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Why pay?


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#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 Tobias'smum

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.






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