Health insurance

[paulswin]

I'm so confused as to what health insurance to get!! Want hospital costs and dental but not sure which company to go through!! Do you guys all have insurance or just Medicare? Can't get my head round what Medicare covers ie if we break any bones or have chest pains does Medicare cover it all etc etc!! Help!!!

[Petals]

When I was younger and did not need running repairs I only had medicare and it served us well. I look at it like this, when one is hurt at work you are covered by Workers Comp. If you are hurt in a car you are covered by motor acc registration. If you have a major emergency they will take you to the nearest public hospital as private do not have many emergency hospitals.

 

To have it you need to be able to afford it, and the extra costs it costs you for using it.

 

I now have it and pay the extra years or whatever but then I now use it as I am of the age to use it and I don't have to wait for a knee op or a new hip. But it does not come cheap, my knee cost me 5 thousand dollars odd that is three grand plus the cost of the health insurance. Another op I had this year cost me over seven grand when you include the premiums. So health insurance does not cover all costs. We have to pick up the slack to pay grand fees to the docs over and above the medicare rebate for services in private hospitals.

 

As for dental well I personally do not think its worth it really, we ended up spending more on the insurance than the dental.

 

So deep pockets are needed to use health insurance.

[paulswin]

Wow! So just out of curiosity if you we're able to wait for your knee op and used Medicare would that have still cost as much? I've got a 13 and 15 year old and was thinking insurance might be better for them but if Medicare covers most things I'll just stick with that??

[nicolac34]

It is very confusing, I'll grant you that!

 

We didn't have it the first year we were here, just had medicare. That was fine for us, hospitals see you for free if it's an emergency (went twice with the OH, once for his back and another when he broke his arm) the service both times was excellent.

 

Our second year we decided financially we'd be better off getting that rather than paying the medicare surcharge levy (if you earn over a certain amount and don't have healthcare then you are charged an extra 1% I think). As we thought we'd be over the threshold we calculated it was better for us to have medical insurance than not. So we took out a young persons basic cover with Medibank, $128 a month for a couple. Few months down the line we thought we might have children in the next couple of years and I'd like to go private, so we upped our policy to include pregnancy cover, which took it to $289 a month (with the 20% rebate) which I'll grant you is a big increase (especially considering we've now put kids on the back burner again!). However, we have used our extras cover considerably, for physio and dental. Each time I go for Physio it costs me $13.50 instead of $45. Had a filling and the cost was $240, I paid $70 of that.

 

You really just need to sit down and crunch the numbers and see if it works out for you.

[Jen Patterson]

Visitors from countries that have a Reciprocal Health Care Agreement(RHCA) with Australia are eligible for Medicare - Belgium, Finland, Ireland, Italy, Malta, Netherlands, New Zealand, Norway, Slovenia, Sweden and United Kingdom. Important thing to remember is that even if you are eligible for Medicare your treatment has to be classed as medically necessary. For more info about what Medicare covers if you are eligible see http://www.humanservices.gov.au/customer/services/medicare/reciprocal-health-care-agreements

 

So the benefits of having health insurance are:

 

* choice of doctor and cover for private practice GP visits

* where you receive treatment and at a time that convenient to you

* ambulance cover which is not covered by Medicare and this can be very expensive depending on the state you are planning to reside in.

* Extras cover is important for cover for things that Medicare doesnt cover like dentist, physio, chiro etc

 

There are a few good providers including Bupa, Medibank, Iman, Ahm etc

 

 

 

 

 

 

[Petals]

Wow! So just out of curiosity if you we're able to wait for your knee op and used Medicare would that have still cost as much? I've got a 13 and 15 year old and was thinking insurance might be better for them but if Medicare covers most things I'll just stick with that??

 

It would not have cost me anything other than maybe the gap on a private consult with the surgeon if I had chosen to wait on a list, however depending where we live how long the list is and for knees where I live can be up to two years. A long time when the knee is giving a lot of bother. Not going to kill me so can wait. On the other hand I had an ovarian cyst a few years ago and waited three weeks to be operated on at public hospital because it was urgent.

 

My oh had a massive operation at a public hospital last year free, he said to the surgeon do you want me to go into private they said no, serious op need to be in public hospital so he went in in three weeks and had it done.

 

We used to pay the extra surcharge when we were working for medicare as we figured that it went for the good of all people and we could afford it, as we were high earners. As I said I only took out health insurance now that I am retired and older because its more appropriate for me and I can afford the extra costs.

 

My daughter on the other hand is a type 1 diabetic and has had brain cancer and she has no health insurance and she gets excellent care in the public system and no problems waiting for anything. She waited on day to be operated on with her tumor so why worry. If its urgent it gets done.

 

With the extras there is a limit that they will pay out each year so you need to add up how much it costs to have it and how much your going to get back for it. Its not as good as it used to be years ago.

[VERYSTORMY]

We have it with Bupa and have a lot of cover (expensive) but have had several claims that has made it worthwhile. My wife needed some complicated dentist work that would have cost a couple of grand, but instead cost a couple of hundred and several other things.

 

One thing to remember is ambulances are not free in WA - even in an emergency and it can be expensive. We live about 20 mins from the hospital and called one for myself when i suddenly keeled over in pain - turned out to be kydney stones. Anyway, it was $500. It would have been $700-800 if they had put the blue lights on.

[paulswin]

But I can get ambulance cover for around $80 for the year so was thinking maybe just to get that!

[Petals]

What people need to know is that private health insurance here in Australia is not like having private health in other countries.

 

Private health only covers us for the use of the private hospital, its theatres, staff, food etc. All medical expenses are paid by medicare therefore if the rebate for medicare is less than what a provider at the hospital charges, be it the surgeon, the anesthetist, blood tests, xrays etc we have to pay the gap between what medicare will pay and what they charge. Good surgeons charge a lot more and the AMA tends to have a schedule of fees much higher than the medicare schedule.

 

Therefore if coming to Aus and not entitled to medicare then people need to have full health insurance where the company will pay for medical as well as hospital cover. I had such cover when I went to sea with my husband. That way when I needed to see a doc somewhere I was fully covered by my insurance.

 

So it depends on why a person is in Aus as to what they need for insurance.

[LadyCroft]

Sorry to kind of hijack the thread but can I ask what you need to bring from the UK in order to register with Medicare?

We are in our 30's so have a yellow NHS card and the kids have the red book and a printed yellow form with their GP practise details but that is all I have.

[nicolac34]

Sorry to kind of hijack the thread but can I ask what you need to bring from the UK in order to register with Medicare?

We are in our 30's so have a yellow NHS card and the kids have the red book and a printed yellow form with their GP practise details but that is all I have.

 

You don't need any of that. Proof of ID and proof of visa is what they asked us for (they don't do VEVO...)

[Justin Grossbard]

Health Insurance is a funny one in Australia.

 

I have a family and just two weeks ago I saw a lot of bloody in the cot and called 'nurse on call' (a free service) who told me to take him to hospital.

Now I have private health insurance but the best option was for me to go to a public hospital and wait for him to get looked at.

What this highlights is having health insurance at this point makes little difference.

 

Now lets look at another situation.

My mate was playing Football and he turned his knee poorly and needs a knee reconstruction.

Medicare covers this but its not critical (even though he does not walk). This means he is put on a waiting list which is over one year (1.5 years if he is lucky).

 

So for emergency activity, medicare is great but as soon as you go into the other pot, medicare lets you down and private health insurance is a must.

 

Personally, because you get taxed higher after a certain threshold anyway, I have private health insurance even though I don't use it much.

The stories of people not getting is and having to wait such long periods is just too bigger risk n my book.

[tonyman]

I have to agree with Justin, this year ive had two knees reconstructed and varicose veins removed and blocked off ,without private health care I would have been waiting well over a year just for one operation , with private health care I was able to choose my own surgeon , choose my own date that I wanted the operations to be performed and have a private room .................

[Peach]

I have to agree with Justin, this year ive had two knees reconstructed and varicose veins removed and blocked off ,without private health care I would have been waiting well over a year just for one operation , with private health care I was able to choose my own surgeon , choose my own date that I wanted the operations to be performed and have a private room .................

 

and how much were your gap payments?

[tonyman]

and how much were your gap payments?

 

the knees were NIL , veins were $600, one anaesthetist was NIL and another wanted $350 I got her down to $30 as I`m a sweet talker when I need to be , I was well caught out by the $600 as was still recovering from the knee surgery but all you have to do is get a list from your heath insurers containing all the surgeons that have no gap, that are fully covered by private health , that bulk bill, they can claim the rest off Medicare .

 

I`v not payed for any of my many MRI or CT Scans and have another next week ,nor do I pay for any GP appointments , so I`m quite happy with the system ..........

[Peach]

the knees were NIL , veins were $600, one anaesthetist was NIL and another wanted $350 I got her down to $30 as I`m a sweet talker when I need to be , I was well caught out by the $600 as was still recovering from the knee surgery but all you have to do is get a list from your heath insurers containing all the surgeons that have no gap, that are fully covered by private health , that bulk bill, they can claim the rest off Medicare .

 

I`v not payed for any of my many MRI or CT Scans and have another next week ,nor do I pay for any GP appointments , so I`m quite happy with the system ..........

 

it's great to here something that is not a horror story. It might be worth keeping my HCF afterall...

[Quoll]

Sorry to kind of hijack the thread but can I ask what you need to bring from the UK in order to register with Medicare?

We are in our 30's so have a yellow NHS card and the kids have the red book and a printed yellow form with their GP practise details but that is all I have.

 

just your passports and visa

[Quoll]

We've had private health insurance for years and I've been extremely grateful for it - waiting 18 months to have a gall bladder removed? I think not! I've had several elective surgeries over the years and, sure, I could have waited for some of them but it was worth every cent to get them done privately. With some funds you can tailor make to some extent to reduce your premiums and you can choose your excess to minimise your premiums. If I were young and disciplined I might think about self insuring but you'd have to be very disciplined about putting your $250 a month away. We've also been grateful for it for dental and optical over the years too. On balance I'd be taking it.

[tonyman]

We've had private health insurance for years and I've been extremely grateful for it - waiting 18 months to have a gall bladder removed? I think not! I've had several elective surgeries over the years and, sure, I could have waited for some of them but it was worth every cent to get them done privately. With some funds you can tailor make to some extent to reduce your premiums and you can choose your excess to minimise your premiums. If I were young and disciplined I might think about self insuring but you'd have to be very disciplined about putting your $250 a month away. We've also been grateful for it for dental and optical over the years too. On balance I'd be taking it.

 

Mrs tonyman had her Gall Bladder removed as an emergency operation while pregnant with twins a few months after we arrived here, she was in some horrendous pain , I`m sure that was in the public system though ......

[fairystar32]

I dont bother with private. We are under the threshold with one working and 4 kids.

I have had a few issues which were urgent and got treated straight away when needed with NO costs at all. I am also under haematology for a rare lymph disease now which I get seen frequently and have recieved Excellent care.

I have two friends with private and yes they get seen immediately, pick their surgeon and operated without a 3 mth wait I had for recent elective surgery, however, they both have thousands of dollars gap each time, which we can not afford anyway. To us we will stick to public.

[Incata]

Sorry to kind of hijack the thread but can I ask what you need to bring from the UK in order to register with Medicare?

We are in our 30's so have a yellow NHS card and the kids have the red book and a printed yellow form with their GP practise details but that is all I have.

 

You need your passport and that is it. Your Australian GP will need to see the children's red books to see what they have been vaccinated against so (s)he can put the children on a catch-up schedule. There are some vaccinations (such as chicken pox and Hep B) which are not routinely given in the UK, but they are required over here. You either have to have them done or fill in a conscientious objector form in order to be able to access centrelink benefits.

[Paur]

the knees were NIL , veins were $600, one anaesthetist was NIL and another wanted $350 I got her down to $30 as I`m a sweet talker when I need to be , I was well caught out by the $600 as was still recovering from the knee surgery but all you have to do is get a list from your heath insurers containing all the surgeons that have no gap, that are fully covered by private health , that bulk bill, they can claim the rest off Medicare .

 

I`v not payed for any of my many MRI or CT Scans and have another next week ,nor do I pay for any GP appointments , so I`m quite happy with the system ..........

 

Which insurance company do you use?