Hi guys, seeking your advice about keeping private hospital cover even if the income is below medicare surcharge threshold.
Private health hospital cover
Bab on 27/03/2013 - 17:54
Comments
I thought getting hospital cover was like car insurance, you hope to never get into an accident but just in case.
That's what they want you to think.
Private cover just gets you operated on quicker for non-urgent issues and allows you to have a private room etc. in a private hospital.
Nearly all emergency and urgent healthcare is done in public hospitals under medicare.
Of course if you want to skip the medicare queue for your knee reconstruction or whatever, you can just pay the retail price at the private hospital, even if you have no insurance.| you can just pay the retail price at the private hospital
I stayed one night in a private hospital, according to HBF the cost of this was….. $4500. No operations or anything just a room, meals and a saline drip (I was severely dehydrated the cause of which is unknown).
I wouldn't count on paying it yourself, sure I could have gone public but compared to car or home insurance health insurance is actually pretty cheap and what is more important?
Not paying $1000+ a year for services you can get for no charge at the public hospital seems more important. You didn't go to a private hospital for a $4500 stay because you needed to, you did because you had insurance, for which you paid hundreds of dollars.
The saline is the same in public or private.Interesting sides, thanks guys I was curious that's all. Don't think I'll drop mine, I sort of like my dental cover as it is since there is no gap for my twice a yearly check up (which I saw on my bill is quite high, but who knows how much my dentist is marking up).
But one to consider since I'm still pretty healthy.
Thanks for the comment. Most dental treatments fall under extras cover so you don't need to get hospital cover for general dental treatment?
Not an emergency, try getting a bed.
I totally agree that without private insurance I would have just gone to public. All I am saying is just paying retail isn't really an option.
However I think its worth considering that the private hospital has incentive to admit me where as the public hospital has incentive not to. I guess it all depends on how much you value your health and how much faith you put in the public system. In Perth the public hospitals are incredibly depressing and who knows who is going to be in the bed one over from you.
I'll add if it's free you are more likely to go.
Would you mind telling me what cover you are on ? I am on medibank private basic 70 or something. So I have to pay 30% for dental. I am thinking of changing/upgrading it to cover few more things.
You hardly can claim much for kids braces. You are better off keeping aside your money and pay as you go. Join only for tax purposes.
My sister works in a public hospital, patients with health insurance go home with bills and those without are covered by medicare. Same bed, same doctor, same everything. Health insurance means a bill. There is a private hospital nearby and often patients want to go there, but they are run like a business, and keep staff to a minimum, so there is never any last minute beds, have seen private hospitals send patients home so they do not have to pay for the staff loading on public holidays. All urgent treatment is available to you in a public hospital, after all they are the ones with emergency departments and doctors there 24 hours a day. I do not know of any private hospitals that have emergency departments. I used to have private health insurance, not now, as I am not sure it is worth it??
My sister is a nurse as well. She says the staffing levels at private hospitals are generally lower as they are trying to minimise costs and make profit$$$.
Private hospitals are basically glorified day surgeries. As soon as the shit really hits the fan, out comes the ambulance and its off to a large public hospital.
Years ago, my oldest was born with a double hernia, and just screamed for the first 5 weeks of his life due to pain. A private system got him operated on in 3 days and i was told a public system would make him wait over 6 months as it was not life threatening and that was the length of the waiting list at that time.
I would never be without private health insurance for this exact reason
You don't need to go top of the range, but just the comfort of knowing that you can get the quick turnaround is piece of mind. And most importantly shop around.
I don't think i could have watched him scream for another 6 months, that in itself was not healthy.
I find that hard to believe. Even a gp will send you to ED for fast free surgical treatment rather than wait weeks for a private consult that costs a fortune. On the other hand if you have private insurance then it's not surprising it would be suggested you use it. Who knows, if you had gone into ED with a screaming child with abd pain you'd be triaged early and admitted, probably operated on before being sent home. I can't see a public hospital sending a child home in that state, it isnt how they operate for non-elective surgeries ….
It's nice to think that the state wouldn't leave anyone in pain, but it's not the case. If the surgery is non-urgent then they will send you home. If you are in pain, you'll just get doped up until your time comes. Some areas are better than others - it just depends what your local public hospital queues are like. Where we live, they are terrible. I would NEVER go without private hospital cover. Note also, that having private hospital cover doesn't mean you can't use the public system.
My husband had a pilonidal cyst that was infected. He was so ill from the infection that he refused to walk the 50m from the car to the house we were looking at buying and just told me to use my own judgement - that's when I realised he was REALLY ill. Despite this, we were told that it would be 4-6 months or so for him to have the 'non-urgent' surgery to fix it at our local public hospital. Antibiotics weren't doing much but keeping the infection from killing him, he was still very ill from it. He wasn't able to work so would have had to take months off in unpaid sick leave. He had his surgery privately and was well on the road to recovery by the time he even got a letter from the public system saying he was nearer the top of the queue.
I had my baby privately. Whilst sitting waiting for an ultra-sound at the private hospital I got chatting to the gentleman in the wheelchair next to me. He was there for a shoulder reconstruction. He was looking forward to it as he'd had to wait a year, in very bad pain, for his private health cover waiting period to expire so that he could get it done. He had been advised to go and get private cover immediately and wait the year to go privately rather than risk the 2+ year wait in the public system. He couldn't afford to pay for the whole cost privately (I think he said it was about $25K???) so had taken out the private cover and was now able to get it done. He was also on the public list and was no-where near getting it done that way.
I've used the Emergency Department of one of our local hospitals once in my life. They missed my broken elbow and then failed to follow the recommendations of their own radiologist who suggested they follow me up on suspicion of a broken elbow (I'd been in late at night so the senior radiologist had reviewed the xrays the next day - I only found this out because I requested a copy of the reports for my GP so that I could get a referral to a PRIVATE orthopaedic surgeon after realising that there was something seriously wrong with my arm and it was not just 'soft tissue damage' as the ED doctor had kept insisting through my screams of agony).
Needless to say we are big fans of private health insurance.
You are completely right, and this is what I was going to respond to the posters above who say that if you really need something, it can be done in the public system. What they don't realise is that there are often long waiting lists, and if something is not immediately life threatening, more urgent cases get put before you (as they should). This means that you could be in a lot of pain and discomfort, and your condition could be worsening, but too bad. Until you have been in this situation or had someone close to you go through it, you won't know… and if it's you, once it's happening - too bloody late.
I too have had the misfortune of going to the ED and being put through the public system when I broke my ankle. I had just moved interstate and knew no-one, couldn't walk etc, so I thought it would be easier to go to the ED and wait rather than organise things privately. My experience is VERY similar to yours. After waiting for 6 hours and realising that no one in the waiting room had been seen in that time (as they only had capacity to service ambulance cases), I decided to go home and come back the next morning (they sent me off without crutches, despite me telling them that I lived on the 3rd floor with no lift and had no one to help me at all, as I knew no one in the state - apparently even if I waited another 6 hours to be seen, I couldn't hire crutches as the physio department only re-opened at 8am).
The next morning it was only a 3 hour wait (I got there at 7am so I could be early on the list), but the ED missed the broken ankle, and actually instructed me to start seeing a physio and walking on it within a week. I was never seen or examined by a doctor or nurse. Ten days later when I still couldn't put any weight on it (and the private physio told me I needed to 'toughen up'), I saw my GP who followed up the ED for reports (which should have been sent to the GP anyway but hadn't been yet).
Long story short, I got a referral to a private ortho surgeon who saw me shortly after, sent me for an MRI and the damage was much worse than any of us expected. I had been doing more damage by trying to walk on it.
I too am a huge fan of health insurance, and will avoid the ED unless it's an absolute emergency or I can't get to a GP etc.
I over heard other in a public hospital (I drove myself there) who said they had been there for 5 hours…
Given that I hadn't urinated for >36 hours I was really worried. 2-3 mins later the stuck a pipe —- I'll spare you that part. Needless to say in an emergency public hospitals still work.
I forget the amount 3L or 5L apparently I should have been in super-dooper pain. (Normally holds 250ml)
Erk! That must have been agony trying to walk on a broken ankle! I was a bit luckier with my physio - he's the one who helped me get the ball rolling on getting it investigated privately.
Oh and during my only experience in ED, there were plenty of screaming children and babies in the waiting room and none of them were being triaged early and admitted. They won't send the child home or advise you to leave (liability issue…) but a lot of the families with screaming children left of their own accord during the 6 hours I was there.
Yep, you are right. The trick is to only mention your private health insurance if you are going to get a better deal, otherwise medicare is not free, so use it.
Thanks guys for the valuable comments. I really appreciate the enthusiasm of ozbargainers when it comes to sharing personal experiences!
If you're young, private health covers are usually cheaper. Also, if you're not earning above certain thresholds, you get a higher govt rebate - the highest is 30%, and that's if youre earning below 80k or thereabouts (not certain on exact figures).
Always good as a backup, in case something happens. I use mine mostly for optical and dental (ie extras)
If you're young, private health covers are usually cheaper.
Not true in Australia. The price is the same for everyone. They are actually cheaper for older people as they get more private health cover rebate.
They keep decreasing the threshold so unless you earn a small amount there is no rebate.
Eivad may be referring to the Lifetime Health Cover Loading - for people who take out health insurance after the age of 30 it is dearer due to this compulsory loading. You have to pay the loading for 10 years. It is in place to try and encourage people to take out private cover at a younger age and to hold it continuously.
I don't have private health cover but I have sufficient savings so I could pay for private treatment if needed. I have only had to do this once for my sons dental extraction day surgery in private hospital and I paid about $400 more than a friend who's son had the same procedure did after the "gaps" in her top cover.
I have had an operation under the public system with no waiting period - saw the specialist Monday got operation Wednesday (quicker than private because he operates private only on Friday). Whenever I have needed a specialist I have been lucky enough to have gotten the best under Medicare ( I have friends who are theatre nurses so they know who they would want treating them). I had the same obstetrician as my cousin who paid about a $1000 gap and I got a private room in public hospital for free.
I have been lucky but because I am a tightwad I know if my kids needed an operation I could afford to pay for it privately.
The important thing is if you save money on insurance make sure you actually save the savings.Sounds like that approach is working for you now. As long as you have plenty of thousands in savings for an emergency, then this can work.
btw - obstetrics isn't covered by any health insurer as it's an out of hospital consultation. It's also illegal for them to cover it anyway.
If it helps I was admitted to hospital for a month and racked up just under $50,000 (since I had been in hospital the month before I already paid my gap of $200) so it cost $0 - I was in no state to worry about finances then. I was told as long as the doc thinks I should be here they will cover me.
I was on my parents cover at the time, I've taken out my own because (in my case) it is likely to happen again.
When we were younger and healthier we opted out of private insurance for about 15 years and didnt need it. Now I am 55 and we have been in private hospital cover for some time. I have had 2 knee arthroscopies within a fortnight of consulting the doctor - was in a lot of pain, and the arthroscopy totally fixed my knee for the moment. I didnt pay anything. A colleague my age had the same thing and had to wait 18 months for the public system. I am very happy I didnt have to limp for 18 months longer (and cause all my body to get well out of whack). I am more than happy to go public, but that "elective" surgery can make a whole lot of difference to the quality of your life. I would say, don't have hospital cover if you are young - hospital visits are more likely to be urgent, but get cover before you start to wear out !
Agree with everyone here: public system takes far too long for common non life threatening problems (dodgy knees etc) - so I would never stop my health insurance.
Plus my wife likes the choice of doctor for having babies.It depends of how affordable it is for you. Private health isn't quite the same as travel insurance, house insurance etc. You will always be covered in the worst cases.
But… I maintain my private insurance because it enables me to avoid public waitlists for not urgent cases, and more personal attention from treating specialists. Those who say they can afford to cover things privately- you would have to be VERY well off to do this. My hospital would not let you through the door saying this, even if you could prove you had enough for the operation itself. What if you end up in ICU? What if you need rehab? What if you need further operations prior to discharge?
I think most people don't quite understand how much the government pays for routine stays in hospital and operations. They think that their private system fees cover a lot of it, but this is just not true. If we were truly private premiums would be 50-100 times what they currently cost (cf the USA).
It is true that as a private in a public hospital you get the same treating team etc, but the junior doctors, at the coalface, are much more likely and able to call the consultant as soon as anything goes wrong. On the public side they will umm and ahh for a while, and handball it up to a senior (also a junior doctor) whose quality is equally variable. Then they may call the consultant of the day, or your consultant…
If you can afford it, maintain some private hospital cover for the unexpected, not for the urgent. I really despair of those I meet in practice who have no private health and have non-urgent but life altering illnesses. Many have waited years in the public system and continually get bumped back, ending up on disability (i.e. shoulder/knee/many back and ortho procedures- all non-urgent)
If you can afford it just get it. Seriously around $60 a month for young adults for basic cover is bloody good.
Obviously if you are living on a tight budget, we have a pretty good thing going with medi-care.
But consider this: I had an ACL reconstruction through HBF and surgery itself costed all up:
- $100 (overnight in hospital)
- $20? (rental of crutches)
- Meds - Free (forgot if covered by insurance or they forgot to charge me)
This was done by a renowned surgeon who operates on footy players - years later when I go in to physios for other things or a sports doctor (to sort out other injuries) they always comment on how well the graft was done.
Without the insurance it would easily have costed many thousands of dollars and I would have unlikely to have gotten it.
Could I have lived without it ? Yes, but I would always be afraid of a weak knee and have something in the back of my mind for the rest of my life.
health insurance should just be a must if your income allows it, should come before any holidays or nice monthly dinners.
If you have kids, the family covers doesn't care how many kids you have either - and I would imagine if you have a kid you are less likely going to take the "eh probably nothing" route with their health.
What's ACL?
Anterior Cruciate Ligament, seems to be something that happens to some basketball players, incredibly painful apparently:
Medibank Private is good if you have a family - theres no excess for kids. We just have the basic hospital and extras. My daughter had to get her tonsils and adenoids out earlier this year, we were able to get scheduled into westmead private within a couple of weeks and it was a breeze. Ive gone the public hospital route with the kids as well, believe me it is worth the extra money to go private.
It depends how much you value pain and suffering. If you are on a public waiting list with pain and suffering does it outweigh the costs of private health insurance so you can get the job done and stop suffering and carry on with your life?.
We dropped it, never made claims.
I'm thinking of getting it again to help with kids braces, but it is really line ball on whether it is worth it.
Even if you get the 2% per year loading for being over 30yro later on, I still can't see it being worth while.
If you are older and have a lot of health issues it might make sense.