What are the advantages of private health insurance?

SlavOz on 23/01/2021 - 22:09

I've had more health problems than I can count but thankfully Australia's public healthcare system is pretty good, even with so many people abusing it (seeing the ER even though it's not an emergency).

I've had 3 surgeries in my 20s - all managed to get done within a few weeks of seeing my specialist. If I'm ever particularly worried or experiencing quality of life issues, the doctors have ways been happy to bump me forward. From my understanding from close relationships with doctors, they are always eager to prioritise young people because there is less chance of complications (which means less paperwork/potential guilt for them).

I've even had situations where I offered to go to a private hospital at my own expense…doctor told me not to bother since some procedures can't even be done at a private hospital.

So for $2k a year, what exactly is the benefit of health insurance? Is it just shorter wait times and your own room in a private hospital? Doesn't seem particularly worth it to me right now but .y opinion will definitely change when I'm older.

Health & Beauty Health Insurance Insurance

Comments

  • Hybroid on 23/01/2021 - 22:12
    +2

    Could have saved yourself the type-up with a basic search: https://www.canstar.com.au/health-insurance/public-versus-pr…

    • gomelbcityfc on 23/01/2021 - 22:40

      Do not rely on Canstar or Choice or other similar "comparison" sites. They both feature sponsored ads. I spent 3 months researchingbefore finally dumping my private health insurance

      Best $3000/yr I ever spent ;)

  • elgrande on 23/01/2021 - 22:22
    +1

    You get a TV in a public hospital.

    • Muzeeb on 23/01/2021 - 23:49
      +4

      For $27/day out of pocket

  • gomelbcityfc on 23/01/2021 - 22:36
    +3

    Nothing! Australias health care system is excellent

  • poldy on 23/01/2021 - 22:37
    +3

    A lighter wallet.

  • AustriaBargain on 23/01/2021 - 22:42
    +3

    The staff at the private clinics and hospitals tend to be more attractive.

    • SlavOz on 24/01/2021 - 12:37
      +1

      Go on.

  • dufflover on 23/01/2021 - 22:44
    +4

    You don't have to pay the stupid taxes for 30+ year olds.

    • Succulent on 23/01/2021 - 23:05

      This!

      So for me, i just get a basic bare minimum hospital cover with no intention of using it ever. Because the MLS (Medicare Levy Surcharge) when you are doing your tax return (If you are over 30 years old and over certain income threshold) could be more than what you would pay for a basic hospital cover.

      • conan2000 on 23/01/2021 - 23:39
        +1

        Don't forget the lifetime loadings if you don't have it for a period of time as well!

        • Succulent on 24/01/2021 - 10:55

          Yep, my wife missed having the private hospital cover for one month when she was over 30. And when she resumed the private insurance a month later, she need to pay LHC an additional 2% on the premium. The rate is 2% per year up to 70%.

          Extract from ATO website below:
          If you have not taken out and maintained private patient hospital cover from the year you turn 31, you will pay a 2% LHC loading on top of your premium for every year you are aged over 30, if you decide to take out hospital cover later in life. For example, if you take out private patient hospital cover when you are 40 years old, you could pay an extra 20% on the cost of this cover per year for 10 years. If you wait until you are 50 years old, you could pay 40% more per year for 10 years. The maximum LHC loading that can be applied is 70%. Once you have paid LHC loading for 10 years of continuous cover, you will no longer have to pay this loading.

          • md333 on 25/01/2021 - 00:48

            @Succulent: The problem is she only missed a month. If you skip it for a couple of years you save enough to cover the lifetime loading if you decide to take it up again later.

            • Succulent on 25/01/2021 - 02:38

              @md333: Yep good point, it can work out that way too..

              Those one month were unintentional as she was moving jobs and the corporate cover from prev company were stopped. But by missing one month, that one month premium pretty much covers for 10 years of 2% LHC in our scenario, so it ends up okay.

      • Succulent on 24/01/2021 - 00:49
        +1

        What happened?

        According to example on below link
        ATO MLS

        For earning $110k you would pay MLS for $1,375

        In your example above, if someone earned $480k and did not have appropriate level of private insurance, their MLS charge during taxation would be estimated around $9.6k

        Who is earning the $480k by the way?

        • This Guy on 24/01/2021 - 10:32
          -4

          You are telling me that 35 year old Josh, who pulls in $117k, is single?

          I did not notice this tax is a percent off all taxable income and not bracketed like income tax.

          You would still need to earn $200,000 as a single or $240,000 as a family to pay more tax than a cheap insurance plan.

          At that income level you should really be looking at more cost effective government incentives to reduce income tax.

          • Succulent on 24/01/2021 - 11:24

            @This Guy:

            You are telling me that 35 year old Josh, who pulls in $117k, is single?

            I told you no such things. Lies, it is all lies…. But yeah I would assume there would be some single out there earning $117k or more. Why do we even come into this "someone would/wouldnt be single at certain income" discussion by the way?

            You would still need to earn $200,000 as a single or $240,000 as a family to pay more tax than a cheap insurance plan.

            The bracket start at $90k for single and $180k as a family according to ATO website.
            So as a single earning $91k that person will need to pay MLS at around $910. If you do a quote with BUPA today for accident hospital cover, it will be quoted around $868.70 annually. So you are saving around $41.30 annually by going with private insurance in this scenario, than paying MLS. You might say that someone earning $91k wouldnt be bothered to save $41.30k per year. As an ozbargainer i respectfully and personally disagree. That worth around 10 Free Coffee + 1 Free one (if you use loyalty card).

            At that income level you should really be looking at more cost effective government incentives to reduce income tax

            Can you give us examples, I want to learn more. Any advice to increase my wealth without the "additional risk of losing a portion of them" is welcomed. :) If you are telling me putting into investment such as shares, that is considered as "an additional risk of losing a portion of the wealth".

            • This Guy on 24/01/2021 - 20:07

              @Succulent: I think I need a better accountant and you need a better financial advisor.

      • lubos on 24/01/2021 - 10:19
        +1

        Where do I start. It's not 1% above the treshhold. Once you hit the treshhold, you pay MLS on your entire taxable income.

        The cheapest hospital cover is just over $1000 per year which means once you hit $90k annually, you better get private health cover to avoid MLS.

        Paying MLS gives you no benefits whatsoever.

  • kawinuyo on 23/01/2021 - 22:45
    +3

    Choice of doctor doing the surgery, lower waiting times on surgeries that aren't considered "urgent".

  • SydStrand on 23/01/2021 - 23:07
    -5

    I can count but thankfully Australia's public healthcare system is pretty good, even with so many people abusing it (seeing the ER even though it's not an emergency).

    Sod off with this tired ER nonsense. People are allowed to go to the ER; it's up to trained staff to determine the urgency of their condition, not you. If you had a genuine emergency, no one else in the lobby will affect your wait time one iota. And 'abusing?' Seriously? For someone who's apparently had several major surgeries through the public system, you're definitely getting more out of the pot than most people put in, including the bloke you're chastising for visiting the ER for an allegedly non-critical condition.

    So for $2k a year, what exactly is the benefit of health insurance?

    Hospital and ambulance cover, shorter wait times for elective procedures, doctor of your choice, a softer bed.

    • [Deactivated] on 24/01/2021 - 05:52
      +3

      Huge numbers of filthy bogans waddle in to the ER or 24 hour bulk billing doctors because they were too busy playing pokies or shoplifting during business hours.

      The people complaining are the ones who lack the self-awareness to realise they are the problem.

      • Headless on 24/01/2021 - 10:13
        +1

        lol, so true - my nearest had to remove the $1 coffee machine because they kept thowing their hot drinks at each other…and the poor souls who actually needed emergency care or the staff who were there to help them

    • Chandler on 24/01/2021 - 09:22

      ambulance cover

      Depends on your state of residence AND the state you used the ambulance in. Suffice to say - it's complicated (unless you're a Queensland resident). Probably why private health insurer's like to try and capitalise on ambulance cover.

      State Service Links
      QLD Queensland Ambulance Service Residents IN QLD, Residents OUT of QLD, Visitors TO QLD
      NSW NSW Ambulance Rates, Residents, Visitors
      ACT ACT Emergency Services Agency Fees
      VIC Ambulance Victoria Fees
      TAS Ambulance Tasmania Fees
      NT St John Ambulance Cover
      SA SA Ambulance Service Cover
      WA St John Ambulance Perth Rates, Country WA
    • SlavOz on 24/01/2021 - 12:47
      -1

      If you had a genuine emergency, no one else in the lobby will affect your wait time

      That's not true. If 50 people rock up to the ER, that means 49 people will need to be seen by a nurse and examined before the person with an actual life-threatening emergency can get assessed.

      Each triage probably takes 2 minutes at the least. 2 minutes × 49 people = 98 minutes waiting until your pounding heart is assessed and determined to be a cardiac arrest.

  • funnysht on 23/01/2021 - 23:26
    +2

    depends…if you're active fit do climbing etc risk of ligament injuries etc then yea i reckon . You don't want to be walking around with a ligament injury waiting for an OT..or hernia etc

    all depends on your risk profile

  • AustriaBargain on 23/01/2021 - 23:35

    I would also say that based on what I've seen, you should never truly trust the public health system. If a health department thinks they can cover up a mistake, they will try. Same with private clinics. Don't assume just because the health system is liable to state standards or a private practice is liable that they will rush to inform you of their suspected mistakes and liability. If it was true that we could trust the state or private practices then we shouldn't have so many scandals. The sheer number of elderly scandals from state to private centers alike should alone be enough to make you realise health "professionals" don't truly give a damn at the end of the day, and that mistakes can go on for years before the whistle is blown, if it is ever blown.

  • Muzeeb on 23/01/2021 - 23:52

    Subsidised hospital patients car parking but only if you have a manual V8 Mustang that never revs above 3k rpm.

  • OldBugger on 24/01/2021 - 01:27
    +8

    I was a big advocate of the public system, I still am somewhat. I even started a popular thread about it which supported my thoughts.

    I suggested that if you needed urgent treatment, you can get it with the public system. If it's non urgent, you can just pay upfront. I believed in self insurance.

    But I've found a slight flaw in my thinking. I broke my clavicle in a nastier than usual spot late last year. At emergency they booked me into public orthopedics which was in 2 weeks. They suggested leave it to heal on its own. The next day I saw a private orthopedic for advice who recommended surgery with such a break and could operate the next day. They gave me all the fees and was happy to treat me.

    So now I had two different opinions. I saw my GP who recommended me to see a third opinion. The problem was, I could not get in to see another specialist as no one would take on a non-insured patient. My GP was surprised but said this is a recent change with many specialists.

    I kept trying and did manage to get into see one. I must have slipped under the radar of the receptionist as upon seeing the specialist, he was totally standoffish and recommended I keep on the public orthopedics list. Upon asking why, he openly stated that there is a risk with any surgery. And that if something was to go wrong and, for example, I had to be treated in private ICU, the costs go up to an unknown amount beyond the initial cost of the operation. And this is partly why many surgeons won't treat an un-insured patient.

    So the whole journey has been a little stressful and a real eye opener. It's not about having the money to pay outright as I thought, but the fact that many private specialists won't take you on without insurance. Not even for advice. And I think when you require hospitalisation, you want to shop around. If not for picking the best surgeon, but to simply get a different opinion.

    On saying that, I'm getting on in my age and am definitely ahead in terms of finance by not having insurance. I've used the public emergency departments and would still go there over any private emergency. Public hospitals have the best specialists (most also work in their own private clinic). I've paid outright for private specialists in the past for simple procedures such as endoscopy. Not a problem.

    But, I now have private health. I don't want to be in that same position I was in recently. I can't help you in your position but my tips are if going ahead:

    • shop around and get in on the sign up deals going around (eg. $400 off HCF, 2 month free with Medibank) and just keep changing as soon as the discount comes in. Kind of like credit card sign up points.
    • if you do decide to get insurance when you are an old bugger like me, get a partner who is much younger than yourself, under 31 if possible. They average out the life time loading. Plus, such a partner keeps you young too 😜

    Good luck!

    • SlavOz on 24/01/2021 - 12:52
      +1

      This post…I swear this why I pay to have wifi at home. Thank you!

    • YesPleaseThankYou on 24/01/2021 - 15:16
      +1

      Great post — all of it!

      As for this part:

      shop around and get in on the sign up deals going around (eg. $400 off HCF, 2 month free with Medibank) and just keep changing as soon as the discount comes in. Kind of like credit card sign up points

      I started doing this last year — I don't know why I didn't do this earlier.

      Anyway, I have just calculated savings over the last twelve months. I have saved a fraction under 60% off my premiums by following the offers. The effort involved, in my opinion, is well worth the savings!

      • lainey13 on 25/01/2021 - 15:33

        What about procedures that have 12 month waiting periods? If you're switching all the time you can never complete a 12 month waiting period which leaves you out of cover for some things.

        • YesPleaseThankYou on 25/01/2021 - 15:37

          By law, the funds are required to recognise waiting periods already served for hospital cover.

          They are not required to do so for extras cover, but every single fund I have seen does recognise the extras waiting periods already served. I guess that this is done due to competitive pressure (and for consistency with the hospital waiting periods).

          In summary, you do not have to re-serve waiting periods already served—they follow you around.

          • lainey13 on 25/01/2021 - 15:40

            @YesPleaseThankYou: But any break in cover will result in having to reserve the 12 months again yeah?

            • YesPleaseThankYou on 25/01/2021 - 15:43

              @lainey13: (We replied at around the same time. See my reply below.)

              Funds address the allowed gap in cover on their websites and within fund rules.

          • YesPleaseThankYou on 25/01/2021 - 15:41
            +1

            @YesPleaseThankYou: See this brochure from the Private Health Insurance Ombudsman: https://www.ombudsman.gov.au/__data/assets/pdf_file/0017/356…

            If you transfer from one health insurer to another without a break in cover, you do not need to re-serve hospital waiting periods you have previously completed. However, if you are adding or upgrading your hospital cover, you do need to complete waiting periods for the new or upgraded items.

            Most funds I have seen allow a 30-day break in cover without having to re-serve the waiting periods. I guess this allows for any gap when transferring funds.

            I always end my membership on one day and start the new one on the following day (no gap and no overlap).

  • Clear on 24/01/2021 - 01:36

    It has been beneficial for me before. Emergency hospital surgery was done with private surgeons as the public ones have a bit of a bad record and serious ramping issues, as well as the extra care I needed from recovery. Private health also covered 100% of $3k emergency eye surgery I needed and the consultations. The only expensive for both of them was medication prescriptions.

  • screensaver on 24/01/2021 - 08:41

    Theres perfevtly good cover available for 20 or under per week. Covers a lot.

    • mskeggs on 24/01/2021 - 12:55

      This is vastly different to my experience, where the basic price insurances cover almost nothing, and often only provide that cover in a public hospital anyway.

      • screensaver on 24/01/2021 - 13:00
        -1

        well not in my expereice, I familiarised myself with most of the funds and policies and found several that are good value, around 20 a week, covering lots. I regulary switch to get sign up bonuses so I am getting to know them all.

  • pharkurnell on 24/01/2021 - 10:13

    Public is awesome until you need it.. after spending 6+ mths and over 50 ops after a hit and run, I'm glad I had private.

    My old man had a stint in hospital, the bill was nearly 6 figures…. private paid, nice comfy room on his own, TV, food you can actually taste and want to eat…

    YMMV

  • ajca256 on 24/01/2021 - 15:18

    In addition to being able to use private hospital (reduce waiting time etc) and to avoid medicare levy …

    List of what's not covered by Medicare: https://www.privatehealth.gov.au/health_insurance/what_is_co… - the one that stands out to me is "ambulance services"

    Also use the above gov website for comparison, not websites that have vested interests i.e. most comparison sites.

  • cassidy02 on 24/01/2021 - 19:12
    +2

    From my personal experience, here's a few examples of private (which I have) vs public:

    1. I found a lump in my breast, was determined to be benign, but I was on an operating table within 3 days to have it removed. My mum's friend had a lump, was cancerous, had to wait 3 months through public to get it removed.

    2. Gallbladder removal; again, in within 2 weeks. Treated amazing. They not only let my husband stay the night with me, they bought him a bed in.

    3. Stroke: after going public for all the aftercare, I loved everything to private and never looked back. No more waiting around for hours in hospital waiting to be seen.

    These are just my experiences, but its definitely been worth it in my opinion.

    • SlavOz on 25/01/2021 - 20:15

      I had gallbladder out a few years ago too. As soon as the surgeon was convinced I had stones, he booked me to have surgery within 5 days through the public hospital.

      It was done at a rather low-class area hospital so I will admit the recovery period sucked. Cramped rooms, too many OD junkies being aggressive, and they basically pushed me out the door the next day to make room for new patients. Whatever, can't expect 5 star room service when it comes to hospitals. They fixed me up pretty good though, surgery was done excellently even under complicated conditions.

      I guess in the end it's more about the experience. If you just want essential treatment, then public seems good enough. If you want to feel special with nice room service while getting treated, you need private cover.

  • Hugh G Rection on 30/01/2021 - 07:53

    you don't have to wait 6 months to see a specialist.
    you also get a lot of other benefits that are a great value and pay the insurance off if you actually use them all.

    • YesPleaseThankYou on 30/01/2021 - 14:21

      Whilst the above is generally true, some specialists won't see you unless you have private health insurance.

  • Stinge Master on 03/02/2021 - 09:00

    Put it this way. My appendix burst and I went to the public ER, after about 12+ hours of waiting they said they should be able to operate within 3 days. Yes 3 days… So I said screw that and basically walked over to the private hospital next door where they had me sorted and operated on within about 4 hours of arriving. Plus my own private room and bathroom for the night. It was all covered in my health insurance.

    • beesider on 19/02/2021 - 10:53

      But you had to pay the excess, hadn't you? Last time I had a surgery through health insurance I had to pay the excess 3 times - to the hospital, to the surgeon, and to the anesthetist.

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