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cabbage88

Private health insurance

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But seriously

Huh?

 

If you're in Australia you're not going to be admitted to a private ICU without insurance and if you're admitted to a public ICU then you won't be charged.

 

If you have surgery in a private hospital and something goes wrong they send you to ICU. Or are you suggesting they let you die because they dont have insurance?

 

Of course not

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Sugarplum Poobah

 

 

If you have surgery in a private hospital and something goes wrong they send you to ICU. Or are you suggesting they let you die because they dont have insurance?

 

Of course not

 

Yes, I later realised you meant self-funded patients. But that didn't stand out on first reading -- and yes I agree that they're not going to just let you die, but that it's going to be an exxy experience. I have added a note to my last post (just before I saw your reply) ::):

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born.a.girl

Because its insurance. Hopefully you will never need it. But you cant just save up and pay. If something went wrong and you ended up in ICU then you'd be looking at a bill of tens of thousands.

 

Indeed, a lot of people think they can just self-insure. That's fine if it's a low risk procedure, and the hospital will agree - many won't.

 

If something goes wrong though, you're not going to be sent immediately to the public system, you'll be in the private system's ICU costing the house.

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Sugarplum Poobah

Dp

Edited by Nasty Poobah
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little lion

The thing about being healthy is that most of us are healthy ... until we’re not.

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Feral-as-Meggs

I mainly have it in case someone has a psychiatric crisis and needs an admission - I have a lot of relatives with MI and the public inpatient options are very limited.

 

A colleague’s wife needed admission to a mother and baby psych unit and he saw the cost the PHI paid. It was in the $300,000s. In NSW, AFAIK we don’t have a public option for mother and baby, beyond sleep schools.

 

Other than that it’s nice to have the option of not delaying elective surgeries - you can’t self insure for major stuff as the hospital doesn’t want to get left in the lurch if you run out of money, so they won’t admit you in the first place.

 

I don’t expect to come out ahead; just as I hope my house doesn’t burn down every year. It’s insurance not savings.

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cabbage88

Thanks for all the fantastic info, all.

 

To answer a few- We have done all we can to up him on the surgery list. I know the surgeon, as I work with her, but her hands are pretty tied as she can't dictate the public system. I don't think we would be allowed to pay out of pocket either as he's higher risk due to being overweight.

 

I'm not really convinced we can afford PHI, and it will pretty much destroy our hopes of getting a deposit, but I think with four little ones that hope is pretty much useless anyway. But I'm probably going to be in the position of having to work even more just to afford it. It just seems so crazy to me!

 

We all need dental, and two of us have very expensive glasses (mine are $800 a pair as my script is ridiculously high, and one of my kids now has the same). We will use the physio cover for hubby especially after his surgery, and I tend to use it as well.

 

I'll have to check out how much cheaper it is to pay an excess or not. I've been close to an admission for mental health, but haven't needed it and the public is really good for it here anyway (I have a bubba under 1, there's mother and baby units nearby). But I'm quite concerned about need gynaecologist input, and possible surgery. And obviously my hubby's ankle surgery. There's no guarantees we won't still be waiting in 12 months.

 

If I get a workplace injury- which has a high occurrence in my industry- I'm a bit stuffed as I am a contractor right now and responsible for my own work cover etc, which I don't pay because WC is pretty rubbish. I feel like I'm running quite a risk there too.

 

I will shop around, but I think for what we probably need we're looking at 100-130 per week. It's a lot of extra money to find. Still learning what's neccesary and what's not- as some of you may remember from my previous posts. Earning enough money to actually afford groceries every week is such a new thing to us- let alone earning enough to even consider things like PHI or private school fees, as I've asked about before.

 

Thanks a ton for the input. The advice is really helpful.

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nom_de_plume

Of course I don’t get to choose where my taxes are spent. The cronies in Canberra do it. I’d rather have that money going into the communal pit and therefore available for spending on something (even if not health) that benefits the general public, as opposed to paying it to a private company in the form of PHI.

 

I think it’s important to ‘opt out’ of the private system because it sends a message that we don’t support a two tiered system. It’s the same as the public vs private school argument.

 

I also don’t think PHI is like other forms of insurance. If you get sick, there’s Medicare and the public system. If your house burns down or someone crashes into your car, there’s no safety net.

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Silverstreak

DH has never had PHI as an adult. I kept mine up for years and used it for very little except optical and dental. It just got too expensive for what I got out of it, so I stopped it about ten years ago.

 

Since then, I get bulk billed eye tests and discounted glasses frames. My GP is bulk billed. Had DS through the public system and they were amazing. My new CPAP machine was expensive, but the last one lasted eight years, which is about average, so now I know to budget for a replacement every seven or eight years.

 

My teeth so far are in good condition. DH's teeth are more problematic, so now I just book an appointment for him every six months. DS gets dental checkups at school. DS sees a private specialist every year and I see a specialist every three to six months. At the moment we're still coming out ahead.

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kim27

 

 

I don't think it's messed up, I see it more like if you are earning enough to be fined by the medicare levy at tax time, you're earning enough to be able to cover your own medical costs and leave the overburdened public system to the people that truly need the help financially!! (but I only looked at it from this perspective recently as it affected us for the first time, when I first heard we would have to pay I thought it sounded messed up too!)

 

We got it this year as DH got a pay rise so it's the first year we were fined by the medicare levy at tax time. We pay the basic hospital cover and no extras and that's less for us than paying the levy. We have ambulance cover separately.

 

Years ago when my husband had full cover he used it when he required non-essential jaw surgery to fix an under bite. One of those things we would have just ignored if we didn't have it.

 

Problem is, some people just buy junk policies with huge excesses to avoid the levy and just go public anyway. Only winner there is the health insurance companies.

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Babetty

I originally got PHI in my early 20s - I'd just come off the "young adult" cover that I got via my parents' policy and hadn't got around to doing anything when my older brother (who had PHI) did his ACL. He was in surgery within a week, other rugby mates without PHI were waiting 18 months+.

 

My best friend had serious mental health issues through her 20s and said she'd be dead if she had to rely on public.

 

My DH had back surgery and PHI paid out over $30k + more for outpatient rehab. While it was emergency surgery, the public hospital which the ambulance first took us to couldn't get the right checks done quickly enough, so I drove DH to private. We found out later that DH would most probably be in a wheelchair by now if we had waited.

 

My brother has also had inpatient stays for mental health which has been really essential for him. His psych said that going public in his home city would have been worse than living with his illness.

 

So in our family, I wouldn't be without it.

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born.a.girl

Thanks for all the fantastic info, all.

 

To answer a few- We have done all we can to up him on the surgery list. I know the surgeon, as I work with her, but her hands are pretty tied as she can't dictate the public system. I don't think we would be allowed to pay out of pocket either as he's higher risk due to being overweight.

 

I'm not really convinced we can afford PHI, and it will pretty much destroy our hopes of getting a deposit, but I think with four little ones that hope is pretty much useless anyway. But I'm probably going to be in the position of having to work even more just to afford it. It just seems so crazy to me!

 

We all need dental, and two of us have very expensive glasses (mine are $800 a pair as my script is ridiculously high, and one of my kids now has the same). We will use the physio cover for hubby especially after his surgery, and I tend to use it as well.

 

I'll have to check out how much cheaper it is to pay an excess or not. I've been close to an admission for mental health, but haven't needed it and the public is really good for it here anyway (I have a bubba under 1, there's mother and baby units nearby). But I'm quite concerned about need gynaecologist input, and possible surgery. And obviously my hubby's ankle surgery. There's no guarantees we won't still be waiting in 12 months.

 

If I get a workplace injury- which has a high occurrence in my industry- I'm a bit stuffed as I am a contractor right now and responsible for my own work cover etc, which I don't pay because WC is pretty rubbish. I feel like I'm running quite a risk there too.

 

I will shop around, but I think for what we probably need we're looking at 100-130 per week. It's a lot of extra money to find. Still learning what's neccesary and what's not- as some of you may remember from my previous posts. Earning enough money to actually afford groceries every week is such a new thing to us- let alone earning enough to even consider things like PHI or private school fees, as I've asked about before.

 

Thanks a ton for the input. The advice is really helpful.

 

 

 

I'd still separate out Hospital cover, and Extras. They are two completely separate insurances and you can take either or both.

 

You may find hospital but paying for your own extras works for you.

 

There can be traps with extras: All of the dental items can have their own sub-limit. My glasses rebate is $200 per year. Physio is very beneficial for me. Without needing the dental and physio cover it wouldn't be worth it for the other things.

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lizzzard

The only reason I have it is because its cheaper than paying the levy. I treat it as a tax.

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Cimbom

Bit off topic but Zenni Optical has cheap glasses for the PPs mentioning claiming it on their insurance. Worth a look even just to compare

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Ivy Ivy

The main reason I have it, is my accountant said to, because it's cheaper than paying the levy. Financial stuff bores me to tears so I had no idea what the levy was until now, but I just googled, and it seems the levy is 1.0 -1.5% of your income, if you earn above 180k (couples) or 90k (singles).

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Grrrumbles

We keep top cover for mental health inpatient care. We have experienced the public and private options in our city and the public ward was a disgrace. The private option was much better but still below what is available interstate in terms of therapy so we may need to use it in the future.

We have also had 2 private births and ENT surgery. The out of pockets on the births were crazy but very small on the ENT.

 

We have also had a CPAP claim.

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SeaPrincess

The main reason I have it, is my accountant said to, because it's cheaper than paying the levy. Financial stuff bores me to tears so I had no idea what the levy was until now, but I just googled, and it seems the levy is 1.0 -1.5% of your income, if you earn above 180k (couples) or 90k (singles).

The levy is 2%. You still pay that, even with PHI. The Medicare Levy Surcharge is what you pay if you don’t have PHI.

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knottygirl

We have it, and have had it entire life. We have been lucky to not need it much, apart from having the kids and then dh getting the snip. But wouldn’t risk being without it. Especially with an aging population the public system is just going to be more and more stretched. Plus once you get to 50s and stuff starts breaking like knees hips ect want to be able to get it sorted and not be on years long wait list. For me it’s peace of mind. I know if something happens we are covered. We don’t earn enough for the surcharge and yes it’s a big chunk of money but I treat it same as car insurance and home insurance.

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theboys2

we have it but i have looked into changing covers.. we use it for dental, optical physio and i have bi annually colonoscopies due to family history of early bowel cancer and i have polyps at each review.

 

We continue to see the same doctor for the colonoscopies and not sure i want to change to the public system.

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Lunafreya

If you're in private and need the ICU, I thought they send you over to the public hospital. Some hospitals have tunnels for this.

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But seriously

If you're in private and need the ICU, I thought they send you over to the public hospital. Some hospitals have tunnels for this.

 

No hospitals in WA have tunnels. And if you were medically unstable, they wouldn't risk it anyway.

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born.a.girl

If you're in private and need the ICU, I thought they send you over to the public hospital. Some hospitals have tunnels for this.

 

 

Which ones?

 

The vast majority of private hospitals here are nowhere near public ones.

 

 

I would imagine certain surgeries would have to be performed in certain private hospitals with the level of ICU needed if something went wrong.

 

Where I used to have colonoscopies was classified as a private hospital, but it was just a day hospital and anyone getting into difficulty I should imagine would have to be taken by ambulance somewhere, but that might still be another private hospital.

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Soontobegran

There are a few private hospitals on the same block as a major Public Hospital, there is one large one in Melbourne and then another one that is on the block next door....still a transfer to ICU would be via an ambulance.

 

I have been in an ICU in both systems, I would recommend a public one.

Private hospitals should not take on patients beyond their scope of practice yet they do but then a private ICU is not generally the same as a public one in terms of staff, skills and equipment.

 

There are some private hospitals which regularly perform surgery that I believe should be left for the public system.....ego and all of that comes before patient care.

 

 

ETA...Self insurance is for the super rich only. I think there is a major underestimation of the actual costs of some surgeries by many people.

Edited by Soontobegran
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FuzzyChocolateToes

The tunnels I know of are definitely not for transporting patients. That's what corridors are for.

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