Health Insurance - Worth It for Pensioners?

Apologies if this is the wrong place or I am in some way uneducated in this area.
I found some other health insurance posts here so I think it fits.

Hopefully a simple question, is it worth paying for health insurance if you are an elderly, unemployed, pensioner, with no income?

I think the important things are ambulance costs and hospital costs but from what I understand, pensioners have free ambulance cover and public hospital can still be used reliably for emergencies?

With no income, it doesn't seem to be worth the astronomical and increasing cost of health insurance.
When on a salary, I think it's great because it's helping people who need it.

Comments

  • +2

    https://www.ambulance.vic.gov.au/membership/faq/

    Under the State Concession Scheme, eligible Victorian’s holding certain concession cards receive free clinically necessary ambulance coverage throughout Australia. In all cases, transport is provided to the nearest and most appropriate medical facility.

    For the purpose of ambulance transport, the Concession classification includes:
    • a person holding a current Victorian Pensioner Concession Card (includes dependent children listed on the card but not spouses)
    • a current Health Care Card holder and their dependents including spouses listed on the card (does not include Health Care Card for carer allowance and foster care issued in the name of the child)
    • a child holding a current Child Disability Health Care Card or Foster Child Health Care Card, but not their guardians/families listed on the card
    • a child under a Family reunification, Care by Secretary or Long-term care order including children on interim accommodation orders
    • a person who is subject to an order under the Mental Health Act 2014, Sentencing Act 1991, or Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 requiring them to be compulsorily assessed or treated in a designated mental health service. This includes compulsory, security and forensic patients.
    • asylum seekers who are clients of one of the 16 nominated agencies for asylum seeker support found here Ambulance Transport Payment Guidelines

    Concession transport from a private healthcare facility
    If a concession card holder is transported from a private healthcare facility the sending private facility is responsible for payment. This includes registered private hospitals and registered private day procedure centres. The private healthcare facility decides whether or not to pass this cost onto the patient.

    Concession benefits do not apply
    Concession benefits do not apply when:
    • a patient only holds a Commonwealth Seniors Health Card and they do not have one of the concession cards listed above
    • a patient requests to be repatriated or relocated to or from Victoria for non-clinical reasons or when the transport is not clinically necessary (repatriation back to Victoria must be authorised as clinically necessary and there must be a demonstrated clinical requirement for ambulance transport)
    • another party is responsible for the account.

    The other party responsible could be:
    • the Department of Veterans’ Affairs (DVA) where a person holds a Gold Card or a White Card (subject to the conditions of the card)
    • the Transport Accident Commission (TAC) (subject to the conditions under the scheme)
    • the Victorian WorkCover Authority (VWA) (subject to the conditions under the scheme).

    Evidence of concession entitlements
    In order to access entitlements, AV will require evidence of concession entitlements. The card must also be valid at the time of transport or the account will remain the responsibility of the relevant individual, hospital or chargeable authority as detailed in the Ambulance Payment Guidelines.

    • +2

      TLDR, well most of it.
      I would definitely get ambulance cover, I had to go in an ambulance once got a 1K bill in the mail.

      BTW hello holdenmg :), haven't seen you around for a while.

      • +2

        Hey there… :+)

      • +3

        I think his post just confirms that pensioners are covered and do not need to purchase ambulance cover.

  • -1

    You need to be OBJECTIVE in assessing your lifestyle and risk factors. Did you smoke for 2-3 decades? Did you work with Asbestos or toxic chemical exposure i.e. dock worker or firefighter? Are you one of those people who eats very little in terms of fresh fruit and vegetables?

    It's difficult for most people to acknowledge their lifestyle-induced risk factors, but the more of these you have the more likely health insurance is to be a worthwhile cost-benefit proposition.

    • OK, so maybe I don't understand correctly.
      What happens if I am a person who doesn't eat well and I end up going to hospital for a heart attack.
      Doesn't this just go through public?

      • +1

        Yes, public. Where private may come in handy in this situation is the recuperative/rehabilitation aspects.

      • -2

        Cardiovascular ailments like heart disease you're pretty much f%cked either way, it's when all those different variants of cancer come in to play that you'll thank your health insurance. I'm in my 20's and if my diet and activity levels remain similar it wouldn't be cost effective to take out private health insurance until my 70's. You can get generic chemotherapy though the public health system, but if you want the latest groundbreaking research chemicals you'll be paying through the nose.

        • I thought private hardly covered cancer drugs. Maybe a few hundred bucks per year.

  • Is it worth it? Yes…and no. It really depends.

    Would I get PHI. No. I accept that by not having PHI I will treated in a public hospital staying in a shared ward and treated by any doctor/consultant and I might have to wait several months or much longer before getting treatment except in an emergency. If you don't mind that either then why get PHI?

    PHI will get you treatment much quicker in a private hospital in a room by yourself and you'll be treated by the doctor of your choice (as long as that doctor has an agreement with your fund). The sooner you get treatment the sooner you can get on with enjoying the last few years of your life. We're only on this planet for a certain length of time. Don't waste it.

  • +1

    No. Don't waste your money.

    PHI are now becoming unaffordable and give you jack in return.
    Furthermore, you have not had PHI before 30 yo hence have to pay HLC if you decide to start. Not sure if Pensioners are exempt.
    To get some sort of return, you need to be on Highest Cover.
    And that is around $2K PA .. and climbing by 3.5% PA on average.

    The public hospitals are very good here and you will be well looked after for any unforeseen ill health.

    Wish you the best in health :-)

    Cheers

  • IMO unless you are really unwell and/or use all the extras/benefits and on the top cover, It's not worth it.

    The public health system is generally very good. the only thing i would look at is ambulance cover (which looks like is covered for pensioners)

  • I subscribed for my family for years with Medibank. Now that I am a single aged part pensioner, I have let it go as unaffordable.
    Medibank started out as a public health insurer. Then both sides of politics agreed to it being privatised. It now rakes in profits to match the huge international private health insurers like Bupa.
    It should have remained a not-for-profit publicly owned service to offer a price-setting service for others to match or compete with.
    What baffles me is that groups such as HCF are supposedly not-for-profit but they are scarcely more affordable.

  • +4

    Australia currently has one of the best health care systems in the world. If something life threatening happens (heart attack, stroke, cancer) you will be seen straight away in the public system and you will get world class treatment. Surgery, medication, physio/rehab & OT all included, no out of pocket expense! You will not be denied a ambulance because you don't have health insurance.

    The problem occurs when you have something non life threatening. Got bad knees? Had back problems? Shoulder injury getting in the way? In these scenarios you will be placed on a public wait list and your are at the mercy of the public health system. Effectively here is your ticket number, get in line and wait your turn. This could be 3 months, 1 year, 3 years. Depending on where you live depends on how long the wait list is. A bit of arthritis in your knees isn't to bad. But should you have a significant disc bulge in your back that is causing extreme pain and means you can barely leave the house… Or have arthritis so bad you can barely walk. You dont want to be stuck this way for a couple years while you wait on the public list.

    Im still young enough to play sports, I did my ACL 6 weeks ago. I had surgery within 2 weeks of the injury. No way in hell would that happen in the public system that quickly.

    If you can afford it, private health cover is great. Ultimately it depends on your financial situation.

    • +1

      On the flip side, I did my knee (meniscus tear).
      -Went to GP, refereed to specialist #1 (private part of PHI approved list)
      -Told it was 9 month wait for appointment
      -Back to GP, refereed to specialist #2 (public)
      -Told it would be over a year, non life threatening.
      -Back to GP, refereed to specialist #3 (private, not approved by PHI)
      -Specialist said he could have me in 1 week, but will be out of pocket.

      Paid for the procedure/hospital fees/etc etc.

      The amount spent on PHI is greater than what all my procedures have/would have cost.

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