Private health insurance is becoming more confusing by the day. Now I have private health and have had so for just on 50 years.
What I find frustrating or annoying is that the funds have changed and now pay out to different providers at varying rates. I am losing the option to go to the dentist or physio of my choice as it is quite likely that my provider is not preferred as they say. A simple filling could cost me up to $80 more by not using a Bupa preferred provider. But I may have to travel many more kms to get to the preferred provider but this is not taken into account. They have limited numbers of preferred providers.
The same applies to the rates charged by health funds. If i lived in WA or the NT my premiums would be less. How is this a fair playing field ??
And the same goes for I Select when they quote on your health insurances. They only quote on the funds who will pay them a trailing commission not all funds .
The problem with health insurance you may be able to pay to be in health cover , But can you afford the out of pocket cost when you go into hospital .
What out of pocket costs are you talking about Brickies. If you are fully insured there should be no extra hospital costs but I have heard and been subject to anesthetists and surgeons wanting some extra monies over and above fees that medicare, and the gap that private health covers and some even up front before they sharpen the scalpel.
Bupa will cover the gap whilst in hospital as an admitted patient up to the medicare scheduled fee It is over the scheduled fee which I mentioned previous that some surgeons require to perform an operation. As an outpatient at a hospital private health covers Zilch.
Depend where you live not to many Doctors in our area accept the medicare schedule fee , And some now charging a fee for blood test in hospital , Lots of people are left out of pocket big time . But we still have private cover last processor the doctor charge $1000 over the schedule .
I had an Ablation Procedure done on my heart last year in Adelaide. Adelaide was chosen because it was the specialist's choice for me because of other health complications, but the net bill to me was Zero. At a subsequent follow-up consulation with him, I asked if the procedure could have been done elsewhere, and he told me that it could be done in virtually any capital city in OZ, but they often charged well over the schedule fee, whereas he and his organisation charged the scheduled fee only.
Frankly, I reckon that the end result for me was worth whatever they charged, but I have certainly been stung many times over the years because I have private health insurance. Often, the first question they ask is "Do you have private health insurance?" If the answer is yes, they seem to assess you as to how much they can squeeze out of you. However, the option of no insurance is not viable these days, especially as we all age.
We opted out of private insurance because it was too expensive and not economically viable. Premiums exceed $8000 a year for top cover and there was no way we were using that amount of claims and all we were doing was drawing down our investment principle. As our investment principle is all we have it is economically more efficient to not pay the private insurance premium and allow it to accumulate and then draw down if some medical emergency arises. Plus, if you're seriously ill Medicare takes care of the tab and having experienced cardiac treatment in both the public and private spheres I can't see any difference other than my having to pay the private cardiologist a non-refundable gap payment.
If you've just won Powerball then I guess private health insurance premiums wouldn't be a problem but if you're scimping and saving where ever you can there are better alternatives.
We're still in Teachers Health Fund but are considering our options. To us there doesn't appear to be much of an advantage in being privately covered these days?
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Cheers Desert Dweller.
Our land abounds in Natures gifts. Of beauty rich and rare.
We have never had health insurance, as for me and l'm 61 now and the wife has hit the magic 65. So over the last few years as for me I've had in 2006 a double hernia repaired, 2012 had my left hip replaced and in 2014 also had my right hip replace, all due to fair ware and tear. The wife on the other hand had a cut and shut ( women's plumming ) in 2012 also.
As for the cost and out of pocket exspences, they were nill and if any it was just a few tablets for pain releif. As for my choice of hospital Mildura only has two. A private and also the public and while i have never been in the private as a patient l've found the public system up hear better that exspected, all staff were just fantastic, food was pritty dam good and can't complain about their the way the nurses/doctors fussed over you. So we went public.
So no complaints from this little black duck !!!!
As for my father inlaw he has a hip replaced at the private hospital and had a good private health sceam as well, but also had to pay up front $5000 before the would operate on him.
-- Edited by valiant81 on Saturday 16th of January 2016 08:55:16 AM
You do wonder at times. I had a double hernia done 6 months ago and costs after refunds was $600. We have top cover with all extras.
Nothing will improve until people leave the private funds in droves forcing the govt review the whole system, meantime there are many snouts in the trough.
We have always had the top Medibank Private hospital and extras cover for many years. Despite having some minor operations over those years, the fees just cranked up each year to the stage we decided we would rely on the public health system. I had a hernia operation through the public system and in a private, public system room - I got the same level of service from nursing and medical staff (in fact the room was larger and more pleasant than the private ward). The only reason I went through the public system for this Op was I went in by ambulance as an emergency and put straight into public. By the time they asked me if I had private insurance, I had already been put into my own room and been seen by the surgeon who did the cutting.
But when we used private, as well as the rates raking up each year, we also found the gap payment got bigger. If you wanted a no gap surgeon privately, they were were young and just starting out in their own practice and few and far between
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Cheers Bruce
The amazing things you see when nomading Australia
I have had private insurance ever since I started work, never had to use it for anything other than dental and glasses all that time, this year had to have a hernia op and so I had the choice of surgeon and he offered me two private hospitals that he operated from to choose.
For the privilege of my own doctor and choice of hospital I paid $250 up front for both the surgeon and aneathistis plus it cost me $195 for my consultation. No hospital costs apart from pharmacy items of $15.
heaven help me if I was to have heart surgery, or a hip replacement, imagine my out of pocket expenses.
If I ever have a major event I think I will go public, my son does that and for every time we have had to take him in for kidney stones , doesn't cost a cent on the public system.
and don't get me started on the gap costs of all the other little claims like for glasses and dental we have to pay because the government rules say private health funds are not to pay above certain levels!!!
if I could have been disciplined enough I should have put the equivalent away each week of the cost of private health in a fund and only touched it when needed, be interesting to see which was more effective, but we can't run parallel lives and don't know what the future will bring, so I guess that's why we have insurance !!!!!!!
Jetta - touch wood - but I haven't had to have a hip or knee operation, but speaking to some who have had these Ops - and full hospital cover for years - the gap payment was between $2000-5000 according to these folk. If that's correct, what a disincentive to have private health insurance - oh but they will give me courses in palates and other non-medical stuff (the Insurance companies say its to keep or get us healthy so we wont make as many medical claims)
And like you, it would have been interesting to put the same amount of money aside to grow interest as we have spent over many years on health insurance premiums. All insurance companies are like the TAB or casinos - they loose some, but make more - that's how they survive and grow their business
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Cheers Bruce
The amazing things you see when nomading Australia
In 2013 I was $4000 out of pocket for a knee replacement even though I was at the top level in my fund and $3200 to have cataract operations on both eyes. Although I begrudge paying it at least I could choose my Surgeons and knew I was getting the best available to me
