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

[Miss E]

We've got mid level hospital cover and the basic extras with Medibank Private and pay about $225 a month. It is a lot of money.

When we decide we're done having babies we will drop our hospital back to the basic level (only put it up to mid level to cover OB's). I too have wondered if it is really worth the expense at times... But because they have the lifetime healthcover (or whatever it's called) if you become a member before you're 30 and stay a member, you will never pay premiums any higher than what a 30 year old would pay. Because we're over 30, if we leave for a year or and then join up again our premiums will get higher and higher each year as we get older. But if we stick with it, they'll stay at relatively the same level. For me that was the clincher.

Olive, who are you with? that sounds like a great rate! I've been to iselect a couple of times, but always found that the plans they recommend are more expensive than what we've got

[jacklicky]

Im with Aust Unity and I really really dislike them. They are the most expensive and in the last three times i have called to enquire about claiming (with the codes from the DR) they have told me i am covered only to find out when I actually tried to claim I wasnt.

Not happy at all. I am going to change providers....but that said i would really look into the benefits you get from having PHI. Would you want to wait for surgery for you or your kids if you dont have to? Does DH's wage put him into the Medicare surchage area because although you still pay a levi....the surcharge on top of that can be huge (my Dh's was over $1000 from memory) so this itself can offset your payments... I know it is hard to come up with the money weekly but if you are going to have to come up with it at tax time you might as well get the benefits from it.

have you tried iselect or one of those kinda websites that compare all the health policies out there and can possibly get you a cheaper one...

[Cranky Kitten]

Oh and if you do drop the PHI - unless you're in QLD where it's covered, keep your ambulance cover!! As someone who has had the bill come in for a very short ambulance trip (less than 1km) to be over $800, I can vouch for the usefulness of ambulance insurance.

[*EJ*]

Thanks ladies.

Cranky kitten i pay ambulance seperately Would never do away with that one.

Miss E that is definatley incentive to keep it going because we've hit the 32 year old mark

I just got off the phone and turns out that the hospital cover i have only allows us to be a private patient in a public hospital with still a very limited list of Dr's to choose from. And as the lady put it quite an expensive cover for not much cover at all. She said it's the one people often take to avoid the extra surcharge at tax time, the high income one which is definately not us. How uninformed am i !!?!? So she is posting out some brochures of our best options of extras only or hospital and extras so i can sit and discuss it with DH. We already pay full price for a couple of things that we could benifit from having extras so i really want to look at having them somehow.

You have all helped me a lot. Thank you

[Olive]

with mine im covered as a private paitent in a public as well as private in private but a shared room only

[BeautifulMadness]

i have basic health insurence no hospital cant afford.

like dental,optical etc if we didnt have em we'd never get to the dentist or be able to afford glasses/contacts

took my ds1 to the dentist for his 2nd visit woulda cost me $45 insted i paid $18.

Dh needed new glasses insted of $500 its only going to be $100 outta of pocket

[e_p]

the extras cover I have pays for itself - I use it heaps for dental, optical, chiro, osteopathic

DH and I will pay the extra Medicare surcharge if we don't have hospital cover, so we do - but have never had the need to use it. I WILL be able to claim back $600 for our homebirth in a few weeks time which is better than nothing

We're with AHM which we have been really happy with - its affordable and good value cover, and the customer service is always good. I review who we're with every year and it continues to be the best value for money for our needs.

[buffy1]

I agree, it's a hard one. Lately my DH has been saying we should cancel ours too because we 'never' use it, and can get fantastic public care. Except...I've used it for dental, optical, hospital cover, fertility procedures and alternative therapy. We're with NIB - the cover is really reasonable and service is great. And I definitely want it for when we have this bub.

I'm a bit of a worrier/planner, so I must admit I feel 'safer' knowing I have it if something went really wrong. Today I've been thinking about that poor woman holidaying in Bali who suffered renal failure and is now in a coma after drinking a very dodgy ****tail. It cost her family $40k to fly her back to Australia - they didn't have travel insurance. Different insurance and situation, but you just never know.

Shopping around and getting lots of quotes is a good idea. Then you know you've made an informed choice.

[Cherished]

It's one of those topics where everyone has an opinion and in the end it just comes down to you and your family and what you are comfortable with. For us it's a must have and we would make other cuts in our budget before we'd let the health insurance go. Our birth experience private was fantastic and we've both had other operations at the same hospital too. a few months back I had another injury and am thankful beyond measure that I can have an operation without waiting too long and with the surgeon of my choice. As it is we are putting off ttc again as I need the operation and there is no way I could handle another pregnancy the way things are. It's not that serious though as far as the public system is concerned, I'd be waiting a loooong time for the surgery and my heart would be very sad that ttc a 2nd baby could be years away not months.

[Amaunet]

I'd never be without at least basic hospital cover. I've used it for the birth of my DS, but found it wonderful when I had a mc last year and was in for my d&c the very next morning, a friend waited an agonizing 5 days at around the same time in the public system. I've also had to have an endoscopy for my coeliac diagnosis, there is a MINIMUM 12 month wait in the public system, I waited 5 days! We would have to pay the Medicare surcharge, so we would have some level of cover regardless but we have top level corporate cover that is partly subsidized through my DH's work.

My family are very pro private health but my DH's family aren't at all. My little brother (foster bro) had to have a spinal fusion (twice- poor bugger). He had no wait because he could see the specialist privately as opposed to waiting to go through the public clinic. He would have had the same operation, with the same surgeon, in the same hospital via the public system...but he may have had to wait as much as 12-18 months longer by which time he would have been in a wheelchair it also meant he got a private room etc which made the two weeks in hossy my mum had to sleep beside him far more bearable.

So, to me, if you have children, it's a necessity, not a luxury.

[Astrid]

We have chosen life/accident and trauma insurance over private health insurance. Where we live any major medical problem is dealt with via the public system and is dealt with reasonably quickly. The same Dr's in the private are the same ones in the public hospital. There was less than 3 months wait for a procedure for me going public.

When we were in Melbourne DH had a life threatening condition, he was seen quickly. When it came to his surgery he had the top Professor in the field do his surgery. We had district nursing visits when we came home, which we found out later if we had private health insurance would have left us $100's out of pocket, as opposed to us just paying for the dressing supplies.

I do have some basic extras and have done since I left home, it costs me very little. When we are more financial I will look at if we can have the family just covered for extra's and not hospital, as I want the girls covered for any major dental.

My sister before she died of cancer gave me one piece of advice and that was to have life insurance instead of private health.

[LionsandBears]

A couple of points: iselect is a private business, it is not run by the government. They promote the insurance agencies who pay them to. I believe there is a different, independent organisation that does the same thing.

I can't remember who told me this or if it's accurate mathematically, but I'm pretty sure if you must have either hospital or extras, take hospital. A stay in hospital could cost you tens of thousands of dollars, depending on the condition. You rarely go through that much in extras. dental can get up there, but it's so expensive anyway. Apparently, you're better off saving for the extras things like dental, optical, chiro etc. I've never actually done the maths. I should do - we're with Aust Unity and we pay a fortune.

I have to look at our cover, as we're paying through the nose to be covered for a homebirth. Well, DS1 came 5 days before our 12month wait was up, so we weren't covered. We did get the midwife reimbursed for DS2, which was a bonus, though Medicare can pay some of it now (circumstances depending). As it was, we ended up birthing in the public system twice in a year and didn't pay a cent. It's not likely I'll ever have a homebirth now, so we don't need that level of cover. Though apparently if we go to the Aust Unity dentist in the city, we don't pay a cent.

Saying that, I have acupuncture weekly, regularly go to the osteo/naturopath etc. Dh has optical. I've run out of PHI claims on many of my extras. I even claim vitamins. I also know my Mum paid a small fortune for all my orthodontic work back in the day (thank goodness for being covered up to 21).

I've heard LaTrobe is good. I need to do my research too.

We also have ambulance insurance independently.

[Taurean]

Definitely have a look at iSelect for other providers. Your PHI does sound awfully expensive.

We have family cover with HBF (a WA company) which includes hospital (private room in both private and public hospitals) and basic to intermediate extras cover. We pay $165 per month.

Our extras easily covers a checkup or two - each - at the dentist each year plus treatment if necessary. Chiro and physio are also rebated as is optical (I have reading glasses). We also have ambulance cover and a few other things I can't recall right now.

We pay a small excess for the hospital cover which I think is $50 per night for a maximum of 4 nights - so a max of $200 excess.

HBF is actually really good and I'd recommend them but I'm not sure it would be that beneficial for those in other states.

[*EJ*]

So much to think about

Astrid we have Life Insurance (for DH) and Income Protection (for DH) aswell as the PHI and that was fine when i was working but now on one wage we are doing our best to keep covering all of this but barely having anything left once we have. For me i know and feel they are necessities and i don't want to let them go but money can only go so far. That is why i want to review what we're paying and see if we have any better options. Thank you

Lionsandbears i think that was what i was thinking also when choosing between the two a couple of years ago. I figured extras to some extent are a bonus where hospital could be seen as a bit more of a necessity (if you have the right type of hospital cover (not like me)).

Next week we have a financial advisor coming out who can help review our LI & IP and at the same time i hope to have some decisions made on our PHI and hopefuly we will be a bit better sorted than we are right now.

I'm a little unsure about changing providers even with most saying Aust Unity is quite expensive. If we change now at the age we are won't it be harder to get less expensive cover anyway if they add on their extra surcharge?

I really appriciate all your help, thoughts and experiences ladies it has helped me see much clearer about why we have PHI and why we should keep it. I'm going on a girly weekend starting from 1:30pm this afternoon so when i don't reply for the next few days i'm not ignoring or thankful for your replys. Time to let my brain and body have a bit of rest with only myself and my little lady to look after for 4 days!!!!

Thank you everyone

[Miss E]

Astrid we have Life Insurance (for DH) and Income Protection (for DH) aswell as the PHI and that was fine when i was working but now on one wage we are doing our best to keep covering all of this but barely having anything left once we have.

Just a thought. It could be worth having a look at your DH getting his life insurance and Income Protection insurance through his super fund instead. There are quite few benefits:
• the premiums come out of you super, not your weekly budget
• it's usually a lot, lot cheaper than buying it as an individual directly from a bank or insurance company, because the super fund purchases the insurance on behalf of 100,000's of members so gets significant group buying discounts which they pass on to you (well at least the Industry Super funds do).
• the premiums are deducted before tax, which effectively makes them even cheaper.

I'm a little unsure about changing providers even with most saying Aust Unity is quite expensive. If we change now at the age we are won't it be harder to get less expensive cover anyway if they add on their extra surcharge?

No. Once you're in the system and a member of one fund, you can swap around as much as you like and still keep your Lifetime benefit (where you never pay more than a 30 year old) and also not have waiting periods. It when you stop being a member of any fund for a period of time that you loose these things. So if you wanted to switch from Australian Unity you wouldn't be any worse off.

HTH

[*EJ*]

Miss E that is really helpful thank you!!

I was just talking to my cousin the other day about the LI & IP coming out of super but wasn't certain how it all worked, we will discuss it next week. Our IP, LI and DH's super are all with the same company. Definatley an option.

And it's also great to know that we aren't tied to a certain company like you said. I've learnt so much in the last few days.

[sepata]

Can I add to the original question? I have never ever had PHI and neither had hubby, nor did our parents when we were kids. I know that not having it means you get put in waiting lists when you need something, but generally everything is covered by medicare? But when you have PHI you may get treatment straight away but you have to pay for loads of things like blood tests, ultrasounds etc. Is that right? And if so, is the only benefit to PHI not going on waiting lists?

[Trillian]

Can I add to the original question? I have never ever had PHI and neither had hubby, nor did our parents when we were kids. I know that not having it means you get put in waiting lists when you need something, but generally everything is covered by medicare? But when you have PHI you may get treatment straight away but you have to pay for loads of things like blood tests, ultrasounds etc. Is that right? And if so, is the only benefit to PHI not going on waiting lists?

No, it's not the only benefit. But you do have to weigh it up for your own circumstances. As I said in my first post, before we had kids we couldn't see the point in it, but now we have them we wouldn't be without PHI. Even if you have PHI, you are still able to get medicare for anything you get treatment for. Bulk billing for bloodtests are still under medicare even if you have PHI (unless if they are ordered by a specialist Dr and in which case EVERYONE would have to pay for them because they are not bulk billed anymore), same goes for ultrasounds - if your PHI doesn't cover it then you are still covered by medicare to make a claim just like someone who doesn't have PHI would be able to do. But if you have an ultrasound or bloodtest in hospital and you are covered for it under your PHI, then you wont pay for it. I see health as a consumer industry just like any other - if I walk into a cafe I'm paying for the food I get so I expect to be able to choose what I want to eat. Just like with PHI - I'm paying for it so I pay for the luxury of being able to choose a Dr. If I was getting food for free, then I would expect to just get what I'm given and this applies in hospitals too. Even if you are able to access great Drs in a public setting, that really is the luck of the draw.

ETA - Taurean, DH's PHI was originally with HBF, but they are virtually non-existent in the eastern states and trying to make a claim for anything was like pulling hens teeth. Not only that, you had to make sure that the person who treated you was actually registered with them as a provider and if they weren't you had to get them to fill in a provider form just so you could make a claim. It was total bull**** so the company changed to GUHealth. Unless they have seriously changed their game in the last 4 years then they aren't worth it to anyone outside WA.