ms2oz Posted January 30, 2015 Share Posted January 30, 2015 Does anyone understand how this system works ?? Someone told me the government stop health insurers paying 100% - why ?? What a great idea, you find out you have some serious illness, so you have to worry how much you will have to pay as well. Unimpressed of Sydney...... Quote Link to comment Share on other sites More sharing options...
Quinkla Posted January 30, 2015 Share Posted January 30, 2015 Basically, you pay insurance premiums and if you have health problems, the insurer helps out with the cost of hospital treatment or specialist treatment. You will have to pay a fair bit yourself and you will get separate bills for the GP referral; initial consultation; xrays; hospital procedure; anaesthetist; pharmacy; hospital service charge; and any rehab. If you have Extras cover (physiotherapy, dentistry, medical devices, etc.) you will get a very small portion of your costs reimbursed - it will look better as they will say something like 60% up to an annual maximum of $500 - but then you'll find that the total cost is $2000, so the $500 you get back is only 25% of your total bill. You also have to bear in mind that if you get sick, you will lose your job and no longer be able to pay for the premiums, let alone for your own out of pocket expenses. You may also find that getting any form of reimbursement involves trips to their physical office (e.g. BUPA has two offices in the whole of Victoria) and then being told to come back with additional paperwork (which you may well have to pay for). The health system in Australia totally sucks; it is devoid of any innovation, waiting times can be horrendous if you don't go private, and if you go private, all anyone is interested in is seeing your credit card for the use of which you will then pay a surcharge (but Amex not accepted). Quote Link to comment Share on other sites More sharing options...
blossom Posted January 30, 2015 Share Posted January 30, 2015 Yep. My partners first child was born 15 years ago using health insurance. They didn't have to pay anything. Now if you have a baby privately it's thousands on top. Crazy. Quote Link to comment Share on other sites More sharing options...
Marisawright Posted January 30, 2015 Share Posted January 30, 2015 Does anyone understand how this system works ?? Someone told me the government stop health insurers paying 100% - why ?? What a great idea, you find out you have some serious illness, so you have to worry how much you will have to pay as well. Unimpressed of Sydney...... If you have PR, no one is forcing you to have health insurance. The insurance companies will try to scare you into it, but if you live in Sydney you'll have easy access to Medicare-funded health care so you don't need it. If you need elective surgery, you may face a waiting list - but it's not as bad as the waiting list in the UK for the same treatment, if my sister's experience is anything to go by (and, like the UK, you can always choose to pay to have it done). My husband has never had health insurance and has never felt the need. He had his cataracts done last year which he paid for himself. I do have insurance, and spent over $10,000 having a neck operation last year (the total cost of which was over $36,000). I was thanking my stars I had private insurance after that - and then my friend's dad had exactly the same op, on Medicare, with exactly the same good outcome. So now I'm asking myself, who's the idiot? Quote Link to comment Share on other sites More sharing options...
Marisawright Posted January 30, 2015 Share Posted January 30, 2015 You also have to bear in mind that if you get sick, you will lose your job and no longer be able to pay for the premiums, let alone for your own out of pocket expenses. If you're so sick that your private health cover lapses, you'll be able to switch to the public system and won't have to worry about bills. You may also find that getting any form of reimbursement involves trips to their physical office (e.g. BUPA has two offices in the whole of Victoria) and then being told to come back with additional paperwork (which you may well have to pay for). The health system in Australia totally sucks; it is devoid of any innovation, waiting times can be horrendous if you don't go private I think this is myth spread by the health insurance companies. As I said in another post, last year I thought I was lucky having health insurance as I was able to get an urgent neck operation immediately and most of my costs were covered. Then my friend's (uninsured) father needed the same op, had it done within six weeks, and it cost him nothing! I had treatment for suspected throat cancer a few years ago, before I had insurance. I was seen very quickly, luckily it turned out to be a false alarm but the waiting time wasn't long at all. Quote Link to comment Share on other sites More sharing options...
JockinTas Posted January 30, 2015 Share Posted January 30, 2015 Neither of us have health insurance. We rarely see a doctor but a few years ago I had to have an op (in Sydney) and was in hospital after a wait of 3 weeks. Very good care in the hospital so I have no complaints at all about the public system. We pay each time we visit the dentist and luckily we both have no problems with out teeth otherwise it could be expensive. Quote Link to comment Share on other sites More sharing options...
Guest Dave53 Posted January 30, 2015 Share Posted January 30, 2015 If you have PR, no one is forcing you to have health insurance. The insurance companies will try to scare you into it, but if you live in Sydney you'll have easy access to Medicare-funded health care so you don't need it. If you need elective surgery, you may face a waiting list - but it's not as bad as the waiting list in the UK for the same treatment, if my sister's experience is anything to go by (and, like the UK, you can always choose to pay to have it done). My husband has never had health insurance and has never felt the need. He had his cataracts done last year which he paid for himself. I do have insurance, and spent over $10,000 having a neck operation last year (the total cost of which was over $36,000). I was thanking my stars I had private insurance after that - and then my friend's dad had exactly the same op, on Medicare, with exactly the same good outcome. So now I'm asking myself, who's the idiot? I beg to differ regarding wait times for elective surgery . In my experience the wait times in the UK are far less than in Australia , at least in the Sydney area where we live . For example both my sister and sister in law have both had complete hip replacement surgery in the UK , one waited 3 months the other just 6 weeks , my wife was told to expect 1 year wait on Medicare ! .. We had private health insurance at the time so of course it was done using our insurance . It was done in 6 days but cost us about $6000 out of pocket .. Incidentally the private health contribution in respect of the surgeon bill is just 30% of the scheduled fee in our case a measly $550 out of his bill of $3400 .... The hospital accomodation is covered in full by the insurance , so what you get is a nice room , nice food and that's about it ..... We are no longer privately insured .. Dave C Quote Link to comment Share on other sites More sharing options...
janlo Posted January 30, 2015 Share Posted January 30, 2015 You're paying just to jump the queue ! the treatment is often performed by the same surgeon. Oh and I think you get nicer food. :wink: Quote Link to comment Share on other sites More sharing options...
Loopylu Posted January 30, 2015 Share Posted January 30, 2015 (edited) If you have PR, no one is forcing you to have health insurance. The insurance companies will try to scare you into it, but if you live in Sydney you'll have easy access to Medicare-funded health care so you don't need it. If you need elective surgery, you may face a waiting list - but it's not as bad as the waiting list in the UK for the same treatment, if my sister's experience is anything to go by (and, like the UK, you can always choose to pay to have it done). My husband has never had health insurance and has never felt the need. He had his cataracts done last year which he paid for himself. I do have insurance, and spent over $10,000 having a neck operation last year (the total cost of which was over $36,000). I was thanking my stars I had private insurance after that - and then my friend's dad had exactly the same op, on Medicare, with exactly the same good outcome. So now I'm asking myself, who's the idiot? I disagree about comparative waiting times for UK and Australia and this comparison report also indicates that the UK has better access to health care for the whole population compared with 10 other countries (not just the rich as is the case in Australia). http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror My personal experience is that in the UK we waited 3 months to see an ENT consultant for our twin boys and then a further 3 months for tonsillectomy, grommets and adenoid removal. In Australia, we waited 3 years to see an ENT consultant and then 9 months for the adenoid removal and a further 6 months for tonsillectomy. During this waiting time, my daughter suffered from a constantly stuffed up or running nose and poor sleep which impacted on her quality of life and academic performance. My Aussie Mother in Law waited over 5 years for a hip replacement and only got it because she fell getting out of bed, broke her hip and they had to do it. I think they were hoping she would die and save them a few dollars. They complain in the UK when you have to wait 2 years for a hip replacement. There is a big healthcare rort being led by the LNP in Qld over hospital waiting times. While they now have guaranteed waiting times for when you need an operation, there are no guaranteed waiting times (only guidelines) from when you are referred by your GP and then seen by a consultant who then decides which waiting list to put you on. For those unfortunate souls whose cases where deemed to be Category 3 (ie 12 month wait) in 2012 in Brisbane only 48% were actually seen by a consultant within that time frame with many waiting over 2 years (or in the case of my daughter, 3 years) to see a consultant. Nationalise the private hospitals and let those paying for useless health insurance pay those premiums to the State so that we all get decent, affordable healthcare on time. Edited January 30, 2015 by Loopylu Quote Link to comment Share on other sites More sharing options...
Loopylu Posted January 30, 2015 Share Posted January 30, 2015 I hate to say it but my MIL in Brisbane waited over 5 years for her hip replacement... Hope your wife is more fortunate! Quote Link to comment Share on other sites More sharing options...
Keith and Linda Posted January 30, 2015 Share Posted January 30, 2015 Someone we know had her knee replacement done in Brisbane and she waited only a few weeks. She is in her 80's and is looking at getting her other knee done in the near future. Quote Link to comment Share on other sites More sharing options...
blossom Posted January 30, 2015 Share Posted January 30, 2015 I haven't used the health system really other than when I had my baby. I did have complications with my kidneys caused by the baby though. I had to have scans every four weeks, and some extra ones when I had pain or was peeing blood. I managed to get in to those extra scans within hours or a day of phoning. When my public ob didn't really know what to do about my kidneys she called a renal Dr at another hospital. He drove straight over from the other hospital and saw me half an hour later! (Even the Drs and nurses there were all chatting about what great service that was). Once baby had been born I had to have a ct scan. I got in the morning after I phoned. Not urgent or anything. My experience of Medicare has been amazing. That's not even starting on the great experience I had with my pregnancy and postpartum care. I'd never bother with private. Quote Link to comment Share on other sites More sharing options...
Loopylu Posted January 30, 2015 Share Posted January 30, 2015 (edited) My Aussie husband has been waiting 4 months to see an orthapoedic surgeon for his knee and is in excrutiating pain. He is only 51, has severe arthritis, a burst Baker's cyst and a torn ligament in his right knee and cannot take anti-inflammatories because he has Stage 3 kidney disease. He is likely to need a knee replacement. He is trying to hold down a part time cleaning job as well as be main carer for our three kids while I work. He is in agony with it. His GP had to write again to the hosptial as they categorised him as Category 3 (ie a 12 month wait to see a consultant) and has now been upgraded to Category 2 - another 3 month wait. I am glad your friend in her 80s got the operation so quickly but I doubt my much younger husband who probably has a lot more responsibilities will be so lucky. Edited January 30, 2015 by Loopylu Quote Link to comment Share on other sites More sharing options...
Keith and Linda Posted January 30, 2015 Share Posted January 30, 2015 My Aussie husband has been waiting 4 months to see an orthapoedic surgeon for his knee and is in excrutiating pain. He is only 51, has severe arthritis, a burst Baker's cyst and a torn ligament in his right knee and cannot take anti-inflammatories because he has Stage 3 kidney disease. He is likely to need a knee replacement. He is trying to hold down a part time cleaning job as well as be main carer for our three kids while I work. He is in agony with it. His GP had to write again to the hosptial as they categorised him as Category 3 (ie a 12 month wait to see a consultant) and has now been upgraded to Category 2 - another 3 month wait. I am glad your friend in her 80s got the operation so quickly but I doubt my much younger husband who probably has a lot more responsibilities will be so lucky. I wish you well, if I can get more info from the friend I will pass on to you. Keith Quote Link to comment Share on other sites More sharing options...
Loopylu Posted January 30, 2015 Share Posted January 30, 2015 I wish you well, if I can get more info from the friend I will pass on to you.Keith That would be great - thanks Keith! Quote Link to comment Share on other sites More sharing options...
janlo Posted January 30, 2015 Share Posted January 30, 2015 All these scans ? When I took my little boy for a scan even the company (very big private organisation) said it was totally unnecessary to scan him to the extent the doctor requested. I Have been told there is a lot of kick backs, at least you know you really need all the scans if the poor NHS is doing them ! Quote Link to comment Share on other sites More sharing options...
blossom Posted January 30, 2015 Share Posted January 30, 2015 All these scans ? When I took my little boy for a scan even the company (very big private organisation) said it was totally unnecessary to scan him to the extent the doctor requested. I Have been told there is a lot of kick backs, at least you know you really need all the scans if the poor NHS is doing them ! Well all the scans I had were needed as the baby was making my kidneys dilate. If it got worse they were going to have to put stents in. And when I was in pain or peeing blood they needed to see if I was at surgery level there and then. All bulk billed through Medicare. I don't for a second think the Medicare Drs who referred me got kick backs for it. Quote Link to comment Share on other sites More sharing options...
janlo Posted January 30, 2015 Share Posted January 30, 2015 Well all the scans I had were needed as the baby was making my kidneys dilate. If it got worse they were going to have to put stents in. And when I was in pain or peeing blood they needed to see if I was at surgery level there and then. All bulk billed through Medicare. I don't for a second think the Medicare Drs who referred me got kick backs for it. I agree you got the best treatment, Medicare at its best by the sounds of it. I was referring to the private system when u never really know if some of the treatment is 100% necessary, bit like those expensive visits to the dentist in the UK Quote Link to comment Share on other sites More sharing options...
newjez Posted January 30, 2015 Share Posted January 30, 2015 I spoke to my parents about this, and they say they have gap insurance and pay nothing? Quote Link to comment Share on other sites More sharing options...
Roberta2 Posted January 31, 2015 Share Posted January 31, 2015 I spoke to my parents about this, and they say they have gap insurance and pay nothing? Obviously, a fraught subject. A lot depends on where you live. We are all rightly suspicious of what the politicians tell us, and rely on anecdotal evidence. If you have something really urgent, you go onto the A list and get looked after pretty quickly. I think women are much better off in a public hospital, especially a major teaching hospital, than in a private hospital when they are having babies. The problem is that if you have something deemed non urgent, such as a hernia, the waiting times can be quite long, depending basically on luck and where you live, and there is no certainty about when you will be treated. Very inconvenient if you are planning a holiday etc. With the baby boomers retiring in droves, obviously there will be longer and longer waiting times for non urgent surgery such as hip and knee replacements. As it happens, I went to Medibank yesterday. It's the leading private insurer, with branches everywhere, and has just been privatized. I decided to drop the hospital part of my mother's health insurance, she is now in a nursing home, and keep only the coverage for teeth, hearing, eyes etc. Her premiums now go down from $188 to $60 a month. BUPA, by the way, is a private British company that took over the Australian private insurers MBF, HBA and Mutual community a few years ago. (It is also moving into aged care here.) I did learn, on asking, that anyone migrating here has one year after joining Medicare to get private health insurance, otherwise they will face a stiff penalty. I have a friend in his early 70s, in indifferent health - mainly because he is much too fat and ignores advice from his doctor. He has plenty of money, but on ideological grounds refuses to pay private insurance. (His mother was a well known communist!) He is now having an elective colonoscopy, which will cost him $1,600. He will get something back on Medicare, but probably not much. I am watching this with some interest... On the other hand, I also know pensioners in their seventies and eighties who have always kept up their private insurance. Personally, I would not want to be without it. There are websites that allow you to compare premiums/costs of the various health insurers. If you're young, you will want to avoid paying for hip replacements if you can! As previously indicated, if you don't take out private insurance, you will have to pay the Medicare levy anyway. The Medicare levy is now 2% of gross income. There is also a surcharge for high income earners. It cuts in at 1% for singles earning over $88,000 or families earning $176,000. Quote Link to comment Share on other sites More sharing options...
NicF Posted January 31, 2015 Share Posted January 31, 2015 As previously indicated, if you don't take out private insurance, you will have to pay the Medicare levy anyway. The Medicare levy is now 2% of gross income. There is also a surcharge for high income earners. It cuts in at 1% for singles earning over $88,000 or families earning $176,000. Everyone pays the Medicare levy whether that have private health insurance or not. It is only the additional levy for high income earners that you avoid by having private health insurance. I've stopped our hospital cover because I'm just not sure we could afford the additional payments if we needed a procedure doing. Instead we are putting money aside every month so if any of us do need something doing we can decide whether to go private and pay for it ourselves or wait and have it done under Medicare. Quote Link to comment Share on other sites More sharing options...
Guest Chewitts Posted January 31, 2015 Share Posted January 31, 2015 I did learn, on asking, that anyone migrating here has one year after joining Medicare to get private health insurance, otherwise they will face a stiff penalty. . Where did you here about this??..... There is no penalty stiff or otherwise specific to people who have migrated here as far as I know......we have to pay the levy as does everyone else and also the extra percentage if you earn over a certain amount but there is nothing to say that anyone has to have private cover or will face a penalty as far as I know Quote Link to comment Share on other sites More sharing options...
NickyNook Posted January 31, 2015 Share Posted January 31, 2015 Where did you here about this??..... There is no penalty stiff or otherwise specific to people who have migrated here as far as I know......we have to pay the levy as does everyone else and also the extra percentage if you earn over a certain amount but there is nothing to say that anyone has to have private cover or will face a penalty as far as I know For every year they're over the age of 30, people taking out private health insurance have to pay an extra 2% premium. New migrants have a year after arrival to take out private insurance before they become liable for this additional age premium. It's to discourage people from taking out private health insurance for the first time when they're old and sick. http://www.privatehealth.gov.au/healthinsurance/incentivessurcharges/lifetimehealthcover.htm Quote Link to comment Share on other sites More sharing options...
Guest Chewitts Posted January 31, 2015 Share Posted January 31, 2015 For every year they're over the age of 30, people taking out private health insurance have to pay an extra 2% premium. New migrants have a year after arrival to take out private insurance before they become liable for this additional age premium. It's to discourage people from taking out private health insurance for the first time when they're old and sick. http://www.privatehealth.gov.au/healthinsurance/incentivessurcharges/lifetimehealthcover.htm That is an extra premium that you would have to pay to you private health insurance.......if you choose not to take out any private cover but stick with medicare you will not have to pay any penalty Quote Link to comment Share on other sites More sharing options...
NickyNook Posted January 31, 2015 Share Posted January 31, 2015 That is an extra premium that you would have to pay to you private health insurance.......if you choose not to take out any private cover but stick with medicare you will not have to pay any penalty Yes. I know exactly what it is. This is what Roberta2 was referring to and you wanted to know how she heard about it. I am just supplying the details, that's all.. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.