How to Best Use Health Insurance (Bupa Gold Ultimate or Similar)

LRosieRenee on 09/03/2021 - 14:51

OzB I need some help to fully utilise my insanely expensive Bupa Gold Ultimate policy. (similar to Medibank Gold Ultra).

I understand many people feel as though the best way to utilise or save on health insurance is to simply not have it but unfortunately it’s needed to access decent mental health treatment.

Since my only option was a $3500/year policy I want to make the most from it. Fortunately much of the extras have high caps with 100% rebate limits so I won’t be caught out like many people who try to use their insurance but still need to pay big $$$$ for every appointment.

At the moment I plan on using:
Dental - check up, fillings, teeth whitening, wisdom teeth removal
Physio - clinical Pilates sessions
Optical - glasses & contacts
Psych - therapy sessions & online CBT therapy
Pharmaceutical - $20/month saved on medication
Remedial massage

Is it worth starting to see a chiropractor or dietician? I’m only 26 but I still want to get the most from this so let me know if you can think of anything that would be handy to utilise.

Also a quick note: health insurance is just that.. insurance, it’s there to cover you when things go wrong not necessarily to ‘break even/ not lose money’. Doesn’t mean I’m not going to try & get the most from it while I’m forced to have it.

Thanks in advance!

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Comments

  • tsunamisurfer on 09/03/2021 - 15:00
    +2

    If you do not need those services, and go out of the way to use those services to get 'max value' from the policy, isn't this part of the mechanism that makes health insurance expensive?

    Wouldn't it make more sense to get the minimum coverage without paying for the ancillaries?

    • RosieRenee on 09/03/2021 - 15:09

      It works out more expensive for me. There is 1 cheaper option which included unrestricted in hospital psychiatric care however the caps for things like psychology & other extras I have to use anyway were much lower & the out of pocket costs per visit were greater.

    • RosieRenee on 09/03/2021 - 15:11

      So essentially because I HAVE to use these services anyway I’m asking people if there’s value in anything else. Definitely wouldn’t have gotten this policy if I didn’t have to but I’m here now & want to get the most from it.

  • Koiden on 09/03/2021 - 15:03

    Not to detract away from what you are asking but dentally whitening isn't considered to be covered by any health fund whatsoever and usually is settled privately at whatever cost the dental clinic does it at. The rest are fine

    • RosieRenee on 09/03/2021 - 15:07

      It’s covered under Ultimate Gold through my dentist, I have it in writing from Bupa.

      • sleepingpanda on 09/03/2021 - 19:36

        You can double check by getting a quote online for service code 118
        Usually they would put 118 for teeth number: 15, 14, 13, 12, 11, 21, 22, 23, 24, 25, 35, 34, 33, 32, 31, 41, 42, 43, 44, 45
        But just check whether 118 is covered under your insurance

        • RosieRenee on 10/03/2021 - 14:05

          Will do, thank you!

  • blueyez on 09/03/2021 - 15:22
    +1

    Please seek medical advice from your GP to see if you really need anything additional. I did something similar to you to 'use up' my ultimate cover - the Chiropractor was a complete waste of money and caused me issues I didn't have before I went.

    When you buy glasses (sunglasses) from Bupa Optical, you can also ask for the original lenses to be included.
    Handy for when you're wearing contacts =) Just ask Bupa Optical to switch the lenses for you

    Do you also have hospital cover? If so, consider using your cover towards laser eye surgery. I wore contacts and glasses for over 20 years and finally had my surgery as Bupa covers 100% of the cost if you're on the top cover (if you only have extras cover, this is not an option)

    To save you money on premiums - try to pay as much of your health cover up front before 1st of April when premiums will increase.

    That's all I can think to suggest. I've used private health cover mainly with Bupa for over 5 years now.

    • RosieRenee on 09/03/2021 - 15:28
      +1

      Hospital cover was the thing that pushed me into such an expensive category as I need unrestricted in hospital psychiatric care.

      I could have gotten a hospital only policy but when I did the math it’s actually working out better for me to get the combined hospital and extras as I’ve been paying 100% out of pocket for optical, therapy, medication, dental, etc. So now I’m like ‘what else can I use if I need this policy anyway & extra services are almost free?’ If that makes sense.

      Definitely want laser eye surgery but I need to wait a few more years for my prescription to stop changing.

      Had no idea about the original lenses! Thank you!! Have that issue all the time, so I have prescription and non prescription sunglasses but the lenses would be more convenient.

      You’re a legend!

      • blueyez on 09/03/2021 - 15:31

        I took out the cover only to use it for the laser eye surgery, as the premiums were the same as paying for surgery and I used dental/optical cover anyways - so it was like getting free extras lol.

        However the current waiting period is 36 months for laser eye surgery - it used to be only 12.

        • RosieRenee on 09/03/2021 - 15:37

          Knowing my luck my eyes won’t get that bad & it won’t be a good choice anyway. Haha.

          I’ll reassess in the future, hoping I only need this level of cover for a couple of years.

          • blueyez on 09/03/2021 - 15:41

            @RosieRenee: Might be worth doing a laser eye consultation (which is free when you initially enquire) to see whether or not you're suitable for laser eye surgery. I'd also strongly recommend checking with Bupa whether or not you qualify for 100% laser eye surgery cover before you decide to change or cancel it - if you are going to be covered for it 100% I would encourage you to look into it before getting rid of the cover.

            For reference, I was mortified and thought my eyes weren't suitable but they were. I've gone from being severely short sighted to slightly long sighted (over corrected) however I no longer need to wear glasses or contacts, I just use my cover for prescription sunnies.

            Deciding on whether or not to have it done is still up to you - would be a shame to cancel it without looking into it further is all I'm getting at =)

            • RosieRenee on 10/03/2021 - 14:01
              +1

              @blueyez: Wow okay! Yeah that does sound like a good idea.
              When I last saw my optometrist he said that because I’m currently only -.5 & -.25 with astigmatism laser could make it worse at this point in time.
              I think I’m due for a new eye test where I suspect my prescription will be a bit worse than last time so it’s probably a waiting game until I’m closer to 30 and they’ve stopped changing.
              Definitely going for a consult though, thanks!

  • Love a bargain on 10/03/2021 - 13:03

    What about orthodontic (if you haven't already had braces as a kid) & exercise physiology (to work on general fitness)?

    • RosieRenee on 10/03/2021 - 14:04

      I have pretty good teeth and never needed braces thankfully but I’m sure at my next dental appointment (the first in far longer than I’d like to admit) they will let me know what may be needed. I’ve developed TMJ & my jaw clicks so there’s probably something that needs to be done there. Not sure if that falls under orthodontic but I’ll look into it, thanks.

      I think I plan on using physio for Pilates classes but I should probably see what else is around that can be covered.

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