Health insurance...confused, where do I begin?

Okay so I'm going to sound like a total ditz but I have absolutely no idea :redface: I am thinking about purchasing health insurance for myself. I have spoken to a few people and from those convos it sounds like it may be worth it just for the extras alone. Basically, I want it for ttc - Chinese docs, acupuncture, fertility speacialist. Do these things fall within extras?? I know I have no need for private health insurance for having a baby, and never ever will. I have ambo cover, but the rest I just can't afford and justify at this point in time.

Also, what is excess? Gosh I'm so out of the loop with this sort of stuff lol, so excuse the ignorance. I've had a look on iselect, found a few policies for around $20 to $30 a month; but I'm not sure how much I'll need for what iykwim. Like I said, I'd like the insurance purely for fertility speacialists, tcm, accupuncture etc. Is this at all possible? Anyone want to help out a very confused pumpkin with a run down? :doh: xx

I'm pretty sure you can get just extras cover, but I don't think it covers and fertility or pregnancy stuff (in fact I'm 100%positive). You'll need hospital and extras for that.

You need to work out if what you will be reimbursed will be worth the outlay of the PHI I guess. Every policy will have a list of the amounts of stuff they will cover. For example some will only cover about $15 with of visit for accupuncture, other will cover more but often they cost more too. We have just gotten rid of our PHI because we worked out that what we claimed over the course of 15years was less than one years cost of PHI. Yes there's always the maybes, but we have a good savings plan so I'm not particularly worried.

Excesses - If you take out hospital cover the cost of your PHI drops if you opt to have an excess for when you go to hossy. Ours was $200 per visit. Not sure how much it dropped our fee by though.

Thanks Kim. So you don't reckon just extras will cover the things I want (tcm, accupuncture, massage, fertility spesh)? Darn! I know I don't need anything birth or pregnancy related for hospital, as I'm planning a homebirth and all my appointments etc at my gp who does shared care with the royal womens.

There's a website, iSelect (google it!) and it compares all the different types of cover. Might be worth going on there and having a look around...

You would see the fertility specialist as an outpatient so not covered by any type of health insurance, just medicare. for the other complementary therapies, you need to check out the fine print for each different fund. for example, my chinese therapist who I go to for a few things, used to have to put something (cant rememeber what, on my account for me to get anything back). they often have a yearly cap on those therapies too so as Kim says, you need to do your sums to make sure it is worth it.

I wouldn't recommend iSelect because they have a lot of little rinky-dink insurers that would pay bugger all back if you made a claim. One thing I have learnt about insurance is you get what you pay for. Some may have cheap premiums but they may not pay you back much either, or they may have a really high excess. You could go to 'productreview' and put in the insurers name and if anyone has posted a review about that company it will show up. Plus you have to be really careful with trying to claim back on natural therapies. Our PHI is excellent - we can claim back 80% of the cost of Naturopathy, Remedial massage, homeopathy, herbalism, chinese herbalism, iridology, nutrition, aromatherapy, shiatsu, reflexology, kinesiology, bowen, myotherapy and exercise physiology BUT they will only pay out a maximum of $400 per person per year and ONLY for consultation costs, not for the herbs/homeopathics. So it's great if you only see them a few times a year, but if you saw them a lot, once they paid you the total $400 for that year then you can't claim for the rest of it. We are with GUhealth

Like Trillian, I'm not a huge fan of iselect either. They only have only a few funds from the many available.

If you google for Privatehealth dot gov dot au, it is the governments website for every insurance policy from every health fund (or so they at least claim)

Nic

My extras cover does cover things like accupuncture. BUT I pay $70 a session for my accupuncture and they give me $13.20 back to a max of $300 a year I think. And given that my extras costs me more than $300 a year you want to be getting it for more than just that.

Fertility stuff is only covered for your hospital stays - it doesn't cover things like specialist appointments or the drugs (except the non-pbs ones - and then it is only $20something that they cover) or anything like that.

I suppose what I am saying is that if you don't imagine youself wanting to choose a specialist for anything then I am not really sure what worth it would be to you.

The advantages of private health insurance are:
you can pick your specialist
you can jump public waiting lists for elective procedures (and pretty much everything that isn't threatening your life is 'elective')
Extras cover is worth it if you wear glasses, see a dentist regularly, have non-pbs medications (I'm pretty sure this one is in extras) and use some alternative therapies (but not all extras covers cover these things)

Also keep in mind that alot of PHI companies have waiting periods. It could be 12mths for O n G and some extras. Also when they have a flexi bonus they will only pay on that on some services. Very confusing. They don't pay alot on alot of things like podiatrist, and so on, you need to do your homework on that one. Even go as far as get the item numbers the practitioner uses for the service and ask the PHI what they would pay on that service.
I have PHI and have gone private for all my O n G stuff. Hospital has cost me only the $250 excess and that's it for the whole stay. As everyone else has mentioned most of the out of hospital has been through Medciare.
I don't have to pay the excess for when one of kids is admitted to Hospital, this has come in very handy as my DS2 has had two lots of grometts, and adenoids removed and is about to go in for another procedure of Friday and the Hospital part is not costing me anything.
If I didn't have PHI I could have been on public waiting list for a very long time with him.
I would say we are in front.

It takes some leg work to check out all of the insurers if you're interested in PHI, because the policies are so varied and the cover (particularly extras) can't be compared by price alone. And then the same insurer will often have different policies/products that offer different levels of cover in different areas.

PHI was more a long-term approach for me. I had optometry (contact lenses), physio issues, etc and then later found out there was to be a HUGE dental expense. Thanks to PHI I have been able to have everything I need done without shelling out $$ I don't have. It's definitely been worth the cost for us, but not everyone might have as many things to worry about. Yes, there are annual limits and lifetime limits on some procedures, but depending on the type of cover they can be enough. You also have to bear in mind that what you think may classify as one type of procedure actually falls into another category in the system. So oral surgery for some things, dental for others, orthodontic for others - it all got too confusing for me! :D

You don't have to worry about cost penalties on PHI until you're over 30. If the current legislation the govt is trying to get through is successful, those who earn above a certain level will no longer qualify for the 30% PHI rebate, so it's worth checking if your income is high.