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.

[*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

[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.

[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.

[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.

[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.

[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