Hi l am 50 years old and up until now l was in good health and never needed to stay in hospital overnight but was diagnosed with Multiple Seclerosis 6 months ago which mainly affects my walking but l can still walk short distances and live a fairly normal life as it is still fairly mild at this stage. WHen l have a relapse l need to go to hospital for drug treatment , any time between 3 days and 2 weeks, so far in past year l have had to stay in public hospital hospital three times and each time l had to share a room and a bathroom with another person separted by a curtain which l dont enjoy and you never know who you might be sharing with, they could be a nice quite person or the opposite . If they are seriously ill , the other person will keep you awake all night.
l dont know what the future holds, if my MS will be stable l dont need to go to hospital much or it could get worse and l need hospital alot. Although My income is well below $90,000 but l can still afford private health insurance but it would be l would have less money to spend and some things l enjoy and be able to save less money . Hospital cover would cost $100 a month plus 40% loading, so $140 a month and as its a pre existing condtion l have to wait a year. l think l would also have to pay a $750 excess, But what happens if you need to stay in hospital 3 times in one year ,do you have to pay the $750 excess three times in that year or just once?
Pity much the only reason l want private health insurance is so l have a private room., But does private health insurance guarantee a private room. Do people often end up having to share a room , or is that unlikely? l live in a regional city of 30,000 people with one private and one public hospital. Is it common for all the private rooms to be often full in a private hospital, if that was the case could l stay in another private hospital in another town a 100 or 200km away so l have a private room?
Do you think l should take out private health insurance ,if so whats the best value company? does anyone who has stayed in both publc and private hospitals, did you find much difference, was the private hospital much nicer to stay in, did you always get a private room in a private hospital?
Should I Take out Private Health Insurance
Comments
yes l tried ear plugs but they never block out all the noise, only some , also l dont like sharing a bathroom with a stranger, also often the other person has family members visting during the day that make alot of noise
$1680 a year might not seem like much now.
But will it be too much if you stop earning $90k pa (assuming its from paid work) due to the progression of your illness?
If it becomes too much and you cease the PHI and therefore revert back to occupying shared rooms during your hospital stays will it just be harder to get used to that later when your condition has progressed? Or would it be better to get used to it now and resign yourself to that's just how hospital stays are.
Private health insurance doesn't guarantee a private room. But it has a greater possibility. We don't know anything about which hospitals are in your regional town or if your town is full of sick and elderly people so we can't tell whether you're likely to get a private room or not.
Excess is typically per hospital admission. So you're already looking at almost $6180 per year for 6 admissions (you said you've already had 3 in 6 months) with PHI. Can you sustain that on an ongoing basis even if your income changes? Do you get anything else other than maybe a private room for that? To my mind that's a pretty expensive room upgrade if that's all you get. You could probably get yourself a tablet, tablet stand, noise cancelling headphones, white noise machine, and other things to make your stay more enjoyable in a shared room for much less.
As for motivation to get PHI considering your condition I'd be more interested in waiting periods for treatments (especially if things worsen and your prognosis could be improved with less waiting time), access to better doctors and if certain cutting edge or gold standard treatments aren't available via the public system.
I'd advise enquiring with your current treating doctor and the local private hospital about how likely getting a private room would be, what else for your illness you can access with PHI. Make sure to have a list of questions for any PHI provider you are considering. I'd guess there are online forums for people with MS (and their families) in Australia, and support networks and charities so I'd try to seek those out. People there have probably sussed all this out already.
Sorry about your diagnosis.
I wonder if OP has factored in the 2% per year over 30 Lifetime Health Cover loading?
In Ops case, being 50 thats a 40% loading and it keeps going up every year you dont have health insurance.Also the Medicare levy surcharge (if applicable in OPs case) for NOT taking out health insurance
Or the fact that all health funds limit claims on pre-existing ailments/ilnesses to a 12 month waiting period.
https://www.ombudsman.gov.au/publications-and-news-pages/pub…So if you ask me, its a bit late OP to be taking out private health insurance.
I wonder if OP has factored in the 2% per year over 30 Lifetime Health Cover loading?
I think they did…
Hospital cover would cost $100 a month plus 40% loading, so $140 a month
.
Also the Medicare levy surcharge (if applicable in OPs case) for NOT taking out health insurance
Not applicable…
My income is well below $90,000
.
Or the fact that all health funds limit claims on pre-existing ailments/ilnesses to a 12 month waiting period.
OP is already aware…
and as its a pre existing condtion l have to wait a year
.
So if you ask me, its a bit late OP to be taking out private health insurance.
Nah it's not too late. In fact it's almost exactly the right time (or really 7 months just past the optimal time) for OP to take out PHI. As discussed previously (in another forum post I can't seem to find right now), LHC loading is always less expensive than paying for unused premiums no matter how many years you delay getting PHI past your 31st birthday. Delay it 1 year, you've saved money. Delay it 20 years you've saved even more money. The only time to get PHI when you won't be making using of the policy is when you're earning a certain amount over the MLS threshold such that getting a junk hospital policy is cheaper than paying the MLS.
Thanks for you answer,, , yu made some good points. l have never been on PHI before at all, only public hospital . Are you sure if l stay multiple times in a private hospital in a year l would have to pay $750 excess each time l stay , that would make it too expensive for me as so far l have had to stay in a public hosptial 3 times this year , if that was private then it would be well over $2000, making it not worth it
Sorry, you are right on the excess. It's just once per year from memory.
The excess is dependent on your policy. For most policies, it will just be one excess payment on your first admission in any year, but some policies require an excess payment for each admission. The PDS should detail this.
@BigBirdy is right. Most companies only charge the excess for the first admission, but to be sure you need to check.
By all means check, but I'm pretty sure it's $750 per year maximum for singles. This is Australian law - it doesn't depend on the insurer.
Whats wrong with staying in the public hospital????
Private health insurance is more for elective (non-urgent) surgery
Username checks out
Private health insurance is more for elective (non-urgent) surgery
Are you sure about that?
Is that true in all circumstances?
Private only handles the non urgent surgeries and refuses treatment for urgent surgeries?
Interesting.
Most of my experience has been the the Private system is where you go when the public system mucks up or can't provide the life saving surgery that you need today because the list is two years long filled with people waiting in the list before you.
Then there's the two recent media candles where patients were given an IV pole and told to take it to their cars to wait until their name was called.
Then the two old people more than 80 years old laying on the floor of the ED, because there were no beds available for them.
Perhaps the most alarming situation of late is the number of hospitals, particularly in regional areas, closing down their entire maternity, pedestrian and women health departments
I love Australia and I love our public hospital system.
You should contact your local hospital to determine the availability of single rooms. Just because its private doesnt necessarily mean its all singles. If you care about the quality of the actual management of your condition, it would be a waste of money. Private hospitals don’t specialize in managing things like MS, there’s no money in it.
This. Most private hospitals have shared rooms.
Private hospitals aren’t necessarily “better” than public’s - in fact, they usually have much lower staff (nurse/pharmacist/orderly/etc) to patient ratios.
Ask anyone who works in one. You have to remember that a private hospital is run by a company trying to squeeze every dollar of profit they can, out of your healthcare.
Not saying public’s are amazing - there’s work to be done - but don’t assume there are amazing benefits.
In public, I've usually only had my preferred Specislist peeking at my private parts and those I'd rather to be kept hidden from random strangers.
Lost track of how many trainee doctors took a peek where they had no business perking, or muttering "whoops", under their breath whilst their supervising doctor was somewhere else in the hospital probably brewing his coffee before sitting down to share lunch with the peads nurse, instead of being anywhere in the vacinity of where my operation was going on.
You do realise you can get a private room in a public hospital, if available.
yes you can my experience is most of the time l cant get a private room
How much are you prepared to pay to avoid sharing a bathroom?
The choices are: In a single room, you may be bored; there's a great deal of luck involved in a public ward.
If you get a ward with someone you know or someone interesting, you may be in for a bit of fun. If they wheel in an alcoholic with the DTs or someone who just killed half his family because he did a U-turn on the M1, you're in for an annoying time in a public ward. I experienced all those and still don't know what to do in your position, but I have private hospital cover (unused).One suggestion: If you go shared and get someone bad in with you, quietly explain to the nurse that the person is driving you crazy and ask for a move.
THanks, yes l did once have to share with a noisey person and l asked to change but the nurse said l had to wait a couple of days and l couldnt take it so l left the hospital early and went home , l don think they care less if you share with a loud annoying person, only if they are totally crazy and totally off their head , for example threatening violence, will they take it seriously and find you another room
l think l read you only have to pay the $750 excess once in a year, so if you stay mulitple times in a year you dont have to pay the excess muliple time its only once you have to pay $750, is that correct.
Also can you stay as a private patient in a public hospital and does that increase your chances alot of getting a private room in a public hospital ,does that mean as soon as private room in a public hospital is avaialble they give it to you, also l think if you stay as a private patient in a public hosptial you dont have to pay the $75o excessMy wife had a shared ward after our third child. The first night was fine, but with a new baby, sleep was elusive. Night #2 they wheeled in a woman in the wee small hours, who'd just had their first. She and her husband spent the night saying, "you're so clever" to each other. When I went in next day, I didn't find my wife in the ward expected. She'd been shifted to a room of her own. At the time, even with private health cover, you were better off saying you were not covered. She made it very clear to the nurse that the couple were sending her insane. 'Quiet' does not mean showing any degree of tolerance for the situation. That said, what you get depends on what they have available at the time and current efficiency practices means a very high percentage of beds are occupied.
I hope you told your wife how clever she is.
Private Health Insurance doesn't guarantee a Private Room! I visited a friend in a Private Hospital last week, he has top level PHI, and was still in a shared room.
Pretty sure it would get down to how full a hospital is at any given time, as well. I presume this is might be why there are long queues for some discretionary procedures.
Well, duh! If a private room is unavailable, it cannot be manifested out of thin air.
Do health insurance companies have rules around disclosing pre-existing medical conditions?
Thanks
Generally, you will have to disclose pre-existing conditions in the following circumstances:
For extras (general) treatments:
- no
For hospital:
- if you are still within the relevant waiting period and need treatment, yes
- If you have served the relevant waiting period, no
See https://privatehealth.gov.au/health_insurance/howitworks/wai…
Long term your issue shouldn’t be about sharing a room it should be access to treatment and support. I would sit down with your GP and have a good discussion on what the likely future prognosis is and what treatments are available, I would also find out what you can do to improve your outlook. Best of luck for your future.
WHen l have a relapse l need to go to hospital for drug treatment , any time between 3 days and 2 weeks, so far in past year l have had to stay in public hospital hospital three times and each time
I'm curious - have you been able to get a bed on each and every occasion in a timely manner?
If no, this is might be where you see greatest value from private health insurance - access to a hospital bed when you need it.
yes l was able to get a bed each time , but l went to the emergency department each time and it took about 6 hours,
Luck of the draw with that approach - though if that's working, and it's an appropriate treatment path for you, then so be it.
but my point is l dont like sharing a room which is why l want a private hospital
@cranswick794: Yes, I understand that.
However, the overarching issue should be whether you are getting timely treatment, and you are.
If you want a private room, take out PHI and sit out the 12-month waiting period.
If you go private, unless your treating doctor has admission rights at whatever hospital you attend and can authorise direct admission, you're going to have to go through A& E anyway to get admission for private.
NFI what your hospitals charge, but my go to cost $650 up front (not claimable as you're still an outpatient until you get admitted. The PHI only kicks in after you clear A&E and become admitted).
On top of that is the cost of any tests or treatments they require in order to diagnose you and allocate you to the relevant department.
Could also be that there is also a gap in what the doctor charges you and how much the PHI will cover. This applies to the doctor/s, medications and even bandaids etc
Private hospitals in my vicinity only have private rooms (I'm assuming this may not be true for ICU though), but certainly for general wards. Thus, a shared room isn't even an option here, but you need to check out how your hospital/s are set up.
Personally, I have no excess or co payment for my PHI admissions, may be worth a thought if you know you're going to be using it.
Some PHI have both an excess AND a co payment. Make sure you're clear about what your chisen insurer is offering.
Think you get to choose your level of excess payment too, might not have to be $750 iykwim.
As far as I know, that excess is only payable for your first admission of each calendar year. No further excess charges for successive admissions until the next calender year. Not sure about how co payments work though, so clarify that if relevant to you.
Double check with your insurer, but it's likely you can choose to be a private patient at just about any hospital in Australia capable of meeting the requirements for your treatment.
Could be your preferred doctor is in another state, but you can definitely go there if you want!
I just read awhile ago where some funds weren't covering some hospitals (healthecare maybe?) because of some snaffuu, but I think that got sorted out - didn't affect me, so never paid enough attention to know for sure, though. However, best to double check if the hodpital(s) your likely wanting to access will accept your PHI and vice versa.
I can't help you make your ultimate decision, but I'm a fan of my own room and bathroom too. Stuffed if I want to be sharing germs and bodily fluids or tolerating the misery of others when I'm crook enough to be in hospital.
Reckon I'd sell an organ and sacrifice goats and stuff if that's what it took for me to afford Private hospital. I'm a whinging sook at the best of times, but when I'm crook enough to be in hospital, I want to wallow in my own self pity without worrying about what anybody else thinks of me and I definitely don't want to be dealing with their misery, support systems and coping mechanisms etc.
Final thoughts about conditioning yourself for a return to public hospital if the finances ever prevent access to your PHI.
Sure, you might live another 50 years, but maybe you'll be dead next month. Could also win lotto, get an inheritance from some rich old uncle you never knew about or beat the house next time you play the pokies or win at Blackjack. Point being, you never really know when you or your money is going to run out.
IMO, do what you can to achieve the best outcomes for yourself right now, cos there may never be a tomorrow to worry about and you sure can't take any left over money with you once you're dead.
I wish you all the best moving forward, you certainly have some challenging times ahead, but hopefully you have access to a framework for support and care to accompany you through the tough times and celebrate the victories with you as they happen too.
I was in a public hospital last year. For 27 days in their ICU. This was a private room.
When I was 'stepped down' to a ward, it was also a private room. Our local public hospital has undergone renovations (basically a whole new beautiful building) and the ward I was in had 2 or 3 shared rooms, the rest were singles.
Alas, I had to undergo rehabilitation (no letting me go home to a house with stairs without it). The main public rehab had reduced capacity due to a Covid/RSV outbreak, so the closest public one was full with a waiting list.
My option was to go private (we do have cover) or wait another three weeks in hospital - which I could not have done. Six weeks or so already was doing my head in.
So I went off to the private hospital - long story, took two attempts to get admitted and ended up in a shared room. That I could handle. It was sharing the bath room with two other patients that wasn't good - ask any female on fluid medication!
After a couple of days I was put in a private room in the newly renovated part of the hospital, with the nursing staff admitted that putting anyone on fluid meds in a shared bathroom being unfair.
Having said all of this - I had begged to go back to the private hospital and wouldn't have put my dog in the private one.
Check out the local private hospital and find out what the standard of care is like. Just because it is private and you MAY get a single room, doesn't mean you will be well looked after.
I am still getting followup care from the local public, including specific care relating to the ICU stay.
Having said all of this - I had begged to go back to the private hospital and wouldn't have put my dog in the private one.
Did you intend the first 'private' in this sentence to be 'public'.
Also, people need to realise that everyone's experience is going to be different for a range of factors, including: availability of surgeons, rooms, anaesthetists, arrangement with insurers, quality and availability of available facilities, personal preferences and perceptions etc etc
My apologies - and I can't edit now.
I wanted to go from private to public. Desperately.
why?
@fredblogs: Because the private hospital was ghastly. On top of the shared room/bathroom issue, the shower actually had black mould in it!
The only thing that I could say was better at the private was that one morning tea was home made scones. That was it.
All services at the public were far superior.
some things to consider, make sure your level of cover covers your condition, find out if your fund has a contract with that private hospital, this makes a difference to out of pocket costs. You can find out by looking it up in the find a hospital section. You only pay one excess per year. You can still switch funds regularly to get free sign up weeks, so long as the level covers your condition
Great advice re switching - follow the 'pay 1 month get 6 weeks free' offers and you will save approximately 58%.
Medibank has Live Better points which can be used for free $200 premium once per year. But you have to wait the full year to go again with that. I have 40000 points but cant use them for that until the end of september! This is in addition to the 6 free weeks
Sydney-sider here. Last time I was in hospital (major teaching hospital public) I was in a shared ward which I don't mind. One night they brought in a very snooty Eastern Suburbs woman who said 'is this your best room?' She had PHI but no beds available whatsoever in private hospitals so she ended up in a public shared ward. Note to self: no PHI for me. Our public hospitals are amazing for free!
Are you sure that quote of $100/month applies to you? The insurer cant refuse you insurance but it can charge you an increased premium or exclude certain treatments for a preeixsting condition. Double check all that.
Although most private hospitals have mainly single rooms there are still a few double rooms that share a bathroom. A 30 bed ward commonly has 4 double rooms and 22 singles.
New public hospitals, built in the last 5 years have about the same ratio but older ones will commonly have a majority of 4 bed rooms and 2 to 4 single rooms.
Single rooms are always prioritorised for infectious and palliative patients. Apart from that its luck of the draw, depending on whats available at the time of your admission.
In the private, you can usually request a single room after admission and they will generally give you one, the next day or the day after, if there's availability or you are a troublemaker.
If you ask the same question in a public hospital, they will roll their eyes and snort at the sense of entitlement.
Public hospitals don't usually take someones gender into account when allocating beds, whereas private hospitals always put you in with someone of the same gender (that you identify with).
You may not be able to go to another private hospital 100-200km away because your preferred specialist needs to have admitting rights at the other hospital.
Although you might never or rarely actually see the specialist in the public system, you will be admitted under their team and they will steer your treatment plan. Every time you get admitted for treatment of your MS, you will be admitted under the same specialist. It might be wise to find out if that particular specialist has admitting rights at your local private hospital. That way you have continuity of care.
The food is mostly better in a private hospital and they are good at creating the illusion of premium care. However private hospitals never have the same resources available, especially after hours, when there are no or minimal medical staff on duty and much less nursing staff compared to public.
I work in both a private and a public hospital. If I need to go to hospital, I go to the public because I believe that's where the safest and best quality care is available and thats more important to me than sharing a room.but it can charge you an increased premium
It 100% cannot do that in Australia.
or exclude certain treatments for a preeixsting condition
It also cannot do that after the relevant waiting period has been served (maximum of 12 months, see Waiting periods).
Unless I missed it, no one answered your qn about excess. You pay it once per year (whatever the ‘year’ is for your fund eg calendar or financial year)
While everyone is trying to be helpful here talking about their personal experiences - every hospital and state are so different . Also your condition may dictate what type of room you get, so I would recommend that only your hospital and your health fund can give you those answers
I always get a private room when I go to my selected hospital, (as public or private patient) but this isn’t the case even with the same condition at other hospitals. The best advice above was that PHI gets you seen and treated quicker if you regress quickly - but I have also seen both sides of the equation where I was in a bed within 2 hours but another time (more sick) I was required to wait in public to get transferred to private
All I’m saying is you want to make sure you’re being treated with the best care possible as quickly as possible with the least cost or out of pocket to you. Then if you’re in regional and there’s not much choice in hospital you may unfortunately not have the choices re; single room
THanks for your answers, after reading them l am now thinking its not worth taking private health insurance as my only reason is to get a private room , but this may not be the case, l dont want to pay thousands in health insurance and turn out having to share anyway, especially when my income fairly low .
One thing l was wondering in public hospitals do people with private health insurance get given private rooms first over the other patientsWe pay medical insurance so that I hopefully will get a private room.
I have had MS for 27 years and have only needed a hospital stay a couple of times for iv steroids. I prefer to get home asap and finish steroids etc at.home.
I also feel more secure having phi as now I have lung disease as well so feel I won't have to wait so long. Hopefully you won't need hospital but I totally get where you are coming from.
My last lung biopsy was private and it happened very quickly due to private. I did check with the hospital that I would have a private room and all they could say was Yes but only if available.
Luckily for me, it was. It was like staying in a motel with room service. 30 pages of menu options at whatever time. However, a month later I had to pay an extra $500 for xray and bloodtests.
All the best with your decision.
My husband and I pay 9oo per month. We are nearly 60 though and he vapes. 😖 Work in progress on quitting.
I find Medibank wonderful to deal with. Good luck 🤞Also - where on earth did you find private hospital insurance for $100 pm?
We pay far more than that for a couple on top cover.
ear plugs
.