can honestly recommend them. I have never bothered with extras, I am happy to fund that myself, when the need arises.

 

https://www.hcf.com.au/

 

 

Curious- were the xrays & mris & medications & pathology all while you were in hospital - not after discharge? 

How did you know the bill was $72k ? Did you have no excess ?

I have hospital only cover but have had OOP with Surgeon & assistant, medications for discharge & Anaethetist. Surgeon & Anaethetist were paid in full up front and charge above medicare allowed amounts. Only xrays while under Surgeons care had no OOP.

Edited by jnsq
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  • 4 weeks later...
Mara

Yes, they were in hospital - I had open heart surgery.

HCF will send you a copy of the paid bill, in case there is something you wish to query!

And yes, as stated, 100% cover, absolutely no excess.

 

I am sorry it has taken so long to answer, but as I am retired from SAAustralia, I rarely come here!

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Tntaglia

For what it's worth for anyone still reading along on this thread: I have two children aged 9 and 12, and just dental fees make our extras worthwhile for the moment. We're with BUPA on silver extras (which includes unlimited basic dentistry and some specialised dentistry since I have horrid teeth) - my youngest had to have 4 fillings earlier this year and the cost for that was more than our total annual cost for extras. It will differ from year to year, but just a basic checkup with x-rays on dental cost about $300 - multiply that by a family of 4 going twice a year and the additional cost for extras become really worth it. 

 

I strongly recommend doing a bit of research and figuring out what you're likely to need on a regular basis, and doing your own math. When our kids are through the early teen years and have had their orthodontics etc we'll probably go off the extras again, but right now I love the peace of mind of knowing if my kid needs a dentist we can just go without worrying about the bill.

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new2forum

bear in mind that if specialist dental services are needed, the top level cover will cover bugger all almost. e.g. braces, gum graft, root canal etc

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