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Private health insurance in Australia?


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What's a good private health insurance provider? Would it be better to go with Medicare or a private insurance provider? What are the costs like? Any help will be greatly appreciated. I would like a cover that includes dental as well. Thank you.

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Well, Medicare doesnt cover dental for starters. You dont go with medicare OR anything else you may go with medicare AND something else. The something else will only cover you for hospital expenses and the dental/optical/other therapies expenses.

 

There are any number of private health companies around and personally we have HCF and have been with them for years and not had any hassles. You could start to check out what you might get for your money with Private Health Insurance - iSelect Not all the companies are involved with that but at least it will tell you what you might get and how much it will cost you.

 

If you earn over the threshold for the medicare surcharge levy (above $77,000 for individuals and $154,000 for couples or families, increasing by $1,500 for each additional child after the first.) then private health is definitely worth considering.

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There's always a great deal of competition between all the major healthcare providers and they're constantly coming up with new ways of attracting either new clients or poaching those from other funds.

 

Offers that remove the waiting period of 6 months before being eligible to make a claim etc are fairly common.

 

IMO, I'd wait till you get here them shop around - they're all pretty much of a likeness and there are many resources where you can get like-for-like comparisons to get a policy that best matches your individual health cover needs.

 

A word of caution though - If you're going to get private cover don't leave it too long after you arrive as you'll be penalised by higher premiums.

 

We weren't aware of this and didn't go private for about 3 years but when we finally did we were told that there is a window of opportunity after which surcharges apply depending on how long you've been on Medicare. It's not just for the first year either - it applies to the entire life of your policy so it can make a heck of a difference over 25 - 30 years!

 

Just one of the little things that no-one seems to tell you in advance!

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Guest shusselmann

We also used iSelect to do online comparisons and ended up selecting HCF. We pay $300 per month for a family of four (this includes hospital cover, ambulance cover and all the extras: dental, optometrist etc and recently went up (was $280)). Although I did comparisons online I also went to a few providers (they have 'stores' in shopping malls and town centres) with my final questions as I wanted to get a feel for the service. I'd recommend doing this, so agree with "Glad I Moved" - shop around when you get here.

 

Good luck!

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Well, Medicare doesnt cover dental for starters. You dont go with medicare OR anything else you may go with medicare AND something else. The something else will only cover you for hospital expenses and the dental/optical/other therapies expenses.

 

There are any number of private health companies around and personally we have HCF and have been with them for years and not had any hassles. You could start to check out what you might get for your money with Private Health Insurance - iSelect Not all the companies are involved with that but at least it will tell you what you might get and how much it will cost you.

 

If you earn over the threshold for the medicare surcharge levy (above $77,000 for individuals and $154,000 for couples or families, increasing by $1,500 for each additional child after the first.) then private health is definitely worth considering.

Thanks guys. Your responses were very helpful. I have had a look at the HCF website . Are we allowed to have Medicare and then use private insurance just to cover the extras or do we have to choose one or the other? We are a family of 3. We have a child of 2 years and both myself and my wife, we turned 31 this year. I read something about surchages for not having private medical insurance when you turn 31. I hope this doesn't apply to newly arrived migrants. I also read something about having to pay for lifetime Health Cover for every year we have not had private health insurance. We are in South Australia at the moment.

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If at the age of 31 people do not take out health insurance and opt to do it at say 41 then the premiums increase 2% for every year over 31. As people are young and not as likely to need surgery other than urgent surgery or things of an urgent nature you have to work out whether you need it.

 

Then when one is older hopes to have more loot, can take out, pay the extra but recoup because more is needed to be carried out at that stage of life therefore its a win win situation and you never paid all the years you did not use it.

 

We had just extras insurance for years and it used to be quite good and we did ok but over the years the returns were not worth it. So we got rid of it.

 

We are covered for any road accident by the registration we pay for on our cars. We are covered at work by workers compensation insurance so you have to think on these things whether you need the extra expense at a time of life when young children are around requiring a lot of dollars.

 

My daughter type 1 diabetic since 12 had the best of care and it did not cost us anything apart from our trips to the docs as they do not bulk bill She is better off without health insurance even now she is older because if she were to go to a private hospital she would have so many extra costs to pay.

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Good points, Petals about the age related premiums - that is a kicker if you an old chook who has been here for donkeys years but new migrants get 12 months to make the decision to sign up at 30 year old rates. After that they pay the age loading. Rates are going up significantly this year too.

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Good points, Petals about the age related premiums - that is a kicker if you an old chook who has been here for donkeys years but new migrants get 12 months to make the decision to sign up at 30 year old rates. After that they pay the age loading. Rates are going up significantly this year too.

 

I got the heads up from a specialist because I need a full knee reconstruction lol and honestly it makes financial sense :laugh:

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Thanks guys. Your responses were very helpful. I have had a look at the HCF website . Are we allowed to have Medicare and then use private insurance just to cover the extras or do we have to choose one or the other?

 

Yes to your first question - everyone has Medicare but what Medicare pays out doesn't cover the full cost of medical treatment. For example, an appointment with a Doctor at our local medical centre costs $60. Medicare pays about half of that so once they've paid his patients trot off down to the Medicare offices where they refund the difference or "Gap" as it's called of around $30 in cash.

 

There are electronic variations to this process and it can be done on-line too but that's the general principle.

 

Health funds don't cover such routine visits to GPs which is why some people prefer to go to "bulk billing" practices where patients aren't charged anything because the practice invoices Medicare directly.

 

As far as actual treatment is concerned, the same sort of thing applies but then any private health cover you may have kicks in to pick up another chunk of that gap. How much depends on what level of cover you have, what you have done and who does it.

 

About a year ago I needed a op for a torn knee cartilage that was causing me acute pain and severely restricting my normal day-to-day activities - in other words it was classed as essential medical treatment.

 

The surgeon I used charges at the recommended Medicare rate (say $1,100 for the operation) my health fund therefore paid him for the full cost but if I had used the surgeon recommended by my GP who charged more than double this amount, I would have had to pay almost all the difference myself.

 

I also have hospital cover so the cost of the day surgery at a private hospital (say another $850) was also paid directly to them in full. Thus all $2,000 or so of surgery and hospital expenses were met by my fund.

 

The anaesthetist , however, charged about $550 for his work but Medicare says that the going rate should only be approx $250. The health fund therefore covered a proportion of what it is obliged to pay based on this standard figure and Medicare pays a chunk of the difference outstanding which left me about $200 or so out of pocket.

 

Some people are sceptical about private cover - like any health fund it rarely covers 100% of all medical treatment costs and most of the time you never need it but that's the nature of insurance...you always resent paying it until something goes wrong!

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Are previous medical conditions covered under a private health insurance scheme??

 

Yes, if you are suffering from a pre-existing condition prior to taking out health cover, you will be covered for this condition. You will however, will be subject to a waiting period before your health fund will cover any treatment relating to it.

 

Health funds are not allowed to refuse you membership due to any condition you may suffer from prior to joining.

 

 

Info courtesy of iSelect. Google is your friend!

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Guest JK2510
Yes, if you are suffering from a pre-existing condition prior to taking out health cover, you will be covered for this condition. You will however, will be subject to a waiting period before your health fund will cover any treatment relating to it.

 

Health funds are not allowed to refuse you membership due to any condition you may suffer from prior to joining.

 

 

Info courtesy of iSelect. Google is your friend!

Ahhhg thats where they have got you!!!

 

I still havent sorted out private health cover yet. Ive been talking to various people and many are saying its a con! I dont mind the dental and optical side but the hospital side im soooo confused and dont know what to do for the best!!

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My aged mum does not have health insurance however she paid to have both cataracts done in private hospital, day procedure, couple of thousand dollars, depends who you have and which private hospital you go to.

 

She also had to have an impacted wisdom tooth removed a few months ago and she went to a private hospital and paid again, not that much to pay for, because she is so old 92 she got the op for a smell of an oily rag just had to pay the anaesthetist out or pockets and hospital.

 

Most people use their health insurance in the later years of their lives as even if you have to wait to have a minor knee op its not going to be such a problem.

 

I need a total knee reconstruction and I will get it done but I will wait until I cannot walk anymore before having it done. Whilst I can get around with minimum of pain and suffering its ok. My best friend's son is a consultant and he told me to wait as long as I can before getting it done so free advice is good.

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Guest Claire82

Hi all. I've lived in Perth for 6 years now (originally from Liverpool) and we recently switched our private cover to HIF (not to be confused with HBF). Their cover is really good and they don't restrict you to using specific 'fund approved' providers like dentists, opticians, etc either, which we appreciate as Medibank (our previous fund) didn't cover the dentist we wanted to use.

 

I know some people are skeptical about health insurance and that's fair enough but I'm really glad we have it. I had to have laparoscopic surgery for endometriosis a few years ago and our private cover meant I didn't have to wait in the public queue - my surgery was scheduled within a week of seeing the specialist and I was so grateful because I couldn't have stood the ongoing pain if I'd had to wait in the public queue. I think the final bill was something like $20k too! Not sure how much of that I'd have had to pay if I'd gone public instead, but I didn't need to worry anyway as my private cover took care of everything, thank goodness!

 

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Everyone is entitled to Medicare. You don't have to have private but, if something serious happens to you, you're going to get stung big time. My Mrs had a 2r procedure and the hospital room cost us $1300.

I did a 'what level of cover do you need' questionnaire on a website somewhere & it came to $200 a fortnight cover or something, which I'm not prepared to pay. We pay $30 per fortnight between us which provides a medium level of cover which we have to top up when something arises.

As an example, if you need an ambulance & have no private, you will pay $500. If you have high level cover, you won't pay. On our premium, we would likely pay $150 or so. Up to the individual as to how you think this balances out & works best for you.

A woman I work with went to Phuket with her family for 5 days & got her teeth done whilst she was there. It worked out less than what she would have paid for the dental treatment alone in Perth.

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Guest camilesjj
What's a good private health insurance provider? Would it be better to go with Medicare or a private insurance provider? What are the costs like? Any help will be greatly appreciated. I would like a cover that includes dental as well. Thank you.

You will need to get private cover when you hit 30 or you pay a 2% loading for every year over 30.

if you stay with medicare the waiting lists are long and at tax time with no private cover you get hit with the medicare levy.

I have private health care for a family of 5 and pay about $180 a month with mbf, But shop around for a deal that suits you.

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There is another thread going on about this.

 

Get to a doctor that does bulk billing and you shouldn't pay anything for consultation. I have had bloods, xrays and other things and paid nothing on Medicare. One x-ray bill alone was $220.

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  • 2 weeks later...
Guest qualmberger

Can someone tell me what is meant by "bulk billing" in relation to routine visits to the GP?

 

Cheers

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Can someone tell me what is meant by "bulk billing" in relation to routine visits to the GP?

 

Cheers

 

It means that you dont have any out of pocket expenses, the doctor just takes what Medicare gives him/her.

 

The system in Aus was designed to be a co-pay system but acknowledging that lower income earners might be deterred from attending a GP clinic if they had to fork out the $30 (or whatever it was then) co-payment, they had a "bulk billing" facility which meant the doctor just got the base rate. It seems to be an essential for most UK migrants these days to hunt high and low for a bulk billing doctor and the spin off is usually that you dont get continuity of care as most bulk billing practices are the medical centres where you get whoever is free rather than "your" doctor. In some places - like Canberra, you can hardly find a bulk billing GP and rightly so, we are an affluent community for the most part and people with health care cards are automatically bulk billed, acknowledging their inability to pay the co-payment.

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You will need to get private cover when you hit 30 or you pay a 2% loading for every year over 30.

if you stay with medicare the waiting lists are long and at tax time with no private cover you get hit with the medicare levy.

I have private health care for a family of 5 and pay about $180 a month with mbf, But shop around for a deal that suits you.

 

You only pay the levy if you earn 77k single or 150k couples and families , stay with medicare ? you pay it with your tax so you are in anyway

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Guest siamsusie

We have continuity of care with a single manned practice.. all bulk billed.

 

We dont posses any concession cards.

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The other thing to remember with health insurance is, if you move from Australia and leave your fund, make sure you get an exit certificate from them.

We weren't aware that we needed to do this and were hit with a biig increase in premiums when we returned to Australia six years later (28% for me and 35% for my oh).

We eventually sorted it out and have not had to pay anything for 6 months to make up for the overpayments, but it would have been better if we could have avoided it in the first place.

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