Michelle84 Posted October 19, 2015 Share Posted October 19, 2015 Hi all Why do you need private medical insurance when paying medicare from your wages? What does medicare cover then? Link to comment Share on other sites More sharing options...
NicF Posted October 19, 2015 Share Posted October 19, 2015 You don't need private health cover (unless you are on certain types of visas) but some people choose to take it out to cover them in case they need a procedure and don't want to wait on the public system or want a choice of surgeons. It is possible to go private without health cover and just pay the costs yourself. Higher earners sometimes choose to take out cover so they don't have to pay the additional Medicare levy. Link to comment Share on other sites More sharing options...
Michelle84 Posted October 19, 2015 Author Share Posted October 19, 2015 Thanks for clarifying. I thought you had to have private medical insurance on top of the medicare payments. Link to comment Share on other sites More sharing options...
Skani Posted October 19, 2015 Share Posted October 19, 2015 In addition to private health cover for hospital mentioned by NicF, there are some areas Medicare doesn't cover at all such as dental, optical, physiotherapy etc ....so some people choose to take private health insurance for these. Link to comment Share on other sites More sharing options...
Guest Dave53 Posted October 19, 2015 Share Posted October 19, 2015 The choice is yours ... We've just paid out $25,000 for a hip replacement versus about $6000 out of pocket if we had health insurance .. We are now looking at taking out health insurance ... Dave C Link to comment Share on other sites More sharing options...
trishenty Posted October 19, 2015 Share Posted October 19, 2015 ... and ambulance fee. My daughter called it out when grandson fell off his bike & was unconcious. She was charged $900 Link to comment Share on other sites More sharing options...
Loopylu Posted October 19, 2015 Share Posted October 19, 2015 In my opinion private health hospital cover is only worth having if you are a high earner and liable for the extra Medicare levy if you don't have the cover. The cost of the hospital cover may be cheaper than paying the extra tax. Don't believe the marketing blurb from health funds that they have 'no gap' specialists on their books. Even if the fund manages to provide you with details of the 'no gap' specialist, the specialist usually ends up saying that they are only no gap for a limited number of procedures and never the one that you want! It is definitely worth having extras cover though for dentistry, optical and physio. We have found HCF good for extras as the 6 monthly dentistry checkups are free (some funds have a gap or only cover 12 monthly checkups) and they have a good deal with Specsavers and so you don't often need to pay any extra for the basic glasses and therefore you can afford to opt to pay for anti-glare and other extras on the glasses. It depends on the State you are in as to whether you require ambulance cover. In Qld, ambulances are free as you pay a small Ambulance Levy as part of your electricity bill. Link to comment Share on other sites More sharing options...
JockinTas Posted October 19, 2015 Share Posted October 19, 2015 In my opinion private health hospital cover is only worth having if you are a high earner and liable for the extra Medicare levy if you don't have the cover. The cost of the hospital cover may be cheaper than paying the extra tax. Don't believe the marketing blurb from health funds that they have 'no gap' specialists on their books. Even if the fund manages to provide you with details of the 'no gap' specialist, the specialist usually ends up saying that they are only no gap for a limited number of procedures and never the one that you want! It is definitely worth having extras cover though for dentistry, optical and physio. We have found HCF good for extras as the 6 monthly dentistry checkups are free (some funds have a gap or only cover 12 monthly checkups) and they have a good deal with Specsavers and so you don't often need to pay any extra for the basic glasses and therefore you can afford to opt to pay for anti-glare and other extras on the glasses. It depends on the State you are in as to whether you require ambulance cover. In Qld, ambulances are free as you pay a small Ambulance Levy as part of your electricity bill. Ambulance free here in Tasmania too (for Tasmanian residents). We have just taken out extras cover with BUPA. Link to comment Share on other sites More sharing options...
AJ Posted October 20, 2015 Share Posted October 20, 2015 ... and ambulance fee. My daughter called it out when grandson fell off his bike & was unconcious. She was charged $900Bet she is wishing she took out ambulance cover now, it only costs about $75. Link to comment Share on other sites More sharing options...
Quoll Posted October 20, 2015 Share Posted October 20, 2015 It all depends what visa you are on too - some visas require you to have health insurance. Some have found that relying on the reciprocal arrangement between Aus and UK doesn't necessarily cover all medical interventions. Another option is to self insure of course - put your $250 pm into a dedicated account for times when you may want not to wait 18/12 for an elective procedure or your kid needs orthodontics etc. Link to comment Share on other sites More sharing options...
Peach Posted October 20, 2015 Share Posted October 20, 2015 Another option is to self insure of course - put your $250 pm into a dedicated account for times when you may want not to wait 18/12 for an elective procedure or your kid needs orthodontics etc. Just got to hope that no one - and definitely not more than one person - needs treatment within the next 5-10 years whilst you build your self help fund..... Link to comment Share on other sites More sharing options...
Quoll Posted October 20, 2015 Share Posted October 20, 2015 Just got to hope that no one - and definitely not more than one person - needs treatment within the next 5-10 years whilst you build your self help fund..... Yup, that's true too - $3k won't get you far but if you're young and healthy 10 yrs should do it Link to comment Share on other sites More sharing options...
fish.01 Posted October 20, 2015 Share Posted October 20, 2015 The choice is yours ... We've just paid out $25,000 for a hip replacement versus about $6000 out of pocket if we had health insurance .. We are now looking at taking out health insurance ... Dave C just to clarify for the OP these $ amounts are for the private system only...under the public system it would be free but your local hospital may or may not have waiting times that are acceptable to you for this particular procedure. Link to comment Share on other sites More sharing options...
Guest Dave53 Posted October 20, 2015 Share Posted October 20, 2015 Yes I confirm , the amount above was for a procedure in a private hospital of our choice . Had the same procedure been carried out in a public hospital it would have been fully covered by Medicare , albeit with a wait in excess of 12 months .. Dave C Link to comment Share on other sites More sharing options...
fish.01 Posted October 20, 2015 Share Posted October 20, 2015 Yes I confirm , the amount above was for a procedure in a private hospital of our choice . Had the same procedure been carried out in a public hospital it would have been fully covered by Medicare , albeit with a wait in excess of 12 months .. Dave C Yes, further to this, anyone who wants to know how long the median wait time is at your local hospital for a particular procedure you can look it up on: https://www.myhospitals.gov.au For example Royal North Shore Hospital (Public) in Sydney says: "Total hip replacement: median waiting timesIn 2013–14, the median waiting time for total hip replacement was 122 days at this hospital, compared to its national peer group performance of 100 days." See: https://www.myhospitals.gov.au/hospital/1153B2180/royal-north-shore-hospital/orthopaedic So the median waiting time nationally for a full hip replacement is 3 months. But note that this is somewhat deceptive as it is the waiting time from when your public hospital specialist decides you need an operation. It does not take into account the time it takes to get the appointment with the public hospital specialist in the first place. So to work out you could: - ask hospital about median waiting time to see the specialist. - add on median waiting time for operation at that hospital using the data from https://www.myhospitals.gov.au Many in Australia who have private insurance don't bother waiting and put it on their private insurance but just note sometimes the wait times are fine and the whole thing can be done for free so it is worth checking. Link to comment Share on other sites More sharing options...
Que Sera Sera Posted October 20, 2015 Share Posted October 20, 2015 I know I had to have an operation and the consultant asked me if I wanted to use Medicare or go private, I asked the time difference and it was just 1 week, so I elected for the public system and received top notch care. We have private health and use it for dental and optical, ambulance cover etc but to be honest it's more more tax purposes. Link to comment Share on other sites More sharing options...
rammygirl Posted October 21, 2015 Share Posted October 21, 2015 Just got to hope that no one - and definitely not more than one person - needs treatment within the next 5-10 years whilst you build your self help fund..... But if you need treatment you can still have it free under Medicare, which is the same as the NHS really. Emergencies are taken care of and some things have a longer wait. we chose to self insure, same as in the UK and we have a fund built up from that. I find Medicare services here good, but as in the UK it can depend where you live. looking at the cost of private insurance over many years plus the gap payments, even with some higher cost treatments I am not sure private is worth it for us. Even with dental, the costs are similar to UK private dentists and the care is top rate. We stopped using NHS dentists as they were poor in comparison with out of date technology etc. and not much cheaper for check ups. You need to look at your own circumstances and weigh up the pros and cons. Did you have private insurance in the UK? Link to comment Share on other sites More sharing options...
Peach Posted October 21, 2015 Share Posted October 21, 2015 But if you need treatment you can still have it free under Medicare, which is the same as the NHS really. Emergencies are taken care of and some things have a longer wait. we chose to self insure, same as in the UK and we have a fund built up from that. I find Medicare services here good, but as in the UK it can depend where you live. looking at the cost of private insurance over many years plus the gap payments, even with some higher cost treatments I am not sure private is worth it for us. Even with dental, the costs are similar to UK private dentists and the care is top rate. We stopped using NHS dentists as they were poor in comparison with out of date technology etc. and not much cheaper for check ups. You need to look at your own circumstances and weigh up the pros and cons. Did you have private insurance in the UK? Yes, had (gapless) private cover provided by my employer in the UK. Only cost to me was 40GBP a month as a benefit in kind, paid in extra tax by me. I agree heartily that for many it might not be worth it. My son recently had a tooth extracted under intravenous sedation at the dentist, total coat $1500. My private healthcare covered approx $300 and Medicare about $100. Yay. Link to comment Share on other sites More sharing options...
fish.01 Posted October 21, 2015 Share Posted October 21, 2015 Yes, had (gapless) private cover provided by my employer in the UK. Only cost to me was 40GBP a month as a benefit in kind, paid in extra tax by me. I agree heartily that for many it might not be worth it. My son recently had a tooth extracted under intravenous sedation at the dentist, total coat $1500. My private healthcare covered approx $300 and Medicare about $100. Yay. Yes, some plans pay out rubbish at the dentist. Especially for major dental. So frustrating. I was able to change mine. Our old plan would have paid around $700 of that $1500 bill. For roughly the same cost our new plan would pay out $1200 of that $1500. So much better. Link to comment Share on other sites More sharing options...
Ken Posted October 21, 2015 Share Posted October 21, 2015 The reason many Australians have hospital cover is nothing to do with waiting times and all about tax. If you earn an above average salary and you (or any member of your family) doesn't have hospital cover you have to pay an extra tax (the medicare levy surcharge). Provided you have hospital cover you're exempt and many people prefer to pay for the cover than to pay the surcharge even when no real saving is involved. Link to comment Share on other sites More sharing options...
fish.01 Posted October 21, 2015 Share Posted October 21, 2015 The reason many Australians have hospital cover is nothing to do with waiting times and all about tax. If you earn an above average salary and you (or any member of your family) doesn't have hospital cover you have to pay an extra tax (the medicare levy surcharge). Provided you have hospital cover you're exempt and many people prefer to pay for the cover than to pay the surcharge even when no real saving is involved. Yes, you pay extra tax if you earn over $180,000 per family; or $90,000 as a single. Link to comment Share on other sites More sharing options...
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