Newbie. Private Health Insurance Yes or No?

LCOVIDLALALA on 14/06/2020 - 19:43
Last edited 15/06/2020 - 21:56

Hello everyone, I was told about this AWESOME website from my Ozbargain addict friend

I am married, 26 years old, just got my first full-time job as a store member in a grocery store for about 8 months. Salary 60k + Occasional Uber Eats driver (earn about $200-300/week). Completely healthy
Partner is studying, works part-time earns about $500/week. Wife has a blood disorder - ITP, an autoimmune disease, her health's been stable and not dangerous so far since she still young. But could be very deadly and critical if something goes wrong.
We both have Medicare

  • I am wondering if I should join a private health insurance or not? If I should, then which one has the best value?
  • I've been always doing tax-return my self and never been to a tax accountant before (trying to save some money by doing it my self and also gaining experience). And since this is my 1st full-time job this year (Uber driving only started 2 months ago), any tips for claiming tax return?

Any advice is greatly appreciated and thanks in advance!

Thanks for everyone's advice. Have decided to skip PHI for now until more suited circumstance in the future. We've already had a emergency-fund account but maybe will put more to it every week.
I can see why this is such a great website not just for hunting bargains. You all giving good advice and positive inputs even to some strangers.

Poll Options

  • 47
    Yes buy private health insurance
  • 296
    No
Financial Health Insurance Insurance

Comments

  • dcep on 14/06/2020 - 19:48
    +89

    wait till you're 30yo / over 90k pa / expecting newborn

    PS: pick a better username

    • COVIDLALALA on 14/06/2020 - 19:52

      yea, didn't realise until that been created, will try to figure out how to change it. sorry

      • Neptunesblood on 15/06/2020 - 17:07
        +51

        Don’t be sorry. You can do what you want. Everything on here are just opinions. Remember that.

        • COVIDLALALA on 16/06/2020 - 19:50
          +3

          I was afraid the username may offend someone who may have had someone/themselves affected by Covid-19. It seems I can't change the name for another year so that's what the sorry for.

          • tessel on 17/06/2020 - 14:36
            +3

            @COVIDLALALA: You offended me by saying you are worried someone might be offended…

    • PissLUR on 14/06/2020 - 20:04
      +2

      It should be 180k for family.

    • Benjamin7711 on 15/06/2020 - 07:42

      Do you mean all 3 things or any one of these things? Thanks

      • kev98 on 15/06/2020 - 12:43

        One of them

    • vinni9284 on 15/06/2020 - 13:48
      +2

      Even then, you're still better off on the public system as the money you'll save from getting thrashed tax time, you'll pay more for gap charges/additional expenses (that PHI promises that you won't be charged)

      • Chandler on 15/06/2020 - 22:43

        wait till you're 30yo / over 90k pa / expecting newborn

        I assume the 30yo & 90k pa is for tax purposes.

        Maternity can be very variable in level of care. Biggest seller for private is continuity - you see the same midwife/obstetrician the whole way through, rather than whoever's on shift when you go in for an appointment/baby, although some public hospitals do have a continuity of care program.

        • MechEng on 17/06/2020 - 16:44

          On this. There are other options too.
          In our case we had a student midwife that helped with the continuation of care. That was really good for us.
          Our experience was excellent on the public system, more than once.
          Our friends used a private system for theirs in the same hospital and ended up paying over $5,000 in additional costs. What they got different to us:
          - Private room
          - 5 nights after delivery (in our case we wanted to go home asap, so we stayed 2 nights)
          - As mentioned an obstetrician during labor
          Hope this helps

          • Chandler on 18/06/2020 - 09:45

            @MechEng: Our were public also, and likewise with the continuity of student midwives (the one we had for our second was fantastic). Ours were also over the weekend so we ended up in there for I think 3-4 days post, and the hospital had private rooms for maternity.

            Also bear in mind that for some complex or riskier pregnancies the private sector palms you off to the public hospital anyway as either the expertise or equipment (or both) are there.

      • morse on 16/06/2020 - 09:30

        Public healthcare is very good, but remember there are waiting lists and eligibility criteria for lots of things depending on urgency and where you live. If you bust ligaments or need cartilage repair in knee, have a hernia or non-malignant tumour and need surgery you may be waiting a long time (months to years) possibly with pain in the public system. If an inpatient admission might be helpful to you for mental health, substance abuse or pain, unless you're very unwell you're unlikely to get admitted at all in the public system. Having said all this though, if getting PHI it helps to have a more comprehensive plan to be able to access the full range of services outside the public system. It is expensive, and yes there are gaps and an excess - however for some getting being able to get surgery quicker or treatment at all is of value. e.g. if knee, shoulder injury etc gets in the way of fitness or work.

    • Tambani on 15/06/2020 - 14:46

      Don't wait until your partner is already pregnant though. 12 month exclusion period for pregnancy is standard.

      Get it if you're planning to start a family. Then you can get your choice of obstetrician if there are any complications. For example - you find out you are expecting twins but you want a doctor who is experienced with non-surgical delivery.

      • SgtBatten on 16/06/2020 - 07:19
        +1

        But remember that private health insurance doesn't cover pre birth costs except for some classes. OB fees are out of pocket save for a small Medicare rebate.

        Also it's best to have your kids in January as the OB fee will likely push you over the threshold of the Medicare safety net. That's been a godsend for us this year.

        • leeroys_dad on 16/06/2020 - 13:10

          not january - better off getting pregnant in january and seeing th obgyn and deliver in august/sep - all the fees are then into the MSN and you get more back

          • SgtBatten on 16/06/2020 - 15:40

            @leeroys_dad: Interesting. I am not entitled to medicare and my wife had barely used anything leading up to the birth so i'm not sure that would have worked for us but I will look into it if we decide to go again.

            We've used a shitload of medicare stuff since the baby arrived so it felt worth it now that the pain of the OB fees is forgotten.

            • leeroys_dad on 16/06/2020 - 19:05

              @SgtBatten: Yep all the appointments all add up, I think we only hit the msn once we paid our obgyn big fee 2k, after that it was great

          • crentist on 17/06/2020 - 16:47

            @leeroys_dad: better would be timing it for school intake, so that they are a little older than other kids.
            then let their early advances roll into better education tracks, better schooling, and better success in future

            then ask them to pay back the $350 or whatever you would have got now

            • leeroys_dad on 17/06/2020 - 17:31

              @crentist: Lol fair enough. Although our little one is repeating kindy, he will be the eldest😀

      • tmg316 on 17/06/2020 - 15:35

        We had twins - many complications but thank God it all turned out okay. We had private insurance but if you run into any complications you will be sent to the best paediatric hospitals, and in Australia they are all public (i.e. Childrens, Mercy, etc.). So all you really get in private system is your own room, an extra night, better hospital food (but lets be honest your husband/partner will be bringing you whatever you want) and it will still cost you 4k. Any complications and they will send you to the public hospitals anyway.

    • chasis on 16/06/2020 - 10:36

      This ^

      • TheCutter on 16/06/2020 - 12:31
        +3

        Hi
        I'm a doc and will give you my 2 cents.
        The Aussie system was designed originally to have an excellent emergency care set up publically and a private elective surgery set up.
        As time has gone by the population has gone up and expanding the public system is a vote winner so private health is not seen as essential.
        TBH if you are in the big centres then they are over-doctored and you can get good care in the public.
        As you leave the centres then the ratio drops and private health becomes more vital.

        With your fund you can see the best doctors and have the finest care…. but the private system is like the wild west with minimal policing so some private docs are actually the worst that no public hospital will employ.
        I find it sad when I see someone has been too trusting and had 3 dud ops by the same person who was recommended by a "friend"
        I think PHI has a problem due to the aging population and i think it will need to be rationed to some point.
        For example I saw an 80 year old woman on her 4th hip - at 100G a time thats not sustainable I suspect but there needs to be a debate on that

          • dualcore on 16/06/2020 - 16:38
            +6

            @screensaver: As a society we need to think about prioritisation of resources. The same way we shouldn't build a 2 billion highway to a rural region with a population of 10, we also should be focusing our efforts on how to provide the best healthcare to all Australians at sustainable costs.

        • PT8483 on 04/01/2021 - 12:53

          That's a gross generalisation.

          Some of the best surgeons in Australia works private only or both public and private. Sometimes, its easier / faster to get an appointment / surgery with a particular surgeon in the private setting.

          I have worked in both public and private hospital as a medico and one problem is lack of junior doctors in the private system. Mostly run by nurses and locums. I still wouldn't say the private is the "wild west". You will need years of of experience (>PGY 3) to get a job in as locum generally as a CMO anyway.

          Most them are very competent and what they do.

          I would agree that anything with Ca or Emergency care is better in public settings.
          Private hospital is really for fast-tracking non urgent elective surgeries and that's where the money is for the private sector

  • Hybroid on 14/06/2020 - 19:48
    +2

    You have Medicare I presume? In which case, probably don't need private insurance.

    If you don't have Medicare, likely due to being foreigner, then you'll have compulsory private insurance anyway as a stipulation of the Visa.

  • CheapandUsed on 14/06/2020 - 19:50
    +12

    https://www.doineedhealthinsurance.com.au/

    If you said you are accident prone and sick every second week then maybe, but by your post it sounds like it will be a waste of money.

    Don't let people scare you with the loading either, the maths usually checks out that not paying for PHI more than makes up for the loading if you do get PHI in the future.

    • COVIDLALALA on 14/06/2020 - 19:52

      thanks, I did have some worries about not paying PHI and something goes wrong expecially with my wife's health, forgot to mention her condition earlier

      • CheapandUsed on 14/06/2020 - 20:00

        That might require a 'what if' discussion with her GP to help decide.

        If the worst were to happen, will the care be provided mostly via Public health or will there be a large number of, for example, specialist appointments which typically have a larger gap payment that PHI can cover a reasonable % of.

        Having said that though, it could be that your out of pocket is still far less than the cost of the PHI cover (level) that would cover this circumstance.

        • Chandler on 15/06/2020 - 22:48
          +5

          Having said that though, it could be that your out of pocket is still far less than the cost of the PHI cover (level) that would cover this circumstance

          That's the biggest issue I've always had with PHI - ROI. (yes, I know I don't need to have it. Just like I don't need to have comprehensive insurance on my car. It's insurance.)

          Call me a socialist, but I'd be happy to pay my PHI premium to the government if we all got the private level of care from the public system; which they'd easily be able to do with all that private money (in my opinion).

          • Tambani on 15/06/2020 - 23:05

            @Chandler: As someone who has worked in the private system, don't be fooled by the marketing material. Most private health care isn't any better than public. It's just the timely access and choice of doctor you're paying for.

            • Chandler on 16/06/2020 - 09:54

              @Tambani:

              It's just the timely access and choice of doctor you're paying for.

              Agreed. The timely access being the key issue - I'm personally not overly fussed about seeing a particular doctor, but having said that I'm not having to see a doctor regularly, so if I was that opinion could change (likely would, to be honest - pretty sure I would hate having to discuss my history every time).

    • Drakesy on 15/06/2020 - 12:14

      There are some rubbish PHI that are lower than the loading which you can take out solely to reduce the total tax. They're not really worth the paper they're written on but still, a $450 private health bill is better than a $1000 tax bill.

      Although it is literally money for nothing to the insurance companies.

      • Pry on 16/06/2020 - 22:39

        Don't confuse the loading with the MLS, they are two separate things.

  • holdenmg on 14/06/2020 - 19:58
    +22

    Consider getting Ambulance Cover (if you don't have it)
    https://www.ambulance.vic.gov.au/membership/fees-terms/

    • miles05 on 15/06/2020 - 10:43
      +4

      ambulance cover is a must! its so cheap, plus if you are in an emergency you don't want to be thinking about the cost and weighing up options if your life is at stake.

    • Yotta00 on 15/06/2020 - 11:00
      +14

      Reason why I love living in QLD. Free Ambulance!

      • virhlpool on 15/06/2020 - 12:02

        Wow.. didn't know that. It's a major plus.

      • OldnBroke on 15/06/2020 - 19:20
        +2

        And free ambulance when us Queenslanders are travelling interstate, which I never knew until my daughter required an ambulance in Sydney and Queensland Ambulance Service paid our bill.

      • Binchicken22 on 16/06/2020 - 07:21
        +3

        Nothing's free… You mean, pre-paid for in our existing tax structures.

        • Dsiee on 16/06/2020 - 07:42
          +1

          Well yeah, I don't think anyone thought the ambulance system just ignored money, didn't pay there workers, and got free equipment in QLD.

          Efficiencies that arise with a larger payer base can make it more closely approximate 'free' than an individual payer system.

    • bubaebae on 16/06/2020 - 08:30

      Couldn't find this sort of cover for NSW.

  • DemocracyManifest on 14/06/2020 - 19:58
    +1

    You have to read the fine print of the policies, but normally you are better off just paying the fees into a savings account with a bank like up. There was a liberal MP who literally said that no too long ago, PHI is a bit of scam. Most people won’t benefit from having the policies

    • bigbadboogieman on 15/06/2020 - 21:42
      +2

      I've been paying some money on a weekly basis to a savings account as health fund since May last year. I use that for buying meds and specialist visit charges on top of medicare. So far I've got 2.5K in there.

  • elgrande on 14/06/2020 - 20:09
    +22

    Just get ambulance cover ($100 p.a) and then use public hospitals.

    One of the benefits of this great nation.

  • dust on 14/06/2020 - 20:11
    +28

    Private health insurance is a scam.

    A lot of the cheap policies provide as much coverage as using cling wrap and a rubber band for birth control.

    • virhlpool on 15/06/2020 - 12:03
      +2

      Private health insurance is a scam.

      I agree with all negatives but you would say this only if you never had to use it.

      • This Guy on 15/06/2020 - 18:55

        If I paid $4,000 a year from 30 to 80, I would have paid $200,000, ignoring interest.

        If I need new knees at 55, I would have $100k to pay for it.

        • spaceflight on 15/06/2020 - 22:21

          Who pays $4000 a year?

          • Tambani on 15/06/2020 - 23:07

            @spaceflight: It's way more than that for silver tier cover.

            • spaceflight on 15/06/2020 - 23:15

              @Tambani: You need to change providers.

              Top hospital (Gold) with Bupa is less than $2000

              • Dsiee on 16/06/2020 - 07:43

                @spaceflight: Depends on the person doesn't it? A family will be more, pre-existing conditions would be more etc. Or do they just do a flat rate?

                • spaceflight on 16/06/2020 - 08:29

                  @Dsiee:

                  Depends on the person doesn't it?

                  Not really. Two people living in the same state and earning the same amount will pay the same insurance premium.

                  Your income will effect the government rebate.
                  Your age will only make a difference if you haven't held insurance since you were 30, if not you'll pay loading as determined by the government

                  A family will be more

                  Yes

                  pre-existing conditions would be more etc

                  No. Pre-existing conditions aren't covered for the first 12 months, after that they are.

                  Or do they just do a flat rate?

                  Yes

              • Geryatric on 16/06/2020 - 21:56

                @spaceflight: 2 adults, 1 kid

                Bupa Gold Hospital
                $4,843.20/year
                - Gold Hospital
                - No Extras

                Bupa Ultimate Cover Gold
                $11.146.80/year
                - Gold Hospital
                - Top Extras

          • This Guy on 16/06/2020 - 12:47

            @spaceflight: I don't know how you run your household, but I don't split bills down to his and hers.

            Looking at Bupa's quotes page, they are competitive with what we were quoted.

            • spaceflight on 16/06/2020 - 13:40
              +1

              @This Guy: Nothing in what you said indicated it was for more than one person

              If I paid $4,000 a year from 30 to 80, I would have paid $200,000, ignoring interest.
              If I need new knees at 55, I would have $100k to pay for it.

              So what about the benifits your wife and children get from the policy?

              but I don't split bills down to his and hers.

              So then why did you apply it down to the benifits that one person received and ignored the rest?

              You can't look at what you pay as a family and then the cost/benifits for only one of the insured individuals.

              • This Guy on 16/06/2020 - 14:32

                @spaceflight:

                So then why did you apply it down to the benefits that one person received and ignored the rest?

                You can't look at what you pay as a family and then the cost/benifits for only one of the insured individuals.

                You sure do seem to think you know a lot about my family's medical history.

                Please tell me all of the non-emergency surgeries that my family will need?

                • spaceflight on 16/06/2020 - 18:10

                  @This Guy:

                  Please tell me all of the non-emergency surgeries that my family will need?

                  I don't know but you might want to consider them when you are comparing how much insurance you pay for a family against how much benifits one person will get from the insurance.

                  If you only think one person will need insurance maybe you would be better off without family insurance.

                  • This Guy on 16/06/2020 - 19:54

                    @spaceflight:

                    If you only think one person will need insurance maybe you would be better off without family insurance.

                    A knee replacement can be as cheap as $15k domestically. If I started saving $4k a year at 30 I could buy six knee replacements at 55 and still be $10k ahead, ignoring compound interest and bipedalism. Better yet, if I have any other emergency I could use my savings for the emergency instead of having no money to cover it.

                    It is my opinion that health and death insurance are predatory products purely playing on people's fear and poor numeracy skill. Any business preying on the less educated and the scared, in my option, is evil.

                    But, I don't think you are evil for supporting it. There are plenty of stupid things I like. After all, people with purely rational beliefs are boring.

    • whooah1979 on 14/06/2020 - 20:41
      +6

      During that 10 years. you can save heaps by switching

      Gen Y & Z can save more by not wasting money on PHI. PHI is for older people.

      • screensaver on 14/06/2020 - 20:47

        his wife may be young but she has health problems. Covering health would be a sensible thing to do

        • whooah1979 on 14/06/2020 - 20:48
          +1

          Wife has a blood disorder - ITP, an autoimmune disease,

          What can PHI do to treat this condition that the public system can't?

          • screensaver on 14/06/2020 - 20:51

            @whooah1979: private health includes public hospitals too.

            • whooah1979 on 14/06/2020 - 20:55
              +1

              @screensaver: Ok. So why should OP pay for PHI when they may get treated for free on Medicare?

            • cheaplee on 14/06/2020 - 20:57
              +1

              @screensaver: Yes but there is almost zero benefit to the user with PHI in a public hospital

            • bigbadboogieman on 15/06/2020 - 22:03

              @screensaver: Just FYI.. PHI won't cover the gap for any outpatient specialist visits. I had raised a forum post here to clarify the outpatient bit as someone I know was trying to buy a PHI that covered 100% specialist visit (no gap)

              The rep was right. By legislation, health funds are not allowed to cover the gap for outpatient medical specialist or GP visits.
              There are some policies available to overseas visitors and working visa holders that do cover outpatient visits over the medicare rate (upto AMA published rates). However, Australian citizens or permanent residents are unable to sign-up to these policies.

          • screensaver on 14/06/2020 - 20:55
            -4

            @whooah1979: it gives more options, more specialists, less waiting, plus respect from the medical world that you bothered to try and cover yourself

            • whooah1979 on 14/06/2020 - 21:06
              +2

              @screensaver:

              plus respect from the medical world

              Yes, I can see how the for-profit MNC stakeholders respect people paying for things that they may get for free.

            • COVIDLALALA on 14/06/2020 - 22:42

              @screensaver: I really think that's one of the major benefits I was opting for. Once my wife was having a flu and her nose would not stop bleeding for like hours. I took her straight to ER at a hospital in South East Vic at mid night. The nurse told her to wait for another 4 - 5 hours and I tried to explain to them that she had a blood disorder but they said she didn't look that serious to the them.
              Then after that her haematologist had to write up a letter to demand an immediate treatment if something like that comes up in the future

              • whooah1979 on 14/06/2020 - 23:14
                +6

                @COVIDLALALA:

                ER at a hospital in South East Vic at mid night. The nurse told her to wait for another 4 - 5 hours

                It is doubtful that PHI would've given you guys priority at a public ER at 00:00.

                • Tonyh87 on 15/06/2020 - 08:59
                  +3

                  @whooah1979: is correct, insurance status does not play any part in the triage process.

                • Tiller76 on 15/06/2020 - 14:38
                  +1

                  @whooah1979: Correct. PHI would not help at a public hospital. If you went to a private hospital however, the ER time would be quicker just because the numbers are less. Yes there are extra costs, but you get that back if you are admitted.

            • Drakesy on 15/06/2020 - 13:13

              @screensaver: You do realise we aren't America right? We all pay taxes and in return get a medicare card for our $1000-$2000 a year levy. So in short all Australian's have bothered to cover themselves.

              But i do agree with the less waiting for specialists (but you pay for this out of pocket anyway), just in public hospitals there's no preference, it's a first come first served/emergency situation

              • Tonyh87 on 16/06/2020 - 00:01

                @Drakesy: Not quite first come first served, its those who need treatment most urgently get served first. Even with elective surgery there is a triage process.

    • toniyellow on 14/06/2020 - 21:29

      if you pay for 10 years straight you will NEVER have to pay a loading

      This is incorrect.

      If you pay the loading continuously it only lasts 10 years.

      There is nothing at all saying 10 years of cover exempts you from the loading in the future. As soon as you cancel your cover then use up the 1094 permitted days, you are liable for the loading again

      If you cancel your cover after the loading is removed, you may become liable to pay a LHC loading again

      https://www.privatehealth.gov.au/health_insurance/surcharges…

      • screensaver on 14/06/2020 - 21:49

        oh no, I am paying an 18% loading for another 9 years, and used up my days of absence earlier, but on the plus side I have the 2 senior rebates ahead, and can get 6 percent off at National Seniors and also 7.5 percent off at NRMA

        • screensaver on 14/06/2020 - 21:51

          but my greatest saving will be the switching, have many choces

    • Spam Service on 16/06/2020 - 10:26

      Firstly, if you pay for 10 years straight you will NEVER have to pay a loading. Now is a good time, while you get the under 30 discount.

      Paying 100% for 10 years to save 20% each year after that doesn't make much financial sense.

  • whooah1979 on 14/06/2020 - 20:34

    26 years old, Completely healthy

    Not worth it. Save your money and invest it in something that will give you a good return.

  • screensaver on 14/06/2020 - 20:39

    You will need to check blood is covered for your wife, and there is a 12 month wait for pre existing conditions. Prices vary but there are still some good deals, familiarise yourself with the lists of inclusions and prices, that what I did, The first one I joined was health.com.au, very cheap and covered everything, but in a public hospital. Still counts towards the 10 years, but would not include private hospitals.

    • COVIDLALALA on 14/06/2020 - 22:44

      I did a few quotes online from several popular PHI, I got quotes for around $150/month with blood cover, and mainly hospital options, minimal to none extras

  • cheaplee on 14/06/2020 - 20:58
    +5

    If your wife had something serious with ITP she is going public, no matter what emergency room she ends up in.

    Serious disorders don't make money

    • COVIDLALALA on 14/06/2020 - 22:45
      +1

      I really thought so at first, until we had a very bad experience with a large public hospital. I'm not sure if private hospitals would do better though since we haven't had experience with them

      • Spam Service on 16/06/2020 - 10:34

        I know a doctor who works in private practice, and she's had two kids. When she gave birth to her first son, her chosen doctors weren't on call, and she ended up in the public hospital anyway. Her advice to me was to stay public unless we wanted any specific therapies, then we'll need to do the maths (and it didn't add up to go private). Emergencies are all treated the same (if you end up in the ER they're not going to check your insurance, they'll treat people based on priority).

  • screensaver on 14/06/2020 - 21:15
    -1

    I will be switching 3 or 4 times a year, will bring it down to well under a thousand a year

    • xsacha on 14/06/2020 - 22:12

      Then won't you never be covered due to waiting periods? Or is this to avoid tax + loading?

      • screensaver on 14/06/2020 - 23:14

        waiting periods are counted if you switch if you stay on the same level of cover.

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