Private Health Insurance-have you got it? What have you chosen to cover?

[DukeNinja]

Hi all, so I’m trying to get my head around the whole private health insurance minefield, and I would like to pick your brains. We lie in QLD, where ambo cover is provided by the state, as I understand it.

How exactly does the public health system work for Joe Bloggs here?

I’m assuming all emergency cover is free.

So does PHI really only provide you with the choice of where and when to have treatment done?

How many of you guys have PHI, and what level of cover have you got?

Thanks,

DN

[bristolman]

I never had private cover in Australia in 30 odd years. The public system is adequate for most things but waiting lists are blowing out. Obviously stuff like A&E is free, as are operations etc. Dental can be hellishly expensive so worth having cover for that at least. Private insurance is becoming very expensive and apparently fewer people are taking it up. If you can afford it get it. 

[ScottieGirl]

I had it because I earned over 85 k or whatever it is so it was a choice of pay extra tax or get private healthcare.  That was an easy decision at least you get something out of PHI.  I used it for dental, optical and physio. If you are young and reasonably healthy I doubt you will use it much but and it's  a big but if you want it later in life it will be much more expensive.

Everyone I knew paid went private for maternity care, I think it's  a guilt thing people worry about doing their best. I am not sure that it is  necessary, I think public care would be fine

[Quoll]

We had it (earned over the threshold so it was a no brainier). When I was told that if I hadn’t had PHI then I would be waiting 18 months to have my gall bladder out (and a subsequent surgery would probably never have made it onto the waiting list but IMHO was essential given the state I was in) I was never more grateful that we had it. It helped a bit with one son’s orthodontist fees but generally the safety net of it was useful to us. It’s expensive and another option we are considering when we return is to self insure but I really valued not having to wait on an elective waiting list for procedures which vastly improved my quality of life.

[Gbye grey sky]

2 hours ago, DukeNinja said:

Hi all, so I’m trying to get my head around the whole private health insurance minefield, and I would like to pick your brains. We lie in QLD, where ambo cover is provided by the state, as I understand it.

How exactly does the public health system work for Joe Bloggs here?

I’m assuming all emergency cover is free.

So does PHI really only provide you with the choice of where and when to have treatment done?

How many of you guys have PHI, and what level of cover have you got?

Thanks,

DN

We moved to Queensland 2 years ago.  Ambulance cover is included in your rates bill.

Because you have 6 months(?) on arrival to decide or effectively pay much higher premiums based on your age I lookd into all this in 2015.  Because I am a low earner here I do not pay the medicare levy so that was a major influence.  The premiums were, in my case, going to come from my savings.

My own opinion is that if you had private health insurance in the UK, and liked it, then you will like private health insurance in Australia for those same reasons plus the potential tax reasons.  I have never had private health insurance nor had I ever considered it in England but the I have never had any medical treatments, elective or otherwise, aside from some physio 25 years ago.  But I am probably not usual in this.

Worth shopping around to see what is out there.  Scratch below the surface of what is provided and covered and it did seem pricey to me for what was on offer.

[ramot]

We don't have a choice as we are self funded retirees, and it's pretty pricey for us. However as we are older we do like the reassurance of getting quick access to specialists when needed. This year because I had an unexpected heart hiccup I have claimed far in excess of annual fee  paid, every bill fully refunded . State of the art equipment and technology, so reassuring as we age.

We have very little experience of the public system until last week , when I had to call an ambulance for my husband. I can't fault his treatment, the ambulance medics were fantastic, totally professional and very caring.we have a brand new local public hospital, no complaints about his care. Paid for by our insurance. If he has further treatment in the public system rather than private he will have a longer wait. So as we pay either way private will be quicker.

Not been our month, all very unexpected hiccups.

[Skani]

9 hours ago, DukeNinja said:

I’m assuming all emergency cover is free.

So does PHI really only provide you with the choice of where and when to have treatment done?

 

Yes and  Yes.

The advantages of the latter  - waiting times for elective surgery - can differ markedly  vary according to postcode.

This website is informative and enables you to compare policies if you decide to go that route:

https://www.privatehealth.gov.au/

I have a fairly basic hospital cover - with large excess to reduce premiums - but I am now classed as a "senior".   I have used it only 3 times in the last 40 years.   If I were my younger self  starting out  now I would  dedicate a special account with top private health premium equivalent and self insure.

[rammygirl]

As in the UK we use the public system and pay for things we need that it cannot provide, like quick access to physio etc.

 

We have a budget for health and effectively self insure.  It seems to me that even with PHC you still have to pay, add that to the premiums and the cost would be much higher for us. Plus you are more likely to have treatments on PHC, over medicalisation is a worry, look at the USA.  The incentive is there for the providers and the patients to get as much out of it as they can.

 

It really does depend on you personal circumstances though, you need to do the pros and cons.  I may well advise my son who is 26 to get PHC before the age cut off (currently 30) as he will be earning over the threashold.  You can always opt out in the future but opting in is expensive due to age loading.

As for childbirth, there seems to be some peer pressure to go private but for many, and it does depend, they get the similar care but have to pay a gap if using PHC.  

Some people get the cheapest cover to avoid the Medicare levy, but as the gap is usually large they don’t actually use it as treatment will be cheaper or free under Medicare!

i know I can get bulk billed or free doctors appointments but I now prefer to pay on the odd occasion I need to as the care is better and the GP has time to actually listen!  Although I did go back to the bulk billed place when I just needed some antibiotics for an insect bite gone bad!

[Bulya]

Totally unecessary use the funds for something else

[Toots]

On 04/12/2017 at 01:24, Quoll said:

We had it (earned over the threshold so it was a no brainier). When I was told that if I hadn’t had PHI then I would be waiting 18 months to have my gall bladder out (and a subsequent surgery would probably never have made it onto the waiting list but IMHO was essential given the state I was in) I was never more grateful that we had it. It helped a bit with one son’s orthodontist fees but generally the safety net of it was useful to us. It’s expensive and another option we are considering when we return is to self insure but I really valued not having to wait on an elective waiting list for procedures which vastly improved my quality of life.

I must have been very lucky Quoll as I had my gall bladder out after a 4 week wait in Sydney.  It would have been awful to wait 18 months as it is not a nice thing to put up with so in your case having PHI was a godsend.  We self insured over the last 5 years but so far haven't needed to use it.  Even with my heart problems, I was admitted to hospital in Launceston very quickly on Medicare and the follow up treatment has been very good.

[CaptainR]

7 hours ago, Bulya said:

Totally unecessary use the funds for something else

Nice first post without any justification or explanation... 

[CaptainR]

We've been very impressed with medicare in Australia, however due to medicare levy surcharge for earning in excess of 180k we have taken the alternative option of Bupa insurance which works out to cost a similar amount to the 1.5% levy we'd be paying otherwise. 

We have the Bupa budget hospital with $500 excess and gold extras. The extras are absolutely fantastic with the unlimited dental and we only seem to pay a very slight gap for some treatments and the optical is also pretty good. We haven't used it for anything else yet and hopefully won't need to. 

We also use a GP who doesn't bulk bill and the rebate through medicare doesn't cover he fees, so we have to pay the gap ourselves and the bupa doesn't cover that either. That being said the majority of GP's do bulk bill whereby just flashing the medicare card gives you treatment without any gap payments.

[Bulya]

3 hours ago, CaptainR said:

Nice first post without any justification or explanation... 

Public get the same surgeon as private etc.  what’s to be gained?

[ali]

3 minutes ago, Bulya said:

Public get the same surgeon as private etc.  what’s to be gained?

No waiting lists.  My first operation which was essential but none urgent I was able to choose when I wanted it done (4 weeks after the appointment), my 2nd operation I was seen on the on the Monday and had the operation less than a week later.

[CaptainR]

1 hour ago, Bulya said:

Public get the same surgeon as private etc.  what’s to be gained?

Well for one, paying for private medical insurance in lieu of the medicare levy surcharge can be financially beneficial for some of us. 

[starlight7]

We've had it for years. It gives you a certain security in case of serious illness and it is also good for dental rebates and optical rebates. A friend of ours had pancreatic cancer and because he was not a private patient he had to wait 6 months, yes, 6 whole months for his op.  Had he been a private patient the wait would have been less than a month.  That is one of the big reasons for private health cover in this fair land!

[bristolman]

2 hours ago, starlight7 said:

We've had it for years. It gives you a certain security in case of serious illness and it is also good for dental rebates and optical rebates. A friend of ours had pancreatic cancer and because he was not a private patient he had to wait 6 months, yes, 6 whole months for his op.  Had he been a private patient the wait would have been less than a month.  That is one of the big reasons for private health cover in this fair land!

He had to wait 6 months for a cancer op, are you serious ? As I said I've never had private cover and I suppose have always been fairly lucky over the years. 

[Parley]

I had it for many years until my last child had finished studying.

If it was just me I would take the risk but witha family of 5 it is worth having I think.

It would be better if everyone took out private health insurance as then it would be a lot cheaper for everyone. But with so many dropping it it makes it more expensive for everyone who is left.

[MTut]

Just an FYI for those of you making the move over soon or recently, we had Bupa cover in the UK and Bupa worked out most competitive here.

It was 55 days from our old policy finishing until we started making enquiries over here and glad we did. Bupa stated that as long as we had no break of 60 or more days from the end of our previous cover, we didn't get hit with waiting periods as new enrollments to the Australian plan. I believe that would have applied even if we were with a different provider in the UK but worth checking when you apply. The instant messaging chats are actually quite good for quick questions. So, if you are thinking of getting it, don't put it on a backburner when you land as long as its financially viable.

We're borderline as to whether its worth it from a financial point of view with offsetting the medicare levy but personally, PMI  and life / illness cover are the two things I'm happy to pay each month. If I'm lucky and never use it, so be it.

 

[bristolman]

3 hours ago, Parley said:

I had it for many years until my last child had finished studying.

If it was just me I would take the risk but witha family of 5 it is worth having I think.

It would be better if everyone took out private health insurance as then it would be a lot cheaper for everyone. But with so many dropping it it makes it more expensive for everyone who is left.

People are dropping private cover because it is so expensive and many others are reducing cover which is putting more strain on the already stretched public system. 

[CaptainR]

3 hours ago, bristolman said:

People are dropping private cover because it is so expensive and many others are reducing cover which is putting more strain on the already stretched public system. 

The NHS, Medicare etc certainly won't exist in their present form within my lifetime I'm sure. Most people don't seem to grasp how expensive medical services actually are and I suspect that for all but the very poor we will all have private insurance whilst still paying for the same taxes as we currently pay. 

[bristolman]

3 minutes ago, CaptainR said:

The NHS, Medicare etc certainly won't exist in their present form within my lifetime I'm sure. Most people don't seem to grasp how expensive medical services actually are and I suspect that for all but the very poor we will all have private insurance whilst still paying for the same taxes as we currently pay. 

I agree in part, those 2 systems certainly won't exist in their present form into the future, they are unsustainable. Personally I would like to see some services means tested in the NHS, those who can afford to pay towards certain things, the low paid sould continue on as is. Changes do need to be made for sure. 

[Bulya]

No insurance, an unnecessary expense.