Private Healthcare versus Medicare

[brucewayne]

I don't know if there's already a thread in this subject, but what tends to be more favorable for ex-pats - Medicare or taking Private Medical cover? I know that there is a reciprocal health care agreement between the UK and Oz but is one more advantageous then the other?

 

FYI - I'm in good health and never really been ill, ever. In fact I've only ever had flu twice in my lifetime but I have had bone breaks through sports and stuff. Would/should this influence the choice I make? My 457 requires me to either enroll in Medicare or take sufficient private cover.

 

Any advice?

[AllyB]

Medicare is free where as private health insurance costs quite a lot. Obviously the benefits of private insurance are much greater than Medicare but up to you really. I'm on Medicare but looking to add private insurance in a few months.

[brucewayne]

I thought that there was a medicare levy of 1.5%?

[Guest siamsusie]

I thought that there was a medicare levy of 1.5%?

 

Dependent on your earnings.

 

 

We have Medicare and Medibank Private, with the latter having a $200 excess...and we have this through our company.

 

To be honest I tend to use Medicare more as a patient than MP and my treatment has been wonderful... but of course MP is useful if you require a procedure to be completed quickly... with the usual dental, topical, podiatry avenues available.

 

If you asked me my preference, it would be Medicare but maybe this depends on your place of abode. Ambulance cover here in Tasmania is free.

 

 

Susie

[Cob]

Hospital admission is costly if you are not insured.

Only emergency admissions are covered on the reciprocal agreement.

So maybe consider your risk factors - age, current health, family history, lifestyle etc

At the very least make sure you take out ambulance cover as I am pretty sure this is not reciprocal.

Cath

[ali]

I know that some places insist you have private insurance on a temp visa. We have private health cover, initially Ambulance, dental and optical cover, we added hospital cover as we did get stung with the medicare levy one year. Medicare Levy Surcharge

[Guest km75]

Hello -

I moved to Australia in 2003 and enrolled in Medicare - it's kind of like the NHS, not quite as free, but heavily discounted, it's reciprocal health care for UK citizens so you're entitled to it. However earn more than $70k, or $150k as a family and you don't have private health insurance you have to pay an extra 1% tax on your salary - your basic private health cost about the same as this 1% and gives you lots of extras like $150 a year to spend on glasses and various other things. However it is aged dependent, and there are incentives to join before you turn 31 - so we did. We are back in the UK at present and have suspended our private health as when we'll return we'll be past 31 so more expensive to join. We are with MBF, but there are plenty of others - in my opinion if you're under 31 and earning more than $77k I'd get private.

Kat

[Guest JonInMelbourne]

Depends on the tax situation. If you earn over a certain amount (this varies between singles / families) then you have to pay an extra 1% 'medicare surcharge' if you DON'T have private medical insurance which gives you a certain minimal level of cover.

 

A lot of higher earners take out health insurance, which saves them this 1% charge and also then gives them extra insurance cover they wouldn't have had. Win Win!

 

Definitely worthwhile looking up the surcharge details to see how this works for you financially.

[Guest Ninni]

In terms of care received, I was on Medicare for 6 years and found the care and quality great (but then I only have positive things to say about the NHS, others think differently...). Think it comes down to the finances and situation really. About half of my friends have private.

[Guest trophy]

I don't know if there's already a thread in this subject, but what tends to be more favorable for ex-pats - Medicare or taking Private Medical cover? I know that there is a reciprocal health care agreement between the UK and Oz but is one more advantageous then the other?

 

FYI - I'm in good health and never really been ill, ever. In fact I've only ever had flu twice in my lifetime but I have had bone breaks through sports and stuff. Would/should this influence the choice I make? My 457 requires me to either enroll in Medicare or take sufficient private cover.

 

Any advice?

 

I have just had a knee op through medicare, treatment could not have been better, I just had to wait longer than if I was private. On Medicare you have the doctor avalible, not the doctor/specialist that carried out the diag,(but this can cost you even on private)

Ambulance cover is a must.

Dental is very expensive, health insurance on dental can be a bit hit & miss.

Generally Medicare is OK,

[Quoll]

We have private health cover basically because we would be paying the surcharge if we didnt - and we have had it for a good many years. Also, being older, if we were to opt out and then opt in again the premiums would be beyond our reach. As it is I am having surgery Wednesday - I had a terrible 2 week wait /sarc/ for elective surgery and I asked what the waiting list for the same op on medicare would be - 18 months and my surgeon (who is the well known expert) wouldnt do the surgery himself but would supervise someone else doing it. It'll cost me just over $1k even on private health but it is worth every cent. This is the third time I have needed surgery which was technically "elective" but pretty much essential to my quality of life (this is the least needy but still needy nonetheless) and each time I have had the op within 3 weeks.

 

I guess if you are young and healthy and dont envisage ever needing your gall bladder out, your kids' tonsils out or your carpal tunnel fixed or any of those other odd complaints then go with medicare. I think in hindsight, I might have self insured the same amount each month - I would have come out ahead I think.

[missshelly]

If you have Private medical and need regular dental/ optical and go to a members choice practice you can get back at least 70% and in some cases there is no gap so can get free especially spectacles. hope this helps

[Guest cosmopolman]

Hi all,

Finally, a thread on this topic that makes sense.

I'm racking my brain over this. I'm from UK, am eligible for Medicare, but also want a little bit of extra security.

 

What I don't understand is why it seems we (poms) are not eligible for the same insurance plans as regular aussies, considering we are paying the same 1.5% tax. Why do I need Overseas Health Cover which is 3x more expensive (and the same price that people without Reciprocal Medicare pay)?? *

 

Also, Overseas Plans are not eligible for the 30% Medicare rebate on the main insurance fee, like regular aussie CHIP plans.

 

And... we need to pay an extra $500 Reciprocal Insurance supplement to be exempt from the Medicare Levy Surcharge. So... is it me or is it better to actually NOT have Reciprocal Medicare eligibility? You still have to get Overseas Health Cover, at all the same coverage levels, but not be subject to the MLS!

 

So, in addition to everyone's 1.5% medicare tax:

 

 

• An aussie pays about $1000 for a year's insurance (counting 30% rebate, in a CHIP plan that qualifies for MLS exemption).
  
• A regular non-reciprocal foreigner pays about $2000 for a year's insurance with an Overseas plan
  
• A brit pays $2500 for a year's insurance (with the extra MLS exemption rider).
  

 

WTH??

 

I pay more than non-reciprocals but get the exact same benefits? What's the point of Medicare, then?

 

And it seems I pay 3x more than aussies for insurance, and get the exact same benefits. (Unless someone can explain * below).

 

*MBF says on their site:

"If you are from a Reciprocal Health Care Agreement (RHCA) country and have a Reciprocal Medicare card, your access to Medicare may be limited to immediately necessary medical treatment. To ensure you are covered for inpatient and outpatient hospital services and treatment by a doctor in private practice, you will need to take out one of our overseas visitor covers. If you were to choose a cover for Australian residents, you would not be covered for these services, which would result in large out-of-pocket expenses."

 

What are these services that are not covered by Australian resident insurance that is covered by Overseas insurance??? No answers!!

[Guest]

This is interesting. Currently here in the UK we have NHS cover free obviously. My hubby used to get private health insurance through his old job but never used it. I used to have private health cover till a few years ago when decided it really wasn't worth it. Better to put money in the pot each month (even 2 Doctor friends told me to do this than continue with private payments ).

 

Now when we move to Aus we'll probably just have Medicare and be fine with this.

 

But is there anything like here in the UK that if you wish to go private for an op or tests you can do so as a one off and not be registered or already covered? This is what we have done a few times in recent years rather than have NHS waiting times or when something wasn't available on the NHS in our area and we had to resort to private. We used Bupa each time for this and simply wrote the cheque once we got the bill after the tests/treatment. Its worked out great and definately no more expensive than years of paying into private healthcare would have cost.

[Guest tandcmum]

can i just ask, is ambulance cover still included in one of the utility bills in QLD (can't remember which one it is)

[Cal2]

thought I read somewhere, that if you opted into a private health scheme within so many weeks of arriving in Oz you would get it as if aged 31 years..........or have I imagined it

[Guest Guest 47403]

thought I read somewhere, that if you opted into a private health scheme within so many weeks of arriving in Oz you would get it as if aged 31 years..........or have I imagined it

 

Yes your right can't remember what the timescale is though, certainly worth anyone over 31 doing it within the timescale if you leave it later your premiums increase significantly also you'll be liable for the extra levy if your salary is over $70k.

[Ken]

Hi all,

Finally, a thread on this topic that makes sense.

I'm racking my brain over this. I'm from UK, am eligible for Medicare, but also want a little bit of extra security.

 

What I don't understand is why it seems we (poms) are not eligible for the same insurance plans as regular aussies, considering we are paying the same 1.5% tax. Why do I need Overseas Health Cover which is 3x more expensive (and the same price that people without Reciprocal Medicare pay)?? *

 

Also, Overseas Plans are not eligible for the 30% Medicare rebate on the main insurance fee, like regular aussie CHIP plans.

 

And... we need to pay an extra $500 Reciprocal Insurance supplement to be exempt from the Medicare Levy Surcharge. So... is it me or is it better to actually NOT have Reciprocal Medicare eligibility? You still have to get Overseas Health Cover, at all the same coverage levels, but not be subject to the MLS!

 

So, in addition to everyone's 1.5% medicare tax:

 

 

• An aussie pays about $1000 for a year's insurance (counting 30% rebate, in a CHIP plan that qualifies for MLS exemption).

• A regular non-reciprocal foreigner pays about $2000 for a year's insurance with an Overseas plan

• A brit pays $2500 for a year's insurance (with the extra MLS exemption rider).

WTH??

 

I pay more than non-reciprocals but get the exact same benefits? What's the point of Medicare, then?

 

And it seems I pay 3x more than aussies for insurance, and get the exact same benefits. (Unless someone can explain * below).

 

*MBF says on their site:

"If you are from a Reciprocal Health Care Agreement (RHCA) country and have a Reciprocal Medicare card, your access to Medicare may be limited to immediately necessary medical treatment. To ensure you are covered for inpatient and outpatient hospital services and treatment by a doctor in private practice, you will need to take out one of our overseas visitor covers. If you were to choose a cover for Australian residents, you would not be covered for these services, which would result in large out-of-pocket expenses."

 

What are these services that are not covered by Australian resident insurance that is covered by Overseas insurance??? No answers!!

 

IF (and it's a big if) the costs of insurance you've quoted are correct you are right it doesn't make sense. However I don't know where you got your numbers from. A "regular non-reciprocal foreigner" on a temporary visa is not entitled to medicare so his overseas insurance will be priced to cover the full cost of all treatments.

 

A brit (or other foreigner entitled to a reciprocal medicare card) on a temporary visa is entitled to some medicare so his overseas insurance will be discounted to allow for the fact it won't need to cover the full cost of all treatments and so it should be cheaper (although your figures don't take that into account) although it won't be as cheaper as for an Australian Resident (e.g. a Brit with a PR visa) since as stated you only have Reciprocal Medicare and not the full cover.

 

The $500 stops you from having to pay the 1% Medicare Levy Surcharge on top of your 1.5% Medicare Levy. Unfortunately I've no idea how much (1.5%, 2.5% or none) Medicare Levy has to be paid by foreigners who aren't entitled to any Medicare so I don't know if you are better or worse of than them - but you are right to be agrieved that permanent residents pay the lower rate just by having insurance while you have to pay the extra $500 as well.

[fish.01]

can i just ask, is ambulance cover still included in one of the utility bills in QLD (can't remember which one it is)

 

Yes...leccy.

[fish.01]

This is interesting. Currently here in the UK we have NHS cover free obviously. My hubby used to get private health insurance through his old job but never used it. I used to have private health cover till a few years ago when decided it really wasn't worth it. Better to put money in the pot each month (even 2 Doctor friends told me to do this than continue with private payments ).

 

Now when we move to Aus we'll probably just have Medicare and be fine with this.

 

But is there anything like here in the UK that if you wish to go private for an op or tests you can do so as a one off and not be registered or already covered? This is what we have done a few times in recent years rather than have NHS waiting times or when something wasn't available on the NHS in our area and we had to resort to private. We used Bupa each time for this and simply wrote the cheque once we got the bill after the tests/treatment. Its worked out great and definately no more expensive than years of paying into private healthcare would have cost.

 

Yes. Public hospital as a private patient or full private...often charged favourably as well when they know you are paying not insurance. A family member without private insurance swears by this route.

[Guest cosmopolman]

IF (and it's a big if) the costs of insurance you've quoted are correct you are right it doesn't make sense. However I don't know where you got your numbers from. A "regular non-reciprocal foreigner" on a temporary visa is not entitled to medicare so his overseas insurance will be priced to cover the full cost of all treatments.

 

A brit (or other foreigner entitled to a reciprocal medicare card) on a temporary visa is entitled to some medicare so his overseas insurance will be discounted to allow for the fact it won't need to cover the full cost of all treatments and so it should be cheaper (although your figures don't take that into account) although it won't be as cheaper as for an Australian Resident (e.g. a Brit with a PR visa) since as stated you only have Reciprocal Medicare and not the full cover.

 

The $500 stops you from having to pay the 1% Medicare Levy Surcharge on top of your 1.5% Medicare Levy. Unfortunately I've no idea how much (1.5%, 2.5% or none) Medicare Levy has to be paid by foreigners who aren't entitled to any Medicare so I don't know if you are better or worse of than them - but you are right to be agrieved that permanent residents pay the lower rate just by having insurance while you have to pay the extra $500 as well.

 

Regarding your first point: all the Overseas insurance I've seen, including from IMAN, do not have different pricing for reciprocal or non-reciprocal elligible foreigners. It's the same plans offered for both; there is no discount for having a Medicare card.

 

Regarding your second point:

As per ATO (I confirmed on their website), foreigners not elligible for medicare do not pay the 1% Surcharge (they do pay the basic Levy 1.5% tax, but can reclaim it later, apparently). Foreigners, like Brits, do pay it, unless the have a CHIP insurance plan (which none of the Overseas plans are) or unless they take out $500 worth of additional "Hospital Cover" (which is CHIP).

 

IMAN has a good summary of this here: http://www.austhealth.com/ausHealthSystemRecovering.php

 

So, it's actually even worse than I thought: non-Brit pays IMAN $2100 plan, gets everything covered 100%, is exempt from 1% Surcharge and can reclaim 1.5% Levy. Brit pays same $2100 plan, pays 1.5% Levy, and pays either 1% Surcharge or $500 Hospital Cover.

 

Unless you're a Brit backpacker and can deal with half-Medicare ("medically necessary only"), it seems whomever negotiated this Reciprocal agreement with Oz has done the rest of us who want normal health coverage a great dis-service. We are actually being majorly penalised.

 

Anyone from IMAN want to opine? Do Medicare card holders get a discount?

[fish.01]

Hi all,

Finally, a thread on this topic that makes sense.

I'm racking my brain over this. I'm from UK, am eligible for Medicare, but also want a little bit of extra security.

 

What I don't understand is why it seems we (poms) are not eligible for the same insurance plans as regular aussies, considering we are paying the same 1.5% tax. Why do I need Overseas Health Cover which is 3x more expensive (and the same price that people without Reciprocal Medicare pay)?? *

 

Also, Overseas Plans are not eligible for the 30% Medicare rebate on the main insurance fee, like regular aussie CHIP plans.

 

And... we need to pay an extra $500 Reciprocal Insurance supplement to be exempt from the Medicare Levy Surcharge. So... is it me or is it better to actually NOT have Reciprocal Medicare eligibility? You still have to get Overseas Health Cover, at all the same coverage levels, but not be subject to the MLS!

 

So, in addition to everyone's 1.5% medicare tax:

 

 

• An aussie pays about $1000 for a year's insurance (counting 30% rebate, in a CHIP plan that qualifies for MLS exemption).

• A regular non-reciprocal foreigner pays about $2000 for a year's insurance with an Overseas plan

• A brit pays $2500 for a year's insurance (with the extra MLS exemption rider).

 

WTH??

 

I pay more than non-reciprocals but get the exact same benefits? What's the point of Medicare, then?

 

And it seems I pay 3x more than aussies for insurance, and get the exact same benefits. (Unless someone can explain * below).

 

*MBF says on their site:

"If you are from a Reciprocal Health Care Agreement (RHCA) country and have a Reciprocal Medicare card, your access to Medicare may be limited to immediately necessary medical treatment. To ensure you are covered for inpatient and outpatient hospital services and treatment by a doctor in private practice, you will need to take out one of our overseas visitor covers. If you were to choose a cover for Australian residents, you would not be covered for these services, which would result in large out-of-pocket expenses."

 

What are these services that are not covered by Australian resident insurance that is covered by Overseas insurance??? No answers!!

 

Without having any experience in it this is my best guess:

 

The Overseas Heath Cover (OHC) seems to be designed around people who need full private cover. There is no provision for people on reciprocal who 'sometimes' need a lower level of cover as they 'might' use the public system instead...seems like a one size fits all to save the complications.

 

Resident private hospital insurance is strictly private hospital cover only.

 

OHC seems to cover the following additional things over and above standard resident private insurance:

- Public hospitals

- GP's

- Public and private specialists

- PBS medicines in hospital

- Medical repatriation

 

Of course with reciprocal cover you are 'usually' partially covered for some of these anyway but OHC doesn't allow for that and you may still choose to claim from your OHC policy if it pays a bigger percentage of the cost than the public system.

 

As you say non residents aren't eligible for the govt rebate on private health insurance.

 

i guess the benefit of being on reciprocal is that you don't 'have to' use the private system even if you purchase OHC...you can mostly use the free system.

 

Not sure what this is: "extra $500 Reciprocal Insurance supplement"...do you have a link I could check out ?

[Guest cosmopolman]

Ok, getting screwed vs. Aussies, I can understand. Yeah, we're guests, yeah we're going to pay the same 1.5%Levy + 1%MLS that you do but get half the Medicare service. Yeah if we want additional private insurance it will cost us twice as much and we're not even eligible for the 30% rebate. OK, fine. I'll be sure to return the favour when you come visit UK. I'll make sure the NHS writes in some nice coverage exemptions for you all.

 

I'll make it up on the LAFHA, you jerks. :-)

 

But getting screwed vs. non-Brits, that part, I just can't comprehend. If we want beyond-minimal coverage, we have to pay 1.5%+$500 more than they do!

 

Ok, I'm getting myself upset at this. Surely, there must be a good explanation! Last vent for the day :-)

[Guest cosmopolman]

Not sure what this is "extra $500 Reciprocal Insurance supplement"...do you have a link I could check out ?

 

Yeah, see this from IMAN: http://www.austhealth.com/reciprocal_levy_surcharge.php, read all the way to the bottom.

I went to NIB (IMAN's parent) to see how much their minimal CHIP-eligible coverage is. It is "Public Hospital" plan, and runs a single person $500 for the year. That's the minimum insurance plan that will exempt you from 1% MLS.

Also, I called MBF a few weeks ago, and they quoted me about $500 for the MLS exemption rider to ther Overseas insurance, too. A rider which has "no additional coverage benefits", incidentally. So, you simply pay $500 to MBF and therefore pay 1% of your salary less to ATO. They call it Reciprocal Health Cover. See here: http://www.mbf.com.au/HealthInsurance/Healthinsuranceoptions/Overseasvisitors

[fish.01]

Yeah, see this from IMAN: http://www.austhealth.com/reciprocal_levy_surcharge.php, read all the way to the bottom.

I went to NIB (IMAN's parent) to see how much their minimal CHIP-eligible coverage is. It is "Public Hospital" plan, and runs a single person $500 for the year. That's the minimum insurance plan that will exempt you from 1% MLS.

Also, I called MBF a few weeks ago, and they quoted me about $500 for the MLS exemption rider to ther Overseas insurance, too. A rider which has "no additional coverage benefits", incidentally. So, you simply pay $500 to MBF and therefore pay 1% of your salary less to ATO. They call it Reciprocal Health Cover. See here: http://www.mbf.com.au/HealthInsurance/Healthinsuranceoptions/Overseasvisitors

 

Dodgy :goofy: