Private health insurance for a family

Shel and I have talked about it, and its pretty important for us to get private health insurance to cover our family. Neither of us has had PHI before, but with the public hospital and dental system the way it is at the moment it seems like almost a necessity to at least have some cover.

Orthodontics is important as I had really bad problems with my teeth and needed braces (and was on the public waiting list from age 7... and ten years later got braces on the public system at 17... amazing that I actually got them at all through public but it became a major medical problem, and not just cosmetic!), and my mum had bad teeth as well (and my bro does too), so I am guessing we are going to face that problem somewhere along the line with our kids.
I also had a major problem with my ears and throat, infections and hearing, and was in and out of hospital getting it checked out, and don't really know if there are waiting lists for that now.

I also want to get hospital cover so if our kids ever need surgery or things like that we won't get stuck to a waiting list if we can't pay for it for something that could be done straight away with PHI.

I have a few questions for those who know anything about PHI or those who have PHI.......

... when would we need to get a 'family' cover (remembering that we don't have cover at all)? Do we do that before bub is born or after? Do we have to get cover then add bub once it is born?

... does PHI really make a difference? My parents never had private health insurance (why pay for something when it is offered for free... despite ten year waiting lists...) and tell me I am being a 'stuck up yuppy' by considering getting PHI. No one I know has PHI, they just get by without it, but I think for the things we need it for (especially orthodontics and ENT) it would be beneficial. But does it really make a difference?

TIA! Any other info that you think is important when choosing let me know! I'm new to PHI, so am doing all the research I can.

It depends a lot on what you want and what you will use.

We have it, but I chose to go public for DS' birth cs I could choose my own OB, it still didnt cost me anything (my GP practices obstetrics) and had the continuity of care.
I know a lot of people who dont have it, and save the same amount of $$ that it would cost them each month in an account that is used to pay for their health/medical expenses.

I like to have it for the security that if something happened to any of us that needed serious medical attention we wouldnt have to go on a waiting list for aan "elective" procedure. Also DH has a history of heart problems in his family, wears glasses and I have the orthodontic stuff like you did - we had PH and my braces were off and all treatment finished by year 7 at high school.

As regards family cover and giving birth, a lot depends on the insurer. some will cover you on singles cover for a singleton birth and upgrade it to family on the day of the birth, others required you to have family cover already, and some have minimum amount of time you need to have had it for prior to the birth.

Having PHI gives you more choices, ie no waiting lists, choice of specialists, doctors etc.

I have top cover (but my employer subsidises some of the cost). I've been in hospital twice now in the last 3 years and haven't paid very much out of pocket. I make alot of use of the ancillary stuff too - optical, dental, physio, etc. If you use these alot then it's worth considering getting PHI. Alot of funds these days will let you choose which bits you want to be covered for as well.

If you don't have cover now, when you join you'll need to serve waiting periods before you can claim the benefits. These can range between 3 and 12 months, depending on the health fund.

When I got pregnant I rang my health fund to find out about family cover with a new baby and they said I just have to add bubs onto my insurance within 60 days of the birth and he/she will be fully covered. My cover will switch to family so will have a higher premium.

HTH

We've had employer subsidised PHI for about the last 9 years. It's through NIB and we have been very very happy. Dental is important for us and we get 80% back per person per visit to the dentist every time we go for our 6 monthly checkup and clean. Basically means that we pay $20 each instead of $100. That alone saves us a fortune. DH also gets heaps back on his glasses... I did a woo hoo thread about him only paying $78 for a pair of prescription Prada glasses instead of nearly $900!!!

After you each turn 30 you will have to pay a percentage more each year for every year after that you don't have cover. This is a government stipulation to encourage people to take it out while they are still young and healthy. We took it out when I was 30 and DH was 32. So we only have to pay about 2% extra for him each year. Does that make sense?

I'd sign up before you have bubs if you are certain you want it.

Remember too that if you earn more than $50k (or thereabouts) as a single person, or over $100k(or thereabouts) as a couple/family, you will have to pay a Medicare levy equivelant to 1% of your earnings if you DON'T having PHI (so around $1000 if you earn $100k)

For that sort of money, you could get PHI, have all the benefits available to you, and only be out of pocket a few hundred dollars if that. The system is geared so that those on middle incomes and above are penalised for not self-insuring, so if you're over the income threshold, PHI becomes a better option than paying virtually the same amount in Medicare levy at tax time.

Great explanation Sushee! :)

We have had PHI since DH & I have been together - which has been about 7yrs now, and I wouldn't be without it.

My ex DH (and father of my DS) refused to get it, despite my ever present medical issues (endo, and all of the IVF etc)... There were too many times where I should have had operations when I needed them and not when I had served my time on a waiting list.... I had an emergency c/s with Luke after numerous complications (I was in labour for 56 and a half hrs before they decided to give me an epidural and deliver him via c/s), I had the doctor on call (who was on the golf course and didn't have service to answer his page).
Afterwards, I caught an infection from the c/s that went undetected for a long time, because despite repeated visits back to say something was wrong, I had to wait on a waiting list for too long for another lap to realise that the infection was still there and had now damaged my tubes so much that IVF was my only possibility for more children...... :(

Now, I know that I'm the extreme, (I seem to have this tendency in all aspects of my life, everything's a drama :rolleyes:)... But if I had had PHI at that time, my life may be very, very different now.

We're with Manchester Unity (they advise to let them know as soon as you know you're pg, and there is some form of cover when you give birth, although there is usually a 12 month waiting period - I think??? - for obstetrics).
We get 2 check up and cleans each a year under dental cover that costs us nothing, and the PHI drops my IVF costs down by almost $1500 each go, because of the hospital fees, etc.

If you do your research (we went with Man Unity because they offered the best cover with assisted conception), and use it as much as you can, then you well and truly get your money's worth.
I claim everything - acupuncture, sports shoes, weight watchers... everything.

Its funny how a lot of people have the misconception that you are snobby, rich or stuck up if you have PHI - Most people will spend $150 a month on foxtel or something similar without batting an eyelid, but think the same amount on PHI is too expensive???!!!!! Priorities....

My cousin has forever picked on us saying that I'm a stresser and that I'm too pessimistic.. constantly tells me what a waste it is. (I'm over prepared for something to go wrong).
Its not just about things going wrong, but prevention and maintaining health as well.
Last year her hubby had to have 3 teeth taken out (it was a necessity because it was making him quite ill)... and it cost them over $3000.... now, we didn't pay that all year in our cover, AND, had he been covered under PHI with his 2 free check ups a year, the issue would have been identified well before it got to that point ;)

Its up to you, hun, but NEVER think its a waste of money, or its for snobby rich people.
Its for what you think is most important for your family. :)

HTH xxx

There are so many good opinions here but here's another way of looking at it. In old job (helping people think about career options) I've seen lots of people who are unable to work at all due to pain associated with back or shoulder problems who have been on the public hospital waiting list for 4-6 years for surgery. They have to take strong pain medication which upsets their stomach and mood. They end up on the disability pension. If they had PHI, they could have had the surgery and return to enjoying their life and returned to work. So think about the "cost" of 4-6 years of unneccesary pain and 4-6 years of unwanted unemployment. I know it's a small chance that this will happen to you, but is it a chance you are willing to risk?

Good thread leasha :)
Now who to go through, where to look???
(hope you don't mind me sitting in on the advice)

:

---

Its funny how a lot of people have the misconception that you are snobby, rich or stuck up if you have PHI - Most people will spend $150 a month on foxtel or something similar without batting an eyelid, but think the same amount on PHI is too expensive???!!!!! Priorities....



Its up to you, hun, but NEVER think its a waste of money, or its for snobby rich people.
Its for what you think is most important for your family. :)

HTH xxx

---

It's true Holly. We know a few families who think along those lines and have Foxtel etc but turn their noses up at PHI. We have never had pay tv and really don't ever plan to. But we have PHI. I agree, it's all about priorites.

Hm its hard me and my Dh would like but its us getting around to it lol lil lazy

We got it a year before I had DS (perfect timing!!) and we are with NIB. We decided to go through them because they were the cheapest quote that we were given (and turned out great cos they recently went on the ASX and gave us 600 shares for nothing - bonus!!) and we were signed up as a "couple" and then once DS was born, went onto family. They said that if anything had happened to DS when he was born, and he needed medical attention, then they would have paid a percentage of the costs, even though he wouldn't have been under the cover for long if that makes sense? I think its great that we have it, save heaps at the dentist etc and was great with the chiro that we took DS to when his neck was out. Saved us LOTS. I definitely don't think that we are stuck up yuppies or whatever, but rather, we are looking out for our family in the best financial way we can. We aren't on a HUGE (or even big) income, so it is a bit to pay each fortnight, but really, the alternative can be more damaging to our bank account if we didn't have it!!!!
Good luck!!! :-)

Good to hear you are happy with NIB AM :) Their policies are great aren't they? And yes! We got given a load of shares too! We're holding onto them though... I think NIB are going to do really well... from a customer's perspective it's been %100 hassle free... word will get around and the company will do well.

Bath - we are definitely holding onto the shares too.. I check them all the time.. haha!!! Its the only shares we will ever own so its pretty exciting for us. And yes, they are fantastic with their customer service, and I'm not tempted to switch to another company, they have been so lovely to us. (even with our stupid questions!!) ;-)

I know, when you ring up you get to speak to the loveliest people who have all the time in the world for you! Last time I rang then to see if we had cover for accupunture and I spoke to a woman for about 20 minutes because we shared the same health condition!

Don't worry if the NIB shares aren't doing too well ATM, everything is down. It might take about 2/3 years but they'll go back up. Hold onto them for as long as you can.

We have private health insurance, my main concern was for the kids to be covered, we are with Mutual so our kids dental is free.
We have a plan so our children are covered in any hospital and DH and I are private patients but only in public hospitals if that helps, so we can go to any public hospital and be seen as private patients.
We have all the extras like optical, dental ambulance etc. The peace of mind was worth the money for me.