So I am turning 31 in April is it worth getting private health insurance?
I work for myself and earn around 35k per year.
No health prior health probs.
If you think I should I am open to any suggestions of plans or companies. I would like cover for my chiro visits (please don't comment your opinion on chiros, I can see that coming already haha)
Thanks!!
you wont be saying this when you do your tax return and get smacked with an extra medicare levy surcharge… It depends how much you earn mate.
I’d rather give the money to the government where someone might see a benefit than a private company who’s business model only works because the government holds a gun to people’s head.
you wont be saying this when you do your tax return and get smacked with an extra medicare levy surcharge
I won't be smacked with anything more than I was when I was last year - you pay the MLS regardless of age. It's only the 2% loading that changes after the age of 30.
There was a report on the abc that some doctors wont treat people privately without insurance for fear they wont cover the costs so self insurance has unexpected consequences
This is the main reason why I have cover :(
That's unfortunately true. Heard it many times from friends who had some medical emergencies. PHI allows access to all sorts of specialists at a very short notice.
This is true.
If there is a complication things can really spiral.
As the self funded crowd are only going to grow doctors are asking private hospitals to treat complication care pro-bono but its unlikely to happen.
If you are needing surgery and don't want to wait 12-18 month on public waiting list, get health insurance. If not, don't.
It's a free world.
Broadly speaking, if you earn 90+ as a single, it will be worth your while getting private hospital cover because the surchage will be approx equal to the hospital cover cost.
That's almost exclusively surgeons… because… you know, you're generally referred to them for possible surgery.
I agree with others that PHI is a scam, and the only reason I have it is to avoid the MLS.
You have to look very carefully at the benefits you get. More often than not, even if you are covered for something, the coverage is not 100%, or if you don't claim in the correct way (even though they don't make it obvious) you may not get back as much as you are actually entitled to.
An example is contact lenses with Bupa. You need to make sure you individually enter the details for each box of lenses, rather than just the invoice amount, or you won't get as much back.
Another example, again with Bupa. I am entitled to claim back $600 per year on Pharmacy items. On the face of it, that sounds great, but when you get past the marketing and look at the detail you can see the limitations:
- "pharmacy" means prescription-only medicines that are not on the PBS
- you must pay the first $40.30 for the item
- the maximum claim per item is $40
Hence they make it difficult to maximise your claim. If the approved pharmacy item cost you $59, then you only get back $18.70 ($59-$40.30). If the approved pharmacy item instead cost you $300, you can only get back $40. So there is really only a limited window of where it is worthwhile, and you'd need to be making more than just a few claims per year.
Insurers setup their prices in a way that you end up paying almost same or just a little less than the MLS if you're at the 1% threshold as a couple. May as well pay 1% MLS and support public healthcare.
Agree with you here. You don't get much value with health insurance unless you have top of the range cover.
I happily contribute my 1% to MLS instead of giving to insurance companies.
Look at this way. Bupa Medibank HFC etc all are big companies they hire hundred smart people to come with a pricing structure that will benefit them.
no, just save up the money you would if you were paying a membership tho.
I pay $3400pa, I'm 33 and single.
It depends what you think you'll use. I'm concerned I may need mental health services and hospital admissions. Plus my foot has a long term injury that will get worse as I get older/need further work.
I don't ever want to be in a public mental health unit. I'll pay the money to ensure I go private should I need to.
But weigh it up. If you're healthy and fit there's probably no point. As was said, if you're in a accident, the first place you'll go Is a public hospital and you'll be treated there.
For $35k, nope.
no. end thread
If you are female, desire to have children in the next 12 months, and don't have a reputable public hospital nearby (ie. Brisbane has the Mater hospital which is public while Hobart doesn't have a great public hospital so private tends to be favoured), I would get the private cover as you need 12 months wait time before pregnancy is covered to have a baby in the private system.
Again, depends on your circumstances and in this case, gender.
Also note, if you have a partner and have a family plan, some private health insurances require both people to have the same cover which means you can be paying for pregnancy cover for a man! So dumb!
Can I ask what people's thoughts are about life insurance?
Say I take out life insurance while my kids are studying, and continue paying the premium even after they've grown up. After 10 years I'd have paid ~40k, but I decide not to cancel the insurance because if I cancel now I'd lose the 40k whereas if I continue paying indefinitely, my kids will someday get more than what I paid over my lifetime (something like 300k) when I'm gone.
If I disregard the fact that that's a poor investment choice compared to, say, buying property, does this make sense?
For every year you dont have PI, there is a little loading to it.
For every year you dont have PI, there is a big saving for you.
Look, no.
Only ones I'd identify: when I was earning less, I needed a handful of minor dental work done. I found the most basic package that covered my dental, and got them to agree to waive the waiting period. Saved around 60% on a bunch of fill-ins and stuff, and check up/clean paid for.
So, if you know you need some dental work done, consider a basic package that covers dental. If you're likely to need wisdom teeth, get a package that covers major with the shortest waiting period, wait it out, then get the work done.
Another risk is ambulance- you should see if you can find an economical ambulance cover, or self insure for the risk (i.e. put >$1000 aside in an emergency fund/savings account).
Well, chiro, it's bullshit, but whatever. If you're going to get it done, and you do the cost/benefit and find a cover that makes it more affordable (not very likely), then go for it.
When/if you come to a point where you're earning >$90,000, then re-evaluate. Avoiding the medicare levy surcharge, even at the base 1% rate can cover >75% of many private health plans, making them worthwhile if you use any of the coverage (1-2 trips to the dentist a year, or eye checkup, or an ambulance every 5 years etc…)
So, if you know you need some dental work done, consider a basic package that covers dental. If you're likely to need wisdom teeth, get a package that covers major with the shortest waiting period, wait it out, then get the work done.
Doesn't that fall under "pre-existing condition" and have a 12-month waiting period that can't be waived?
Look, maybe. That's what I'd expected.
Called my provider, very honestly and transparently told them the situation (that I'd be immediately claiming on a bunch of minor dental work) and they had no problem with it.
Guess I should have done that when I was told I needed fillings done when I didn't have PHI. Just automatically assumed that it wouldn't be covered and paid for it myself.
Anyway, I think if you have bad teeth, or are easily prone to problems with your teeth, that dental is one of the better coverages to get, and it can be had pretty cheap.
If you use all of the included extras (usually 1-2 check ups + clean covered per year, maybe 1 x ray?) you're rarely worse off.
If your teeth are great and you can get away with going less frequently great, but my teeth are super super soft and need checking up on regularly.
No
I am 25 and earn $65,000/year and signed up for health insurance when I was 24, I pay about $1,700 a year for medium level hospital cover and premium extras.
I pay $170.00 every 45 days for a medication which is not covered under the PBS and am eligible to receive back $80 of that per script up to an amount of $500/year. This obviously will only cover approximately 9.5 months of the medication but still helps to ease the burden. I also access psychology benefits (hence the premium extras) and can claim $80 back per session (I only use this once the 10 Medicare funded sessions run out), leaving a gap of about $42 each time. The limit on "therapies" cumulatively (including psychology, chiropractor, physiotherapy, remedial massage etc) is $1,400. If I see my psychologist once every 3 weeks each year, I save approximately $600. So there's about $1,100 saved. I figure if I also see a physiotherapist (I have carpal tunnel), which has a refund of about $70-$80, three times a year there's another $240, so $1340 saved. Then throw in dental once a year (which is separate to "therapies"), the occasional 'remedial massage'and I will get approx. $1400 - $1600 of benefit out of my health insurance + any benefit I might get out of hospital cover.
Because I signed up before I turned 26 I will receive a discount of 10% each year until I'm 40, at which point the discount will reduce by 2% each year. I am hoping that I will no longer need to take such an expensive medication or see a psychologist long term at which point I will drop the extras and keep the hospital cover, or maybe even drop both, I'll reassess when that happens.
If you are not as unhealthy as I am and your income is $35,000 it's is probably not worth it.
If your job is a safe job (like a desk job), you don't have hobbies that can get you injured like playing sports or abseiling, and you're in good health, I would say no.
Wait till you're older.
Don't worry too much about the loading. The money you save in claim-free insurance more than makes up for it.
Obviously anything can happen. That's a risk assessment for you to make.
Private health is good for elective surgeries. For emergency surgery, public is good enough, and their hospitals are actually better than private hospitals.
People say they have it to avoid the MLS I pay anywhere between 3 and 5k a year depending on how much overtime I get in that year. You have to pick the best of to evils a private company making a profit or the government in charge taking it and spending it on God knows what.
I like to think my extra contribution goes back into the health system. That's how I deal With it in my head.
So you earn between 200k and 333k pa? Mate just take out AHM's cheapest hospital policy for around $800 and save yourself at least $2k per year.
For me the only time I've gotten something good out of our hospital cover was when my wife gave birth in a private hospital and even then we were still out of pocket by about $5k.
There are some services I would get PHI for, mental health is one, public mental health follow best practices, however the problem is the other patients who are extremely mentally ill.
Another is ED, I would rather pay the co-payment for ED than waiting upto 7hrs.
Just get viagra for ED
I know this goes against the Ozb grain of me me me but despite the PHI lack of perceived value it somewhat subsidises the public system. It's just another tax which nay hopefully help orhers in real need and even the PBS. Reality is that the public health system isn't going to br sustainable in its current form and trajectory so one way or another people will pay.
The problem with most of the PHI arguments above is that they are made from a purely financial viewpoint. Think about a situation where you have a painful but non-urgent condition that requires surgery, or perhaps a non-urgent condition that stops you being able to work. Being non-urgent means there may be a several month wait in the public system. Private means you have a choice to have this done quicker to relieve your pain or get you back to work, but at a financial cost. It's a trade-off… time cost vs pain cost vs financial cost. Nothing wrong with the public system, but you need to make your own judgement on priorities & not just make a pure financial decision.
Sure, there are other discussions much broader than this, such as why PHI insurers have increased their profits several fold over the past several years & yet decreased payments to hospitals & doctors for individual procedures in the meantime, meaning further out-of-pocket expenses for patients, why Medicare has frozen payment rates while costs to run a practice continue to increase, and so on. That's another whole discussion.
(Disclaimer: I'm a medico.)
Exactly… but ozbargain
Hmm, minefield of a question.
I will suggest this. Sit down and chart/write the medical problems that your parents have. EG hypertension, diabetes, cardiac issues etc. Go back another generation to your grandparents just to be certain. Then either research what are the most common potential complications for each problem. You can either use google (Yes, I hear all medical professionals cringing) or book in for an appointment with your GP to have a long consult.
Once you have done that, using google or search engine of choice, enter the necessary surgery and the word item number, medicare benefit scheme. This will give you a number that medicare uses for a particular procedure. Then using that number, plug in into any PHI cost tool.
For this purpose I am using the BUPA tool and an ACL recon (https://www.bupa.com.au/health-insurance/Out-of-pocket-tool)
So it tells me the Specialist cost is approx $2989.50. Note this does not cover hospital stay, medications, anesthetists fee etc, so you have to add it all up.
This will then give you a rough guesstimate on how much surgery will cost and how much you need to save.
Being a registered nurse, the most expensive surgeries I know of are orthopedic, neurosurgery (back and brain) and cardiac.
So please do your research and try as much as possible to work out what could be the potential expenses. Yes, if you stay in the public system and on medicare, everything is free. But what I have seen commonly with orthopedic and back surgery, the delay is that long that patients have become reliant on opioids to tide them over and/or other parts of the body are consequently affected.
Working for self? 35k?
Forget private health insurance, consider getting some income protection insurance with trauma cover.
Accidents can happen with anyone, and even having insurance you might not be 100% covered. We are not talking about the ones you need for overseas trip otherwise you are screwed.
Common sense is the best solution for everything on our lives. If you have it, you will die without having used your health insurance.
Also, if you happen to drink lots of whiskey, maybe should get some cover hehe
True thing hahahahaha
lol no.
PHI is a scam.
Simple, you got money you pay for it
But if you don't just head to the gym.
Or if your work is physical….even better dun need gym.
Lots of stories like this (https://www.abc.net.au/news/2019-04-02/hobart-woman-claims-t…) where private hospitals have turned away old people because they were not equipped to care for them and they were told to go to public hospital.
Apparently paying for private hospital cover your whole life is no guarantee of access:
https://www.abc.net.au/news/2019-04-04/private-health-insura…
You will receive excellent care in most Australian public hospitals, sometimes by the exact same doctors who work in the private hospitals like Public and Private sections of the Mater Hospital in Brisbane (same hospital, different floors).
Having said this, I chose to use Private Hospital for having my wisdom teeth removed (cost $2000 13 years ago) and recently for my 6yo son to have bad tooth removed under general ($3000). This was a small cost compared to having family hospital cover over 13 years.
Like the Barefoot Investor recommends, unless you earn too much and need to avoid Medicare levy, in the long term it's better to save the money and put it into a "Mojo" Emergency Saving account so can effectively insure yourself and use your Mojo money not just for medical costs, but in case you lose your job, car breaks down etc. Once you have 3 months income saved, invest in diversified share portfolio and save for a house.
You have better things to spend your money on. Don't fall for the Private Health Insurance fear mongering.
In summary.
If you are earning enough to pay the Medicare levy surcharge then work out whether after claims you are ahead (paying less than surcharge) otherwise wait.
If you are making 35k then no it isn't in your benefit.
People make a long story of a short answer on here.
These guys don’t get Private Health Insurance at all…
Wait until you get old and require specialist treatment such as cataract surgery…
My parents no longer work but they still pay PHI and it is definitely worth it for them.
No matter it is health insurance or home insurance. All insurance is for unforeseeable events. Do you have any assets to sell if you need to cover $200K surgery cost ? Or do you want to be on a long waiting list for public hospital when you need urgent elective surgery to save your life ? You might think you are healthy now and you don't need health insurance as you don't claim much. However if things happen and you don't have the cash to get the medical treatment you need, then you are doomed. Haven't you heard on the news that guy in the shooting event who won Olympic gold medals have to sell his medal in order to do heart surgery ? And stories like people have to go to the GoFundMe page or sell their house in order to get treated. Public hospitals are just too stretched these days.Recently I have a friend who needs colonoscopy(under 50 yrs). His GP told him if he wants to go public, he probably have to wait for a year. My friend ended up going private and had the procedure done within 3 weeks. The procedure cost around $5-$6K (NSW). Because he has health fund, he was out of pocket for about $1K. So I guess the questions you have to ask yourself
1. If you do need surgery or if you are sick needing treatment, can you pay the hefty cost and have the cash to pay immediately
2. If you want to rely on the public system, are you happy to risk and wait for a place at public hospitals ?
3. Do you want to have your preferred doctor to treat you at all times or different doctors to see you at various time if you go public ?
I heard people saying they don't want to buy health fund and rather put aside the money themselves and pay themselves if need arrived. The fact is people never do.
N.B. waiting list varies between different states and different surgeries/procedures have different waiting time
This isn't the US, you aren't going to have $200k surgery costs for emergency, life threatening surgery.
To add to that, any emergency surgery is very likely to go through public anyway - private hospitals don't want any part of emergencies.
I might have inflated the figures to show that surgery and treatment costs could be expensive.
https://www.health.nsw.gov.au/Hospitals/Going_To_hospital/co… Having said that unless those people in the GoFundMe page are lying, go and check out how much people need to raise for cancer treatment and transplant. Treatments that are not under government pharmaceutical scheme are very expensive.
If you ask on ozb it’s like be a “no”
To all the people saying No because OP doesn't earn enough - if in 10 years time they are earning more than 90k they're going to have to pay a lot more for private health than they would now. IIRC it adds 2% loading every year.
Something to think about.
Well you didn't have to. I'm turning 31 next year and I won't be taking out a policy. It will make my health cover more expensive if I take out private health later down the track, but spending 100% now to save 2% in the future is not a good investment. And if I never take out private health, I'm just saving money in general.