Health insurance - to have or not to have???

[*EJ*]

I have grown up with my parents telling me i 'should' have private health insurance. When i turned 18 (i think) my mum took me to set up my own account as i was no longer covered by theirs.

So since i was 18 that's what i've had. As a young adult i had hospital and extras and when DH came along we had couples cover. Then the children came along, finances changed and the cost of family cover was out of our reach. So my logic was choose hospital only more so just so i still had health insurance.

But now that i'm at home with three kids, we're on one wage and watching every dollar spent this seems like a really pointless bill. Then again the second we get rid of the cover whoes to say we may not need it? Idealy extras only would be more of a benifit as i'm sure with three kids we would get more use out of it. Not even sure if this is possible and if it's in our price range??

So we're in the process of making some financial changes to suit our situation better and to have or not to have health insurance is on the cards. I'm struggling to let go because of what my parents have always instilled in me and DH is saying just get rid of it, we're paying this money for no real reason.

Just curious as to others logics of having or not having health insurance? There's also the 'tax time' advantage they they advertise but we just did our tax return and even with health insurance we payed a significant amount in medicare levi.

Ideas and experiences would be greatly appreicated

[AnyDream]

This is so tricky and it's the same conundrum for every insurance you buy, not just health.

I never thought we needed it either, but then I found out I had lymphoma and breast cancer completely out of the blue. Luckily we're living close to one of the major tertiary treatment hospitals in the country, because suddenly I was a public health patient in a big way. I was entirely lucky to 'score' 2 very good doctors, because there is no way we could have paid for the treatment I had without insurance in the private system.

Also, every year after you turn 35, health insurance gets progressively more expensive, in the event that you develop a health condition and decide you need the insurance after that age.

[black_rose]

I have hospital and extras, the hospital cover I have needed twice this year and without it I would probably still be waiting and be very sick by now. Our extras have been worth it as dd1 needs glasses and has had to change them twice this year and we have used it for dental, physio and Chiro too.

[AnyDream]

ETA - forgot to mention that being without PHI meant I had to wait about 4 months of excruciating gallstone attacks before i could get the sucker seen to. Not nice.

Extras - have always kept top extras - you only need a pair of glasses and a little bit of dental each year and it pays for itself.

[Olive]

we have basic hopital ($74 a month for the family) and we've used it once for DD's grommets, once already for me this year and will again next month when i have surgery, without id still be waiting! its worth it, maybe find a cheaper fund

[Trillian]

We were always of the view that we didn't need it - we were healthy people who don't use doctors a lot and we were in the financial position that if we needed anything, then we had the money to just pay to go private anyway. But then we had kids. Kids who need glasses (and now I need them too!), kids who need a truckload of dental work (2 kids with crap teeth), kids who play football and need mouthguards, kids who need chiropractic (and DH and I need it too), a DH with worn out knees that needed fixing, me with endo problems that needed fixing and the PHI has been a GODSEND! We only got it because DH's work pays for it as a fringe benefit but even once he leaves there we will continue to keep the PHI because you can't afford to be without it these days. the health system is that crappy that even if you are a priority 1 public patient where you need immediate treatment, you are still better off with PHI because it gives you more choices in how you want your treatment handled and not just hoping the hospital lottery pays off.

So it's not always a financial benefit that you will get from it, but it is more of the type of treatment you get and the time it takes you to get it. Some people still have a lot of faith in the public system and in some cases there is little or no difference between public and private - or in the case of maternity services public is far better - but I want the choice, I want to know that I'm able to acess health services quickly if I need it. When I had my endo problems, I saw my GP, saw the gyno 2wks later and had the op 4 weeks after that - 6 weeks was all it took! When I was a lot younger and had the same op done, it took nearly 9 months from seeing the GP for a referral to having it done publically. Even with DH's knees, if he went public, he would be looking at a 2+ year wait, but it only took him 8 weeks with PHI.

I know it is hard to visualise the benefits when all you see is the premium being paid out each month, but it is like that with any insurance - seems pointless to have it when you never make a claim, but if you have to use it for something really substancial, then it immediately pays for itself.

[Jellyfish]

So far it has been worth it for us (family hospital and extras) having both my babies privately and now that my DD has speech issues. I also have glasses for driving (watching movies and such too) and dental is the big one, I had to have a wisdom tooth out after DD and I can't imagine having to wait in pain, letting the situation get worse (it had just come through and was pushing my other teeth) because of not being able to afford getting something done.

I think Trillian said it well.. it is more than the financial thing, it is about the security of getting something done with choices and speed.

[LizLemon]

I agree with what the others said - sometimes it's worth having in the event something goes wrong. At the very least hospital.

Re the tax time financial advantage - PHI will only help avoid the medicare levy surcharge (and if you earn under a certain amount you wouldn't have to pay this anyway), it does not reduce your medicare levy, which is a flat rate of earnings. It's shoddy advertising really, they make it seem like it will save everyone by having PHI but it will only save those earning over a certain amount.

[*EJ*]

Thanks laides, that is so much of what my gut says but then the $ issue is so tricky at the moment.

Thanks marydean - I'm so thankful for you and your family that you were able to receive treatment and care for your cancer. I hope it's never to be seen or heard of again

It really is a positive thing to hear of all your expereinces and how quickly you were seen in comparison to if you only had the public system to go by. Trillian you really did sum it up well, thank you

It is hard to visualise and expecially for my DH who has never really had anything to do with priviate health until he met me. His attitude is just get rid of it but i think my best option is to shop around a bit and see if i can find something more affordable for us.

Do i need to start a new thread to now change my question to who is your provider? I am with Aust Unity and always have been, are you best to go with the well recognised companies or not? We're paying approx $150 a month for hospital cover.

Thanks so much for your help ladies

[*EJ*]

Re the tax time financial advantage - PHI will only help avoid the medicare levy surcharge (and if you earn under a certain amount you wouldn't have to pay this anyway), it does not reduce your medicare levy, which is a flat rate of earnings. It's shoddy advertising really, they make it seem like it will save everyone by having PHI but it will only save those earning over a certain amount.

Absolutely is shoddy advertising!!!! But at the same time a good argument for me with my DH and pursuading him to keep it going

[Olive]

there is a government website like iselect, that's where i found my fund, i only have basic cover

[Jennifer13]

EJ, I'm with Australian Unity too and they are def the most expensive. The flip side is that they provide much better benefits than the other funds I've been with. Their extras cover is fabulous.

It might be worthwhile looking at how you can reduce your current premiums. Increasing your hospital excess, reducing the level of hospital cover to what will still work for you but not be as expensive, what level of extras cover you need, etc. After I have my homebirth (which Aust Unity cover), I will be reducing my level of cover to a slightly lower and less expensive level. I calculated that what we would claim back for the homebirth and everything else during this pg made the more expensive cover worthwhile for a period of time, but not ongoing.

Phone them and see what you can do. Explain that finances are an issue atm as well. I think it's worthwhile using your standing as a longterm customer to see what you can do where you are first and then compare.

[Cranky Kitten]

If anything with kids I'd keep the extras and maybe reduce or change the hospital cover. And yes, some funds will do an extras-only policy. DD is staring down the barrel of braces/orthodontic work once her adult teeth finish coming through if they don't straighten up on their own, DH and I both wear glasses and I see a chiro every 2 weeks. Plus I only paid about $50 out of pocket for my last extraction (ouch) rather than the $200 it should've been.

We're with HBF which is a WA based insurer and have both health and car insurance with them through salary sacrifice with DH's work - definitely a better deal than paying directly, maybe check with your DH's employer to see if this is an option for you?

[~Kaz~]

Just want to second what MD said about the unexpected. I was also raised with PHI and parents who continued it for me while I studied until I was 21. I have kept it up ever since because you just never know what is around the corner and there is nothing more important than your health or that of your family. I did need it at 21 when I fell through a roof (don't ask!) and broke my wrist.

I would actually go without in other areas to maintain basic cover after witnessing DP go through his treatment (mainly in the public system) over the past 12 months.

DP was like your DH, never had it, never needed it. Even after we were living together and then had DS he still didn't get it straight away which cost ME at tax time two years running He finally took it out in early 2010 and then got sick with Lymphoma. It covered him getting his teeth cleaned (important during his second round of chemo/stem cell transplant to have a really clean, disease free mouth), it covered a lot of our travel and some occasional accommodation as we are in the country, it covered his out of pocket medication expenses and he was able to claim on most of his scans (which were many and each cost hundreds). He was treated mainly in the public system as he needed the specialist care in a large city hossy and they didn't diferentiate between public or private but when the cancer came back unexpectedly in his brain, he was able to book into the private system to have surgery to remove it the following week. If he'd stayed on the public waiting list it could have been a lot longer as although it was scary, it wasn't life threatening in an immediate sense. It was so lovely to just book in and get it taken out straight away. Money can't buy that kind of relief.

Having said all of that, I truly hope that if you take out PHI, you never actually need it in the way that we or MD did (don't wish that on anyone) and that years from now your DH can hassle you for all that "wasted" money because of how healthy you all are!

[*EJ*]

Wow ladies thanks again for sharing your stories. I think what i might do is get DH to sit down with me and read through your posts and to see how he feels then. You have all explained it much better than i ever could from true real life experiences.

I will also give Aust Unity a call and see what they can do for me. DS1 has kinder this afternoon and my other 2 should be in bed (hopefuly) so i will do it then.

[The[cookie]Doctor]

Although I am worried how we will continue to afford it while I am not at work, we signed up with Australian Unity with Hospital, Extras and mid-range excess and with the rebate applied I am paying $86 a week. It IS a lot, but when I thought about the benefits from dental alone it is totally worth it! My DH family has a string of health problems including sleep apnea and it covers CPAP machines, taking all those things into account - even though they are really only 'potential' issues it made it worthwhile for us.
That and oh I have been putting off seeing a chiro for years so if paying for PHI actually encourages me to see one - I see it as a good thing.
I really struggled to convince my husband but his parents always had cover so he was a little easier to bring around. Mine never did (but does now) and with one ambulance trip and two dental appointments in the space of a month, mums yearly premium just paid for itself.

And as MD said - I believe it is over the age of 30 you pay an additional 2% per year over 30 for your cover.

[Trillian]

I think it makes it harder to see the necessity of having it when you are well and lets face it, no one likes to think that they could have a serious medical issue where you need immediate treatment. I admit that if DH wasn't getting it paid for by work then we more than likely not have it, but we would be really struggling to pay for a lot of the things we really need like glasses, dental etc. Where I live there is a publicly funded dental clinic for kids, but she isn't a dentist, only a dental technician which means that her skills are limited. We used to take DD1 to see her all the time when she was a preschooler, but it got to the point where she needed better treatment because the public dentist just wasn't cutting the mustard so to speak. But now that we have the PHI, I don't think we will be without it again. I'm not sure how much it costs us because it is a corporate package for the company he works for and the premiums are hugely dicounted, but it would be costing us around $5000-6000 per year if we paid for it ourselves. This is with GUHealth. I don't know if once you stop working for them if you can continue paying it at the amount that the company pays or if it will revert to a normal policy.

[Olive]

DC i think its around 32-33