What Level of Heath Cover Are You on?

thegamerulez on 24/08/2022 - 10:06
Last edited 24/08/2022 - 10:21 by 1 other user

Hi All.
Partner and I are both in our mid-30s and we have a 1 year old. Currently we are just on the Basic Accident + Basic Extras cover & paying around $220 per month. We have been hearing a lot about increased pressure and wait-times on the public system with some elective wait-times even running into months. Therefore, wondering whether we should increase our cover to a higher tier? The max our budget would allow us is Silver or equivalent but unsure whether it's really worth the extra 100 odd dollars a month. Just to be clear, we do not have any pre-existing conditions. This is more a "risk mitigation" requirement.
Keen to hear what level of cover the rest of the community is on & whether it's worth upgrading to Bronze/Silver.

Cheers!

Edit - Typos

Poll Options

  • 19
    Basic
  • 13
    Basic + Extras
  • 3
    Bronze
  • 9
    Bronze + Extras
  • 4
    Silver
  • 39
    Silver + Extras
  • 11
    Gold
  • 38
    Gold + Extras
  • 4
    Ambulance Only
  • 57
    No Private Cover (Public System)
Health & Beauty Health Insurance Insurance

Comments

  • El cheepo on 24/08/2022 - 10:09
    +2

    If you can afford more cover and it will ease any anxiety you have about potential future issues why not pay for better cover?

    If an extra $50-100 a month will give you more peace of mind it’s a decent investment.

    Personally I’m happy to chance the public system.

    • thegamerulez on 24/08/2022 - 10:13

      I guess my worry is the insurer will play the "Ohh, but this ain't covered" card. I then end up paying higher premium and still am out of pocket anyway! Although I have had private insurance for the past 7 years (ever since I have come to Australia), thankfully, I have never needed to use it. So not quite sure if things can go pear-shaped when a claim is actually made.

      • El cheepo on 24/08/2022 - 11:04
        +1

        This is why it is very important to read and be sure you understand your PDS issued by your insurer.

        It will tell you what is and is not included etc.

      • reactor-au on 25/08/2022 - 08:00
        +1

        Well you should decide what level of cover you would like by looking at what is covered by each tier.
        Is much simpler than it was just a few years back since the gov had pushed to have the tiers and cover standardised.
        https://www.privatehealth.gov.au/dynamic/Search

  • coffeeinmyveins on 24/08/2022 - 10:10

    and wait-times on the public system with some elective wait-times even running into months.

    Well, do you plan on doing any elective stuff in the next few years?

    No-one can give you advice for your personal circumstances, everyone is different.

    I just have basic.

    • FranGC on 25/08/2022 - 09:38
      +1

      No one plans elective surgery- it’s not what it sounds like, it can be for items such as knee or hip replacement if you were unlucky enough to have a fall or accident. And I think you’ll find in most states the wait list is now in years not months, and that is not for the procedure required but just to see a specialist.

      • Jackson on 27/08/2022 - 09:24

        Mid 30s is still pretty young, prob doesn't need it

  • onetwothreefour on 24/08/2022 - 10:11
    +4

    Need an option for no cover

    • thegamerulez on 24/08/2022 - 10:15
      +1

      Ugh. Wonder how I missed that! Unable to edit the poll now :( Sorry about that!

      • Moderatorhamza23 on 24/08/2022 - 10:21

        I'll add it in. It will be at the bottom of the options, so the existing votes don't get skewed.

    • steven6 on 24/08/2022 - 10:25
      +1

      That's the OzBargain level of Health Cover

      • kiitos on 25/08/2022 - 09:48
        +3

        "Take two Eneloops and call me in the morning"

        • steven6 on 25/08/2022 - 10:20
          +1

          Thank you for the money saving tip. I took two Eneloops and this has reduced my living expenses to $0.

  • brendanm on 24/08/2022 - 10:12
    +9

    Zero. Paying the premium for private, then a gap anyway on anything you need, doesn't make sense to me. I've just had a procedure done, paid out of pocket to get it done privately, cost me less than what private cover and gap would be. Plus I didn't have to deal with anyone else but the specialist, paid and done, no mucking around.

    • thegamerulez on 24/08/2022 - 10:16

      This is what my worry is as well; that cover + gap will exceed the out of pocket cost anyway.
      Isn't it detrimental to not have private insurance from a tax perspective though?

      • brendanm on 24/08/2022 - 10:22
        +2

        I'm the same age as you, with 2 kids, probably similar (good overall) health. We paid out of pocket years ago for our son to have tonsils out privately as well, as public wait even just to see a specialist was ridiculous. We are still miles (miles and miles) in front compared to paying for private health this whole time.

        Isn't it detrimental to not have private insurance from a tax perspective though?

        Depends how much you earn, as you are a couple, your combined earning cap before paying Medicare levy surcharge is $180k or so. My partner works part time, so we don't hit this cap, so no surcharge for us. Your milage may vary.

        I hate that they make people buy these "junk" policies just to avoid the surcharge.

        • coffeeinmyveins on 24/08/2022 - 10:29
          +5

          I hate that they make people buy these "junk" policies just to avoid the surcharge.

          Yep! Wonder who pocketed when that happened. Government is literally subsidising private enterprises there. disgusting.

          • brendanm on 24/08/2022 - 10:47
            +2

            @coffeeinmyveins: Yep, it's not good at all. I think I'd rather just pay the surcharge than line the insurance companies pockets, at least it will go to Medicare (I would assume?).

        • thegamerulez on 24/08/2022 - 10:37

          you are right. From what I recollect, I think I was just about in the next tier and it made sense from a $ perspective to have the basic policy. My partner is part-time too now, so perhaps I need to revisit that calculation!

          • brendanm on 24/08/2022 - 10:48
            +1

            @thegamerulez: Should be pretty easy to calculate, and it's good not to give those rorting pricks any of your money.

    • O K on 25/08/2022 - 07:41
      +1

      Part of me agrees until you want to see a private specialist who won’t even look at you without private health. Orthopaedic surgeons are the worst for it. It feels like I’m forking out a fortune just for peace of mind.

  • Clear on 24/08/2022 - 10:33
    +3

    I was surprised to learn years ago that in some states you have to pay for an ambulance.

  • Drakesy on 24/08/2022 - 10:40
    +1

    The cheapest least pandering to the health lobbyists who are crying poor cover

    (Only have it to minimise tax.)
    The policy itself is pretty much trash.

    As much as i like medicare
    Subsidising the private health system is not high on my to do list.

  • Switchblade88 on 24/08/2022 - 10:41
    +3

    It all depends on your actual health expenses.

    We started with extras only, since the 85% reimbursements we were getting was well and truly more than the costs each month, and this was basically only for dental and massage. $90 a month for the policy netting easily $200 in saved out of pocket costs was an easy choice.

    Then, my wife needed a specialist procedure not available in the public system - which would cost us $30k out of pocket. We got Silver+ hospital cover just for her and waited the 12 months; and whilst this was still $2k of expenditure on the policy + $500 copayments etc it was still a saving of $25k just for one procedure.

    The problem we still face is there is many, many health things we have to pay for like non-PBS medication etc that isn't covered by Medicare nor the health funds - and there isn't any trimming the fat on a disability pension.

    • thegamerulez on 24/08/2022 - 10:46
      +1

      The problem we still face is there is many, many health things we have to pay for like non-PBS medication etc that isn't covered by Medicare nor the health funds - and there isn't any trimming the fat on a disability pension.

      Medical tourism is the only option then.. haha

      • Switchblade88 on 24/08/2022 - 10:56

        "Yes, officer, I know it's frowned upon to import cannabinoids… but it's so cheap!!"

        Jokes aside, a month of THC costs us over $250… Genetic opioid resistance is a bitch.

  • Ozymandias on 24/08/2022 - 10:58
    +2

    Extras only at the moment.

    • thegamerulez on 24/08/2022 - 10:59

      Interesting. Does it work out better for you? What level of extras are you on?

      • Ozymandias on 24/08/2022 - 11:04
        +2

        Definitely better - 28yo male, paying $320 a year and using up my optical/physio/dental allowances for ~$1200 of benefit, the package is Youth Extras with QLD Country. I think it's effectively their middle of the road cover but with a discount because of my age.
        I haven't had to go through the public system for hospital stuff yet but I'm inclined to trust it rather than pay a little extra for poor hospital cover or a lot more for usable hospital cover, or just pay out of pocket if/when the times comes. I'd probably concur with @brendanm above in that respect.

    • Member 0230 on 25/08/2022 - 11:18

      Likewise.

      OP, that's another poll option that may be worth asking a mod to retro-fit (but probably too late)?

  • Cheaplikethebird on 24/08/2022 - 10:59
    +6

    Worked for a PHI at one point and company wide meetings were always "we need to convince young people that PHI is a good deal so they can subsidise the 50+ year olds"

    • Drakesy on 24/08/2022 - 11:23
      +3

      And then they cried to the government and got what they wanted in the Private Health cover loading.

      Everyone loses (except pensioners).

  • macrocephalic on 24/08/2022 - 11:05

    None. My previous employer paid for it for 7 years, and while it was good to elect for a private hospital when my wife had our kids, there's not really any financial sense to keep it now. I barely used it, and when I did the things were only partially covered.

    When I changed jobs a little while ago my wife wanted to keep paying for it, then I showed her how much it cost, and we decided that we'll just use the public system and pay out of pocket or re-evaluate if we need something.

  • redfox1200 on 24/08/2022 - 11:36
    +2

    only the basic to save on tax

  • gustus on 24/08/2022 - 11:52
    +1

    I used to have no cover. But then I discover my elderly mom (who just migrated here) got hit with a 70% (I think? its been awhile) loading on top of the fees due to her never having a private cover in Australia. Combined with Covid crisis and its possible reported long term side effects, I decided to take the Silver + extra earlier this year to avoid the higher fees in the future and to have an ease of mind. Thought I properly would not use the it much, just to have myself got admitted into emergency a few months later. My company also has a corporate discount so I get to pay a much lesser fees too. OP, if you decide to upgrade, look into it.

    • Drakesy on 24/08/2022 - 12:00
      +3

      Emergency is covered by medicare already.
      Private health just allows the hospital to recover costs through them.

      Either way you would've already paid for it in your medicare levy.

      • FranGC on 25/08/2022 - 10:16

        Technically correct, but in ph you are usually seen within 30 minutes in emergency as opposed to 6+ hours in public. You also receive around half back from Medicare.

        • Drakesy on 25/08/2022 - 10:19

          Source?
          Everytime I've been to emergency I've been seen to in less than an hour

          • FranGC on 26/08/2022 - 22:19

            @Drakesy: Wow, I don’t know where you live, but on the Gold Coast, every time I have been in the public emergency wait was between 6-8 hours. But in saying that, our population has dramatically increased since Covid lockdowns mostly from fed up Victorians.

            • Drakesy on 26/08/2022 - 22:29

              @FranGC: Doesn't really sound like emergency then
              What were you brought in for

              • FranGC on 28/08/2022 - 09:08

                @Drakesy: Several times, several reasons
                Child bitten on face by dog
                Kidney Stones
                Suicidal teenager

                All over 6 hours wait

  • screensaver on 24/08/2022 - 12:20

    Theres another level, bronze plus, which I am in. I am paying a 18% loading for another seven years. I still pay only less than 100 a month

    • FranGC on 25/08/2022 - 09:48

      That’s what people need to be aware of - if you join ph after 30 years of age, your premium increases 2% each year over that age. And if you decide to join say at 50 when problems usually start occurring, you’ll pay 40% extra until you’ve held continuous ph for ten years, at which pint it goes back to the price it would be at 30 years old.

  • AustriaBargain on 24/08/2022 - 12:38

    If it helps you avoid state health service, it's worth ti.

    • Drakesy on 24/08/2022 - 12:54
      +1

      You'd be surprised.
      Financially, many cases you'd be ahead by not taking it out.
      Only thing is the Private Health Cover loading which is it's only redeeming feature.

  • Kaz0551 on 24/08/2022 - 12:57
    +3

    If you are disciplined enough,

    Reduce your plan to hospital only, circa 80-120/month and transfer the difference to a savings account… offset… whatever. IF/WHEN you need dental or optical use those funds. IF/WHEN your kid needs braces down the track you should have THOUNSANDS available instead of the pittance private health will give you.

    • thegamerulez on 24/08/2022 - 13:38

      Makes a lot of sense when you get a long-termish view. Thanks

    • macrocephalic on 24/08/2022 - 14:57

      $80-120/mo isn't very realistic for family cover.

      • thegamerulez on 24/08/2022 - 19:30

        It comes to $150..not too far off I guess

    • Benoffie on 24/08/2022 - 20:25

      Completely agree. We got a better deal on orthodontics by paying cash than going through extras.

  • screensaver on 24/08/2022 - 19:21

    I just got a free $200 woirth of premium using the Livebetter app

  • thegamerulez on 24/08/2022 - 19:31

    Not sure if the gold+extras voters are genuine or trolls.. Haha..
    All comments seem to median more towards no or minimal cover.

  • Benoffie on 24/08/2022 - 20:23
    +2

    We dumped extras years ago, pay cash and upped our coverage to Gold.

    Best decision we ever made. Save min $1300+ a year (not including gap payments).

    • rowanb1 on 25/08/2022 - 12:41
      +1

      I did the same a few years ago. Extras wasn't worth it and the basic hospital cover has a lot of exceptions. I'd rather have maximum hospital coverage just in case and pay for extras out of my own pocket.

  • Sunshines bright on 25/08/2022 - 08:08

    I only have it now for a future procedure not covered in the public sector. Once it over will cancel as I feel it is not necessary to pay when chances are I will never use it.

  • thrillhouse on 25/08/2022 - 08:10

    "Corporate 80 Extras" by Bupa provided by employer. Honestly I would never have thought twice about bothering, but it has been pretty damn great with dental and optical.

  • Stoozer on 25/08/2022 - 08:38

    $133.85 per fortnight
    Mid Hosp Silvp 250
    Hcf Vital Extras

    Easily recover the $3480 cost each year from claims.

    • Drakesy on 25/08/2022 - 10:02

      Geez what are you using it on!?

      • Stoozer on 25/08/2022 - 21:16

        Lots of dependants on card

  • FranGC on 25/08/2022 - 09:58

    Would probably look around at bronze or silver cover, depending upon your health requirements and what they cover. You can always increase your level of cover as you age, but be aware that any increase from one level to another requires a 12 month waiting period. I was on what would now be classed as a silver level, but had to increase it to gold in my 40s to cover chronic pain treatments and neurosurgery due to a bulging disc. The cost (around 6000 per annum) have been far outweighed by the return over $30,00 most years and recently $70,000 which there is no way at our stage of life (50s and 60s) we could afford to save for.

  • SlavOz on 25/08/2022 - 20:13

    Does private health cover make a difference in emergencies? People keep telling me to take it out as I have a sporadic condition which causes unpredictable ER visits, but I've never seen the value in it. Might you get a bed quicker in a nice room but in terms of actual treatment time, doesn't seem any different.

    I'm happy to pay for everything I need through Medicare, don't see the value in paying again.

    • thegamerulez on 26/08/2022 - 12:02
      +2

      I asked this to a Medibank rep. I asked her what happens if there's a sudden heart incident for example requiring emergency assistance. She said by default, the ambulance will take you to a public hospital.
      After you are "out of danger" per se, you can then decide if you want to go with your own doctor, move to your personal room in a private hospital etc.
      Not sure if that's what you are asking but hopefully this helps.

      • SlavOz on 26/08/2022 - 14:41

        Yeah, that's what I meant. Thanks for confirming.

        I'm fortunate enough that my specialist works within the local hospital. So any time I'm there, they let him know and he comes around to see me occasionally (and sets up a priority appointment in his rooms).

        Can't underestimate how important it is to find a consistent doctor who's passionate and well respected. Don't just settle for whoever your GP or hospital refers you to.

    • rowanb1 on 26/08/2022 - 13:30

      Doesn't cover emergency treatment in a private hospital, you have to pay everything out of pocket. For a real emergency I would be going to a public hospital unless there was a crazy wait time.

      • SlavOz on 26/08/2022 - 16:32
        +2

        Public hospitals always have crazy wait times. People are selfish with their visits. Whenever I'm there, I need to be rushed in, someone usually carrying me because the pain is untenable. On a good day I'll pass out from the pain ans wake up in a hospital bed because the nurses took one look at me and called it in.

        Other times I'm waiting for triage, crying out in pain, while I see people there sitting comfortably, legs crossed, smiling at the TV, getting something from the vending machine. I get the urge to ask them "are you really concerned for your wellbeing at this very moment?" The E stands for Emergency - ie urgent cases of life or death.

        • [Deactivated] on 26/08/2022 - 17:37

          I had a case where I was rushed to emergency and provided urgent medication and was asked to remain in waiting room so they could monitor as they had other cases they could prioritise. They monitored every 15 minutes (credit to them) and then when it got a tad quieter admitted me.

          I used to judge people as you do in your commentary, so it was a good lesson for me to experience what I did. I don’t judge people in emergency anymore because that could’ve been me you saw in relative comfort.

          • SlavOz on 26/08/2022 - 23:23

            @[Deactivated]: Individual cases aside, at least 1 in 3 ER visits are not emergencies, so it's not just a personal observation. People visiting the ER for trivial reasons is a serious and widespread issue.

            • [Deactivated] on 27/08/2022 - 09:19

              @SlavOz: Assuming you are right, at 2 am in the morning, someone that desperately needs medical attention but its not classified as an ‘emergency’ where should they go?

              • SlavOz on 27/08/2022 - 09:20

                @[Deactivated]:

                desperately needs medical attention

                Isn't that an emergency?

                • [Deactivated] on 27/08/2022 - 09:21

                  @SlavOz: I don’t know what you consider an emergency.

                  • SlavOz on 27/08/2022 - 09:31

                    @[Deactivated]: I guess it's hard to set a clear line, but it's not that hard to expect people to have some common sense.

                    If you're experiencing sudden, unexplained and severe pain, it's probably an emergency. Your body should not be reacting that way. Something is clearly wrong. This is especially true if you can't pinpoint or see the source of the pain.

                    Suddenly noticed a rash on your back? You'll be fine until the morning when your GP opens. Generally, most infections or inflammation go away after 3 days. If they don't, make an appointment with the doctor.

                    It's actually quite common for people to use the hospital as an after hours GP or 24-hour service to pick up your X ray results.

                    • [Deactivated] on 27/08/2022 - 10:20
                      +1

                      @SlavOz: I thought I’d take a quick look at the figures because I didn’t feel like what you were saying was accurate.

                      In Australia in 20-21 only 10% of emergency presentations were classified as non urgent.

                      I don’t think it’s that big of a problem. Especially I’d say in regional areas where sometimes the only option is a hospital because of the lack of GPs.

                      • rowanb1 on 27/08/2022 - 11:11

                        @[Deactivated]: There's tv ads all the time in SA about emergency dept being only for emergencies, so it must be a problem to some degree

                        • [Deactivated] on 27/08/2022 - 11:43
                          +3

                          @rowanb1: Of course. That’s understandable the goal is to get that 10% down as much as possible. But it’s not 30%. And sometimes the issues are far more than selfishness or lack of common sense like the other OzBargainer tried to suggest. Sometimes the issue is access to GPs or health providers.

                          And I’ll never criticise a parent for erring on the side of caution, particularly with babies/toddlers.

    • [Deactivated] on 26/08/2022 - 14:53

      Emergency is provided by the Government at no cost to you. No need for private to get treatment.

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