Jump to content

Health Insurance
Why pay?


  • Please log in to reply
46 replies to this topic

#1 DamiansMama

Posted 11 February 2013 - 01:30 PM

I'm one of those silly people who pay Private Health Insurance and have done since I started working. A couple of years ago I had to have a procedure but would have been out of pocket for approx $1,500. I elected to go public, and did not pay a cent, with the same doctor and funnily enough didn't wait that long.

End of last year my DS was told by a Paediatric Dentist that he need to have day surgery for 3 fillings. Again out of pocket would be approx $1,500. Today I went public and will now pay nothing.

Seriously, given the above, I'm not sure why I pay? Unfortunately I am one of those that would have to pay the Medicare Levy Surcharge should I opt out.....can't win really.

#2 Safety Queen

Posted 11 February 2013 - 01:46 PM

i had a waiting list of 18 months for my surgury and because i was young and no children at the time i would have been bumped for older paitents  no way was i going to wait to have my neck fixed to feel better

#3 Rachel70

Posted 11 February 2013 - 01:53 PM

I am a nurse and I have seen some dodgy doctors and so I like the idea that I can choose my own doctor if I need one.
I also know that if myself or my family need a procedure that we can get it much faster than waiting for public waiting lists.
Plus for tax reasons it makes sense to have it.
We can afford to pay and it might mean we are not jumping on the list of someone who can't and has no option but to wait.

#4 Carmen02

Posted 11 February 2013 - 01:54 PM

we pay for it basically because my DD and DS had to wait 14mths for grommets and its basically buggered DDs hearing...she now needs a new set and we have only have to wait a couple weeks..does seem useless alot but we really need it

#5 Carmen02

Posted 11 February 2013 - 01:55 PM

DP

Edited by Carmen02, 11 February 2013 - 01:57 PM.


#6 MrsLexiK

Posted 11 February 2013 - 02:00 PM

It depends on what operations you have.  For something that has a "need to be seen within 1 month or 3 months time frame" I would def considered public (especially the 1 month) if it was anything else I would look at how much it would cost me to go private.  There is no way I would be granted a hyst in the public system without a long wait, they would try and manage my issues with hormones until they couldn't.  I watched a sibling wait months for her tonsils to be removed, I know I only had to wait 2 weeks.

#7 Bluenomi

Posted 11 February 2013 - 02:01 PM

Why I have it:
Got to pay huge levy if I don't
Wanted my choice of OB when I had DD and a private room
Like to have a choice between going private or public if I/DH/DD needs to go to hospital. There are a lot of painful but not urgent things than can leave you on public waiting list that I'd pay to get done sooner.

#8 cad0

Posted 11 February 2013 - 02:06 PM

Because I've stayed (unfortunately) in both public and private hospitals and know which one I vastly prefer!

#9 Julie3Girls

Posted 11 February 2013 - 02:13 PM

QUOTE
I'm one of those silly people who pay Private Health Insurance and have done since I started working. A couple of years ago I had to have a procedure but would have been out of pocket for approx $1,500. I elected to go public, and did not pay a cent, with the same doctor and funnily enough didn't wait that long.

Not silly, I would simply consider you lucky.  Lucky that you didn't have a long wait to be able to use the public system.
Lucky to not have expenses that aren't covered in public system, like glasses.

#10 SemiRuralGirl

Posted 11 February 2013 - 02:13 PM

I'm in the same boat as you OP and just last month decided to drop the insurance and keep extras. We figure if the kids need anything we automatically go to the Children's Hospital and hubby and I have always gone public even though we had insurance in the past.

I kept it until I was done having bubbas though so I could choose my ob and go to private hospital.

Here's hoping we don't need any "semi urgent" stuff soon lol.

#11 glasnost

Posted 11 February 2013 - 02:14 PM

QUOTE (Carmen02 @ 11/02/2013, 02:54 PM) <{POST_SNAPBACK}>
we pay for it basically because my DD and DS had to wait 14mths for grommets and its basically buggered DDs hearing...she now needs a new set and we have only have to wait a couple weeks..does seem useless alot but we really need it


That is a horrible thought that children are waiting that long to have essential procedures done. That could have serious long term delay in speech etc. I have heard of adults waiting a long time for elective surgery but I always assumed that kids would be prioritised.

I agree that sometimes PHI sounds like a rip off. One of my friends recently had a op to clear up her endometriosis. She was in agony every time she had a period however it was still considered elective surgery and ended up costing her over 5K even with PHI  just for the surgeon, anesthetist etc.

Our public maternity hospital is so great here that I don't understand why some women pay 5K+ to go private. I know that it is their choice but I really don't get it. Sometimes I think that we have all been brainwashed into thinking that private maternity care is essential.

#12 SemiRuralGirl

Posted 11 February 2013 - 02:16 PM

Julie... You can get extras cover for optometry, dentistry, Chiro, physio etc etc without hospital insurance. Great, economical option. original.gif

#13 Just Another Cat

Posted 11 February 2013 - 02:23 PM

I don't have private health insurance. I'm considering it due to the levy.


Does anyone know, if you have the most basic cover, can you still opt to go private for things you're not covered for?

For example, basic cover may not cover knee replacement. If I needed knee replacement could I still use the private system but just pay all the costs?

#14 Bluenomi

Posted 11 February 2013 - 02:24 PM

QUOTE (glasnost @ 11/02/2013, 03:14 PM) <{POST_SNAPBACK}>
Our public maternity hospital is so great here that I don't understand why some women pay 5K+ to go private. I know that it is their choice but I really don't get it. Sometimes I think that we have all been brainwashed into thinking that private maternity care is essential.


Because not all public maternity hospitals are so great. Ours has an OB I would not let near me if my life depended on it so going private means I know I won't get him. Plus some of us are willing to pay money to have our own room and more importantly own bathroom.

#15 qak

Posted 11 February 2013 - 02:31 PM

QUOTE (BlackKitteh @ 11/02/2013, 03:23 PM) <{POST_SNAPBACK}>
I don't have private health insurance. I'm considering it due to the levy.


Does anyone know, if you have the most basic cover, can you still opt to go private for things you're not covered for?

For example, basic cover may not cover knee replacement. If I needed knee replacement could I still use the private system but just pay all the costs?


Anyone can go to a private hospital and pay their own way, but the costs would be astronomical (I can find out for sure if you want to know, but I am sure it would be upwards of $10,000). ETA: for a knee replacement.

Edited by qak, 11 February 2013 - 02:32 PM.


#16 notorico

Posted 11 February 2013 - 02:41 PM

I have had quite a few surgeries using health insurance and I wouldn't be without it. DS has health issues and has had many procedures/surgeries and we have been very little out of pocket because our surgeon doesn't charge any gap for children which is great. I have lost track of the amount my health fund has paid the children's hospital but it runs into the tens of thousands, if we went public we wouldn't have been any better off but the hospital would be a lot worse off. There is no change in treatment or accommodation if you are a private patient in a public hospital but the amount the hospital gets is much different.

In relation to surgery in a public hospital, speak to the hospital accounts people and see if they will waive any excess of out of pocket expenses in return for you going private, they quite often will to increase the amount they get per admission.

#17 Just Another Cat

Posted 11 February 2013 - 02:44 PM

QUOTE (qak @ 11/02/2013, 03:31 PM) <{POST_SNAPBACK}>
Anyone can go to a private hospital and pay their own way, but the costs would be astronomical (I can find out for sure if you want to know, but I am sure it would be upwards of $10,000). ETA: for a knee replacement.



Really. I thought private hospitals/clinics/doctors only took private patients.

I just want to avoid the levy, not spend a fortune and have the option for private if we need it (especially with the kids).

Edited to add - I don't actually need knee surgery. Just using it as an example original.gif

Edited by BlackKitteh, 11 February 2013 - 02:45 PM.


#18 DamiansMama

Posted 11 February 2013 - 02:55 PM

I do understand that I have the option of a Doctor but it costs so much ON TOP OF the insurance that I pay so it just doesn't make sense.

I had my DS in a private hospital but it wasn't cheap. My point being is that I pay so much for the insurance, why do I have to pay further out of pocket expenses and if then I have a choice of going public and pay nothing - why would I not.

Let's look at Car Insurance, if my car was written off and I pay the excess. Nothing more.

#19 MrsLexiK

Posted 11 February 2013 - 02:57 PM

QUOTE (glasnost @ 11/02/2013, 03:14 PM) <{POST_SNAPBACK}>
That is a horrible thought that children are waiting that long to have essential procedures done. That could have serious long term delay in speech etc. I have heard of adults waiting a long time for elective surgery but I always assumed that kids would be prioritised.

I agree that sometimes PHI sounds like a rip off. One of my friends recently had a op to clear up her endometriosis. She was in agony every time she had a period however it was still considered elective surgery and ended up costing her over 5K even with PHI  just for the surgeon, anesthetist etc.

Our public maternity hospital is so great here that I don't understand why some women pay 5K+ to go private. I know that it is their choice but I really don't get it. Sometimes I think that we have all been brainwashed into thinking that private maternity care is essential.

I agree it is horrible for children waiting that long.  I feel for your friend, my laps have cost me nothing (other then the meds after and the premiums) It is good you have a mat hospital that good.  One of my siblings went through my local pub mat hospital - she never saw the same person twice.  Which ended up costing her (in time taken from work, money in petrol etc) because one midwife would say come back next week I want to check this, she would go back but the midwife on duty that day wouldn't know why she had been made to come back the following week when it should have been the next 3 weeks, clearly it was a differing of opinion.  Whilst I may give birth at that hospital I will still pay for my OB.

QUOTE (BlackKitteh @ 11/02/2013, 03:23 PM) <{POST_SNAPBACK}>
I don't have private health insurance. I'm considering it due to the levy.

Does anyone know, if you have the most basic cover, can you still opt to go private for things you're not covered for?

For example, basic cover may not cover knee replacement. If I needed knee replacement could I still use the private system but just pay all the costs?

yup this is how it is now. However no all specialists will work with patients that are not private.  My old gyno wouldn't you had to have private cover.  However other gyno's I know work in both the public and the private hospitals, you just book in where you want to go, if you choose a private hospital you will be bileld from the anthestists, hospital, & dr.  If you choose public it would just be the dr you are billed by.

#20 liveworkplay

Posted 11 February 2013 - 03:00 PM

My grandmother was on the waiting list for Cataract surgery for 3 years. She has only just got one eye done so still can't really see well until she has the other.

Same grandmother was waiting so long on the public dentist list that my dad paid for her to go private for a new set of teeth.

We had over a 12 mth wait to see a public speech pathologist with DD1, We had a 7 day wait going private with DD2.

When DD1 was diagnosed with hip dysplasia, we had a 6 week wait to see a specialist at the local public hospital. I rang and got into the private clinic with a 10 day wait.

I could go on and on with stories I know first hand but I won't.

Health insurance is like any other insurance. It's a PITA to constantly pay premiums, but when you need it, it's worth every cent.

Would you get rid of your house and contents insurance if you never need to claim? Car insurance?

Edited by liveworkplay, 11 February 2013 - 03:03 PM.


#21 MrsLexiK

Posted 11 February 2013 - 03:04 PM

QUOTE (DamiansMama @ 11/02/2013, 03:55 PM) <{POST_SNAPBACK}>
I do understand that I have the option of a Doctor but it costs so much ON TOP OF the insurance that I pay so it just doesn't make sense.

I had my DS in a private hospital but it wasn't cheap. My point being is that I pay so much for the insurance, why do I have to pay further out of pocket expenses and if then I have a choice of going public and pay nothing - why would I not.

Let's look at Car Insurance, if my car was written off and I pay the excess. Nothing more.

Because you are paying to use the hospital, not the dr.  You may get lucky and the dr you choose is a gap free dr (meaning they bill your health fund as well) I always shop around for those before I commit to one. But essentially you arre paying so that you get a bed in a hospital and a surgical spot on the list.

Whenever I go public I ALWAYS go in as a private patient because then the hospital bills the health fund for my time in the room or whatever and it gives a tiny bit of money back to the public system.

#22 Julie3Girls

Posted 11 February 2013 - 03:05 PM

QUOTE
Julie... You can get extras cover for optometry, dentistry, Chiro, physio etc etc without hospital insurance. Great, economical option.

But that still doesn't help with waiting lists for surgery.

As for maternity .. Not everyone has a great public option. Public hospital is great, but very very busy. Much preferred my private hospital stay, not rushed out rather than someone I know getting kicked out of the public hospital 2 days after her csection, baby still in nicu, because they were so desperate for beds.

#23 *dreamer*

Posted 11 February 2013 - 03:05 PM

I was rushed to A&E at our closest hospital about 2 years ago with breathing difficulties.  I had pneumonia and spent at week in the geriatric gynaecological ward (because there was no beds in the respiratory ward) with 5 elderly patients all having a very tough time of things.  There were no private rooms. It was hell.   We had top corporate health cover.  

Not sure what I could have done differenty.  Perhaps presented at the nearest private hospital with an A&E and been admitted there.  That was a 45 minute drive away though, and I honestly wasn't thinking straight at the time.

You live and learn - we have our plan in place now though if it ever happens again  wink.gif



#24 PrincessPeach

Posted 11 February 2013 - 03:07 PM

Look around for a different fund.

A lot have agreement doctors which mean your out of pocket costs are minimised.

I have private health & wouldn't be without it, but that is because the public hospital here on the Gold Coast is stretched to it's limits.

Also the private hospital is the same distance away from me as the public.

Edited by PrincessPeach, 11 February 2013 - 03:09 PM.


#25 Dylan's Mummy

Posted 11 February 2013 - 03:12 PM

QUOTE (BlackKitteh @ 11/02/2013, 02:44 PM) <{POST_SNAPBACK}>
Really. I thought private hospitals/clinics/doctors only took private patients.

I just want to avoid the levy, not spend a fortune and have the option for private if we need it (especially with the kids).

Edited to add - I don't actually need knee surgery. Just using it as an example original.gif


If you are prepared to pay for all costs, you can go private and you will just get the Medicare rebate back. This applies if you dn't have insurance or if your cover doesn't include what you are having.

You will be able to avoid the levy if you have the most basic hospital cover. Look around at various funds and see what they have available. Remember that when doing the online quotes their websites usually ask what your situation is and give you some cover options based on that to choose from and they may exclude some of the cheaper covers if you afe a family. you may need to adjust your answers so that their quotes offer you a cheaper cover. Some funds quote system do include a search option for people wanting to avoid the Medicare Levy Surcharge.

Another thing to remember is that those companies that will find a suitable fund and cover for you (eg iSelect) only reccomend funds that have registered with them, they operate on a commission type basis so not all funds are registered with them. This won't affect your premiums though.






1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users

 

What you need to know about ovulation tests

Most people who are trying to get pregnant know that the best time to conceive is in the few days after ovulation.

Surviving a miscarriage at sea

A cruise with your family is among the most absurd settings for a miscarriage, but it is certainly not the worst.

Mum of three denied tubal ligation because she's 'too young'

A 22-year-old woman who is pregnant with her third child has had her requests for a tubal ligation denied because doctors believe she is too young.

Slapped cheek syndrome a danger for pregnant women

When a pregnant woman is infected, the likelihood that her foetus will be infected is about 50 per cent.

The signs and symptoms of ovulation

If you're hoping to conceive, one of the most important things you need to know about is ovulation.

We all know 'mum guilt' - but what about 'dad guilt'?

I remember the first time I felt mum guilt, within days of having my first child. The feeling was so intense I rang my own mum to debrief, hoping she'd tell me I wouldn't feel this way very often.

Kristen Bell urges mums to be their own superhero

When it comes to motherhood, actress Kristen Bell is her own superhero and she thinks other mums should be too.

Pram review: GB Pockit travel stroller

In a world of ever-shrinking gadgets, it's no surprise prams are getting smaller. We put the record-holding GB Pockit through its paces.

The beautiful Bombol Bouncer is back

The gorgeous Bombol Bouncer is back - and boasts two chic new colours to boot.

Gadgets and accessories for wine lovers

Looking for a gift for the wine lover in your life - or just something for yourself?

Free ticket offer

Pinky Mckay joins us again at the Essential Baby & Toddler Show presented by Blackmores with her expert baby settling advice. Register now for your free ticket.

The adventure doesn't have to stop: here's how to travel with baby

The best part about our outdoor adventures? It makes my husband and I better parents, since we're happier while adventuring.

Woman crashes car to save mum and baby's life

A good samaritan saved a mother and baby from being seriously injured by crashing her own car into theirs.

Should you tell your boss about your postnatal depression?

Returning to work after having a baby can be daunting, and when you're experiencing postnatal depression or anxiety it can seem even more overwhelming.

TV noise can slow toddler word learning, study finds

Background noise from the radio or TV might be making it harder for your toddler to learn learn new words.

Teresa Palmer on her molar pregnancy and 'unsexy' conception

Teresa Palmer is basking in pregnancy glow as she awaits the arrival of her new baby.

 
Advertisement
 

Top 5 Articles

Advertisement
 
 
 

What's hot on EB

Why drinking water can be deadly for babies

H2O is one of the necessities of life, but for babies a seemingly harmless amount of water can be fatal.

5 ways having a baby is different when you have older children

So much parenting advice is geared towards having your first baby, but what's it like having a baby when you already have children?

You can now make your own plush Falkor

Fans of The NeverEnding Story – of which there are certainly plenty – went crazy for these plush Falkors when they first went on sale last year.

Baby steps

10 things that will actually happen after having a baby

I thought I had prepared myself for motherhood. Then my baby girl arrived and knocked everything flat.

Having a baby: expectations vs reality

People love to warn you about what to expect when having a baby, but they can be way off when it comes to the reality.

Are we having fun yet? Thinking positively as a parent

Motherhood is wonderful ... except when it sucks.

The adorable smile of a baby seeing his mum clearly for the first time

There is no doubt seeing their child smile for the first time is an unforgettable moment for parents everywhere.

When breastfeeding doesn't go with the flow

Breast is best, except when it's not. And in our case, it most definitely wasn't.

'If you don't vaccinate your kids you're a bloody idiot'

The photos are heartbreaking and almost too difficult to look at, but Kayley Burke is begging other parents to take notice.

Why pregnant women should eat chocolate

In news that will make expectant mums jump for joy - and reach for a block of Cadbury - scientists have revealed chocolate could provide health benefits during pregnancy.

The baby born with an incredible head of hair

If you're in any way challenged in the follicle department, prepare to feel a jolt of envy - at a two-month-old baby.

The push for Medicare to fund lactation consultants

While meeting with a lactation consultant can make an enormous difference to a new mother, it's not a service that is available through the public health system.

Parents, this is how to cut grapes to avoid choking

One mum has learnt a harrowing lesson about the best way to cut grapes to make it safe for toddlers and little kids to eat.

Three truths about C-section mums

Lately I've been thinking about the caesarean stories and the brave women who birth their children with strength and beauty.

Help! My baby will only sleep in my arms

It's stressful to be the one who is holding your baby most of the day, but it's even more stressful to wonder, 'am I doing something wrong? Or am I creating bad habits?'

 

Free ticket offer

Essential Baby & Toddler Show - Sydney

The Essential Baby & Toddler Show, presented by Blackmores, will be held in Sydney on 23-25 September. Register for your free ticket now to save $20!

 
Advertisement
 
 
Essential Baby and Essential Kids is the place to find parenting information and parenting support relating to conception, pregnancy, birth, babies, toddlers, kids, maternity, family budgeting, family travel, nutrition and wellbeing, family entertainment, kids entertainment, tips for the family home, child-friendly recipes and parenting. Try our pregnancy due date calculator to determine your due date, or our ovulation calculator to predict ovulation and your fertile period. Our pregnancy week by week guide shows your baby's stages of development. Access our very active mum's discussion groups in the Essential Baby forums or the Essential Kids forums to talk to mums about conception, pregnancy, birth, babies, toddlers, kids and parenting lifestyle. Essential Baby also offers a baby names database of more than 22,000 baby names, popular baby names, boys' names, girls' names and baby names advice in our baby names forum. Essential Kids features a range of free printable worksheets for kids from preschool years through to primary school years. For the latest baby clothes, maternity clothes, maternity accessories, toddler products, kids toys and kids clothing, breastfeeding and other parenting resources, check out Essential Baby and Essential Kids.