Is it worth having health insurance just for extras?
I'm researching and I see that the annual limits are low.
For example: If I have a dental treatment that costs $2000 and the annual limit for Bupa, for example, is $800 (they refund 60 or 70% of the amount in the annual limit), I will have to pay $1200 plus the weekly plan amount ( in this case $9.24 per week).
Wouldn't it be better to have dental treatment without the plan? What is the opinion of those who already have? Tks!
Not for Extras
I have basic hospital + some base tier extra with Bupa. I pay $110 in total, and I think $25 of that is extras, which works out to be $300 for a year of extra.
In that I get and use.
Tbh for just dental alone, I think it's worth.
For example: If I have a dental treatment that costs $2000 and the annual limit for Bupa, for example, is $800 (they refund 60 or 70% of the amount in the annual limit), I will have to pay $1200 plus the weekly plan amount ( in this case $9.24 per week).
$9.24 * 52 = $480.48. $480.48 < $800.
A dental treatment that costs $2,000 sounds like it would be major dental though, which means a 12 month waiting period.
For me it's been worth it. I'm on Medibank's "Healthy Start Extras" which is about $6.16/week in VIC ($320/year), it covers ambo, 2 free dental checkups yearly (at specific clinics), and then 60% on $500 of general/major dental/physio/etc and $150 of optical.
Honestly, I consider the 2 yearly checkups already worth it for clean up & xrays (typically around $200). But that's just me, if you're not keen on ongoing treatment you can just cancel the insurance after its been covered - though be mindful of waiting periods when signing up, usually there are promotions to waive waiting period of general dental, however major dental waiving is rarer.
With AHM with the most basic hospital cover (because tax) but mid-level Extras - I manage to use up more than the extras cover cost so its starting to subsidise my hospital cover.
I do a calc once a year on whether it is worth it to do so based on what I tend to claim, but so far its passed every year. I end up better off by around $300/year or so
Dumped extras. Even if you go to the dentist and have a clean twice a year:
$200-250 per visit
Let's say you require a random emergency crown ($1200-1500), you're still better off paying cash.
At $480-500 a year (by what you've said), that's just the amount to be able to claim. You need to factor in the cost of the gaps on each claim. Ask your dentist. My experience is they jack the prices up so the amount paid in cash vs the amount of the gap is the same. Except the gap cost you the low low price of $10 a week.
My experience is they jack the prices up so the amount paid in cash vs the amount of the gap is the same.
Can you provide some itemised cost to back this up, for our benefits?
Why? Several dentists (including my own) charge gaps of $150-200 even after claiming (both on Bupa and HCF).
This isn't a new phenomenon. How many people complain they get a quote for a crown costing close to or over $2k yet you can negotiate a crown replacement for cash down to $1200?
I've negotiated down with my dentist for a big job, insurance notwithstanding. I have no experience of dentists charging one price for those with insurance and another for those without?
@Sweet3st: You're lucky.
My own dentist (NE suburbs of Adelaide), charges the same out of pocket whether you're paying cash or insurance ($175).
Two dentists in the eastern suburbs - one is known to be overcharging gaps on insurance. I've spoken to 3 insurers (Medibank, HCF, Bupa) who all recommend a nearby dentist who does not do this. Do customers listen? Nope.
Endodontist - insured - crown was $1800+. Cash (no insurance), $1200
Many treat it like the NDIS - they charge the absolute maximum they can get away with under insurance and because people get back 60-100%, many don't stop to ask how much the actual service originally cost (or if it would be cheaper if they paid cash).
While the OP is on a relatively cheap extras plan and it may not concern them, for people on Silver or Gold extras, it's worth the asking.
@Benoffie: I have met dentists who jacked up the insurance claim, so they receive the same amount in their pocket as they will receive in cash. I have not met one who will take same amount of cash as insurances gap.
But sure, go with generalised accusations.
It's (almost never) worth it to take out extras cover if you only use one of the components. If you need optical, dental, physio, etc then it becomes more worthwhile.
It really depends how much you will use it. How are your teeth? I'm with Qantas Assure (basically NIB rebadged) and for $32/month I get 60% back on dental (dentist of my choice), unlimited check up and cleans, $800 limit on general + $800 on major. I'm older and always seem to need something done so it's worth it, plus need optical. Also earn about 10,000 Qantas points a year on the app.
You do the maths for you, but don't forget the taxation implications as well (if applicable)