Private Health Funds experiences

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  hellothankyou on 09/07/2012 - 14:58

  You need to look for a dentist who will waive Gap fees. I have never paid gap with mine.

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  jennkei on 09/07/2012 - 15:10

  I've been with Medibank for a few years now. Probably going to be switching to something cheaper.

  Yeah, I never paid gap at the dentist either. Except for the extraction of my wisdom teeth…which wasn't nearly subsidised enough, haha. But I can't remember the last time I got a cavity so..

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  marcusv on 09/07/2012 - 16:00

  I am with Australian Unity and have never had to pay any gap for dental.

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  hb40 on 09/07/2012 - 16:44

  Ok, I should have mentioned the dentist is dspa.. a little pricey :)

  The point being that HCF seem to have a higher payout in my experience than Australian Unity. They were also cheaper on the monthly fee side of things. I can't comment other providers. I've heard the same from a couple of people now.

  It would be interesting to see how they compare with Medibank. There are always so many factors (wait periods, rules) that make it hard to compare exactly apples for apples.

  Cheers
  dealsminder.com

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  rack on 09/07/2012 - 18:02

  I have also been looking at health insurance and this thread is very helpful. I am looking at getting extras cover only. I trust the government when it comes to hospital lol. Would love gap free dental scale, clean checkup maybe every six months.

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  DeWalt on 09/07/2012 - 18:24

  +1

  I also recently changed to HCF - their rebates are way, way, way better than my previous provider - and i'm paying far, far, far less monthly fees. I also get rebate on my kids swimming lessons, unlike my last "expensive" health provider!!

  If you're an RAA member, you get an extra 10% off HCF membership!!!!

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  hb40 on 09/07/2012 - 22:10

  DeWalts now we're talking!

  What's RAA and how does the swimming lessons rebate work? :)

  Also who was your previous health provider? this might help others find a better deal.

  Thanks
  DealsMinder.com

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  Geewhizz on 10/07/2012 - 06:33

  On the subject of health funds, is it common for them to NOT cover anything on which medicare gives any sort of rebate?

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  tss on 10/07/2012 - 07:25

  If you are a member of the Defence Force, work for a Defence related company or Government Department (or if you are related to a Defence member), then I recommend you look at Defence Health: http://www.defencehealth.com.au/ as their cover seems quite good with slightly better limits and at the same price (comparable to HCF from what I could see - at least for my situation - Family with kids).

  Might be worth a look …

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  hb40 on 10/07/2012 - 10:20

  Geewhizz,

  I tried to do some research on your question online and from what I can tell it really depends on the treatment.

  Here is an example from a HCF FAQs:

  "The Pharmaceutical Benefits Scheme (PBS) is a Government scheme which helps pay for pharmaceutical items. Non-PBS drugs are those that are not listed under the scheme.

  If your doctor prescribes drugs that are not covered by the PBS but are approved by the Therapeutic Goods Administration (TGA) and are on the HCF approved list, you can claim a benefit for the difference between the actual cost of the item and the maximum PBS specified charge where you have extras cover. Where you are covered, HCF will pay up to the cost in excess of the current PBS fee for all HCF approved non-PBS drugs."

  I have to agree it's a little confusing to know when to pull out your private health cover card and when to pull out your medicare card, and when you can use both together!

  thanks
  DealsMinder.com

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    Geewhizz on 10/07/2012 - 17:26

    Thanks for that. We've recently taken out private health insurance, and it just seems strange to me that if medicare pays even a miniscule rebate for a service, then the fund pays nothing. I wasn't sure whether this is an accross the board policy, or just specific to the particular fund.

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    Doey21 on 11/07/2012 - 00:48

    There are certain exclusions for certain funds. Each fund has their own policy, so you should ask them yourself dependent on what drug you take.

    For eg 1, Lipitor (atorvastatin) - Government subsidised for everyone - No healthfund will cover this.
    eg 2 an anti-epileptic drug used for neuropathic pain - Subsidised ONLY for treatment of epilepsy. So if you're using it for neuropathic pain, you'll have to shell out the full price. However since it is subsidised for epilepsy, some health funds will claim that it is government subsidised and this drug will appear on the exclusions list. Other health funds may decide that they will allow it and have a different exclusions list

    I am currently on a drug that fits under example 2. BUPA would not cover it but NIB would. However their monthly fees are a lot higher - So you should call around if you happen to fit into this category.

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      Geewhizz on 13/07/2012 - 07:28

      I personally don't take any drugs at the moment, so it's not so much PBS that I was asking about. It seems strange to me that we're paying $360 a month for health insurance, but anything over the $30ish medicare refund for the doctor's visit, for instance, we have to wear ourselves.

      As an aside, anyone who might have once taken up health insurance when they bought in lifetime health cover but has let it lapse (like we did,) don't automatically assume that you have to pay all of the loading depending on your age. Hubby recently joined us up again and had forgotten that we'd originally had cover (for about a year or so) so we're paying a 40 per cent loading. I found the calculator on the Govt site yesterday, and that single year of membership we had early on takes it back down to 19 per cent. Woo Hoo! Now we just have to remember which company it was, and hope they still have the records from then.

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  SirFlibbled on 13/07/2012 - 14:10

  I would warn you against NIB. I joined them and 9 months later by complete coincidence I ended up in hospital for 4 months. NIB refused to cover me as they claimed it was pre-existing even though for 3 of those months I was not diagnosed and my doctors and specialists all wrote to NIB telling them this. Long story short I spent 4 months in a public hospital waiting for procedures I could have had quicker if I was in a private hospital and was essentially baby sitting 3 90+ year old men who were all incontinent and smelt like it.

  Thanks NIB!!!

  I'm now with Defence Health.

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  hb40 on 30/07/2012 - 14:50

  A quick update on HCF.

  They rang me 2 months after we switched to them to check how we were going with their private health cover!

  It was a pleant surprise to have them call out of the blue with no alterior motive.

  It was good timing as I wanted to know how the HCF swimming lessons rebate works. As it turns out, on our family plan we get $300 per year for the family ($150 max per person) to spend on Health Management services (swimming lessons for kids, gym membership etc). For the swimming lessons rebate they just need a receipt (back dated or otherwise). He confirmed over the phone that our swimming centre was listed with them, so it was all straight forward it seems.

  So so far HCF is still looking like good value for money and the service is above average compared to AusUnity.

  cheers
  DealsMinder.com

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  [Deactivated] on 30/07/2012 - 22:25

  Medibank have terrible customer service. Each time you call you get a different answer on what you can/can't claim and the amount covered.

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  Brooklyn99 on 31/07/2012 - 00:04

  I was with MBF on a corporate account and they were pretty good until they merged into BUPA.

  Just went for a Gastroscopy today and was told that I need to pay $65 co-payment on top of my $250 excess even though my health cover has stated that I have NO co-payment.

  Contacted BUPA and was on hold for 15mins before speaking to someone whereas with MBF, I get a agent instantly everytime I contacted them as a corporate customer.

  Enquired with BUPA regarding the $65 co-payment and was told that it was the hospital charging the co-payment because they have no agreement with BUPA. I then asked what has that got to do with me because I paid monthly for NO co-payment and on my health cover is stated NO co-payment hence BUPA should be covering the cost. But BUPA refused and kept insisting that this is the hospital's policy and BUPA is not charging me any co-payment.

  So I told BUPA that I will be leave and join another health insurance if that is the case and his response was: "I wish you would reconsider but if that is your decision, it is entirely up to you"

  So since they do not want my business, I'll start looking for another Health provider and HCF sounds decent.

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  POWERevolution on 31/07/2012 - 00:20

  HCF Young singles Multicover $60.20 per month (with 30% rebate)

  I can't find option for basic cover or they don't have this option?
  I'm looking for around $30/months with basic, ie. optical, dental, travel vaccinations & waive 2 month waiting period
  Any good one out there beside HCF?

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    Geewhizz on 31/07/2012 - 14:10

    For $30 a month? Good luch with that. If you do find somewhere that will give you that for the price, please share the info

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      POWERevolution on 31/07/2012 - 21:13

      As I said I don't need multicover, I just need few basic one
      Found this $25.15/month Your Choice Extras @BUPA
      the down side is 2 month waiting periods as I'm about head to asia soon so want to claim back travel vaccinations

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  cinnamon85 on 31/07/2012 - 07:23

  Has anyone had any experience with Latrobe Health? I havent looked into extras cover as we dont want that but for top hospital cover they seem to be the cheapest by far at $1989 per year for a COUPLE! Anyone had any good or bad experiences with them? That price is also based on $500 excess as well.