Author Topic: Health insurance Australia  (Read 9335 times)

deborah

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Health insurance Australia
« on: June 29, 2020, 01:18:38 AM »
I’ve been thinking about our health insurance. Almost everyone seems to say that we shouldn’t have it. The public system is pretty good, and it doesn’t cost much if you don’t want to wait. Given that we’ve been retired for a long time, and don’t pay much tax, the tax implications are different to what they would be for a high income worker.

What do you recommend? What do you do, and why?

Nudelkopf

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Re: Health insurance Australia
« Reply #1 on: June 30, 2020, 03:31:22 AM »
I'm young (29) and have no major health concerns. I spent a week in hospital last year after being hit by a car ("cycling is good for you!" they said). Zero out of pocket expenses.   My dad has early onset Parkinson's disease... without private health, they'd be fucked. So... are you healthy?

marty998

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Re: Health insurance Australia
« Reply #2 on: June 30, 2020, 05:43:01 AM »
I'm young (29) and have no major health concerns. I spent a week in hospital last year after being hit by a car ("cycling is good for you!" they said). Zero out of pocket expenses.   My dad has early onset Parkinson's disease... without private health, they'd be fucked. So... are you healthy?

My dad too @Nudelkopf  :(

Private Health Cover is worth its weight in gold for my parents.

Hope you're ok after that accident! Sounds terrible, so sorry to hear.

mrmoonymartian

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Re: Health insurance Australia
« Reply #3 on: June 30, 2020, 05:46:34 AM »
Parkinsons? They just worked out how to cure that. https://www.nature.com/articles/s41586-020-2388-4

Coming soon to a private hospital near you.

ozbeach

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Re: Health insurance Australia
« Reply #4 on: June 30, 2020, 03:18:00 PM »
I went to the GP last Thursday for an issue that's been troubling me for a while. After checking if I had private cover she referred me to a specialist surgeon who I saw yesterday and I'm booked into hospital Friday for exploratory. Eight days from go to whoa. This one episode would have cost more than my annual premium. (Of course, I've gone many years without claiming anything, so...)


I worked with a guy years ago that had been wearing a truss for 18 months while he waited to get an umbilical hernia operated on. No thanks.


For me, the risk I'm insuring against is not so much the cost as the waiting periods. There's also the loading to consider if you opt back in to private at a later date.

Gremlin

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Re: Health insurance Australia
« Reply #5 on: June 30, 2020, 06:49:15 PM »
I went to the GP last Thursday for an issue that's been troubling me for a while. After checking if I had private cover she referred me to a specialist surgeon who I saw yesterday and I'm booked into hospital Friday for exploratory. Eight days from go to whoa. This one episode would have cost more than my annual premium. (Of course, I've gone many years without claiming anything, so...)


I worked with a guy years ago that had been wearing a truss for 18 months while he waited to get an umbilical hernia operated on. No thanks.


For me, the risk I'm insuring against is not so much the cost as the waiting periods. There's also the loading to consider if you opt back in to private at a later date.

This!

FIRE is about enabling me to live my best life.  I don't know how many more sunrises I'll see, but spending a disproportionate number of them on a public hospital waiting list is not that.  Private health cover is a must for me and is in my FIRE budget without a doubt.

mjr

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Re: Health insurance Australia
« Reply #6 on: June 30, 2020, 08:22:02 PM »
Don't forget you don't need to have PHI in order to use a private hospital.

The calculation you need to be doing is whether or not you'll be ahead of the game in saved premiums even if you have to pay once or twice in your life when the public system doesn;t suit your needs.

deborah

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Re: Health insurance Australia
« Reply #7 on: July 02, 2020, 12:27:54 AM »
This is very odd! I was expecting everyone not to have health insurance, and to advise me against it. I was talking to a financial advisor the other day, and he advised against it, yet the MMMs are advising for it!

mrmoonymartian

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Re: Health insurance Australia
« Reply #8 on: July 02, 2020, 02:14:29 AM »
Will it increase your happiness compared to whatever else you could do with the money? If so, then it's mustachian-approved.

It's really no different to coke and hookers.

marty998

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Re: Health insurance Australia
« Reply #9 on: July 02, 2020, 04:12:59 AM »
Will it increase your happiness compared to whatever else you could do with the money? If so, then it's mustachian-approved.

It's really no different to coke and hookers.

Paying bills will not ever increase my happiness.

Funny thing is cocaine and hookers wouldn't increase my happiness either.

mrmoonymartian

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Re: Health insurance Australia
« Reply #10 on: July 02, 2020, 08:59:26 AM »
Will it increase your happiness compared to whatever else you could do with the money? If so, then it's mustachian-approved.

It's really no different to coke and hookers.

Paying bills will not ever increase my happiness.

Funny thing is cocaine and hookers wouldn't increase my happiness either.

It's a metaphor for any kind of drugs and prostitutes you're into. Whatever gives your zeppelin buoyancy.

marty998

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Re: Health insurance Australia
« Reply #11 on: July 02, 2020, 08:28:26 PM »
Will it increase your happiness compared to whatever else you could do with the money? If so, then it's mustachian-approved.

It's really no different to coke and hookers.

Paying bills will not ever increase my happiness.

Funny thing is cocaine and hookers wouldn't increase my happiness either.

It's a metaphor for any kind of drugs and prostitutes you're into. Whatever gives your zeppelin buoyancy.

Yeah I know... it’s that old George Best quote too.

I just found it a little interesting that I have not the slightest desire for either of those.

Now I feel old.

alsoknownasDean

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Re: Health insurance Australia
« Reply #12 on: July 03, 2020, 02:14:52 AM »
Theoretically if you're able to pay upfront to get anything done rather than join the public queue, then maybe it's worthwhile.

But I've still got private insurance, even though it's a fairly basic level cover for hospital and extras.

Now the extras, that's where I could probably get by without, but the price difference between hospital only and basic hospital and extras is minimal.

happy

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Re: Health insurance Australia
« Reply #13 on: July 03, 2020, 02:49:02 AM »
I have private health insurance and intend to keep it. If I was in my twenties again I would self insure by saving and investing the premium each year. It really depends on where you live, what resources are available to you and what you want to insure for. There are a wide range of serious illnesses that can be treated in the public health system perfectly well, that are generally NOT treated or not treated WELL  in private hospitals, and if you are insured and in a public hospital it makes not one jot of difference by and large.  That being said being a in a public hospital is like being on a bus...it will reliably get you there in the end, but you won't go the most direct route and there will be stops and starts along the way.

That being said elective and even urgent surgery sometimes, can be treated well and quickly in the private system in comparison to the public. Although I'm pretty healthy, and without going into details ( secret women's business) I've had 6 surgeries, 3 of them urgent in the private system. And probably as many day only minor procedures. Access in the public system would have taken forever.

If you have a large comprehensive private hospital nearby, then you will get better value for money than if you don't. My parents used one in Sydney that had an emergency department and this was invaluable over the years and a vastly more pleasant experience than public hospital EDs. Again if you have a large comprehensive private cancer centre you can access this will be useful, but public cancer centres are also pretty good.

I have bad teeth and bad eyes, so generally break even on my extras cover without anything else. Throw in a couple of ambulance trips and some physiotherapy in recent years and I'm not losing.

However  its not a clearcut question and many folks are happy not being insured and I wouldn't argue with this either.

Model96

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Re: Health insurance Australia
« Reply #14 on: July 04, 2020, 07:48:14 AM »
I never bought into private health insurance, and am way ahead financially because of it.
Surgeries that we have needed were either covered totally by the public system, or paid up front by us for private hospital and then mostly reimbursed by the public system anyway. Doctors have always seemed flabbergasted when we have said we don't want to wait for elective surgery and we will pay cash for private hospital to beat any public hospital waiting period.....and in the end 80% of costs have been refunded by medicare!
In fact what I have seen over the years leads me to believe that Australian private health insurance in the Medicare era is a massive rort and little else. And doctors and dentists etc are just as bad as mechanics and other repairmen when it comes to overservicing and outright fraud for financial gain from trusting customers.....

Bloop Bloop

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Re: Health insurance Australia
« Reply #15 on: July 09, 2020, 06:50:37 AM »
PHI is not worth it unless you're having to pay the surcharge.

I pay $1500 a year for pretty basic cover. I get about $250 a year worth of "value" out of it in the form of extras and dental. So really I'm losing $1250 compounded each year. Run that over 10 or 20 years and compound it and it easily pays for the cost of an operation.

Mind you, a lot of surgeries can be had through the public system anyway - you just have to know how to navigate the system of referrals. A lot of private surgeons do operations in public hospitals.

Mark31

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Re: Health insurance Australia
« Reply #16 on: July 15, 2020, 12:05:40 AM »
I’m not clear if you currently have it and want to get rid of it or don’t have it and are thinking of getting it. If you don’t currently have it I would have thought the surcharge would be extreme.

Beyond the fact that I reckon health insurance doesn’t make financial sense for most people, I have big philosophical issues with the government subsidy of it. The health insurance system has administrative costs to run the whole operation, they spend money on advertising themselves, they’re mostly for profit so have to take some off the top, and the private hospitals are sometimes for profit as well, I reckon there’d be much better health outcomes if that money was spent on public health. Not that that is on topic for your question of course.

Anyway, I never understand why some people are down on public hospitals. Emergency Room wait times for one. If you never had to wait, that would mean the system was inefficient – highly paid and trained medical staff would effectively just be sitting around twiddling their thumbs waiting for a customer to come in. Of course no one wants to wait too long, so there’s a balance there. But I’ve found them to be pretty good overall.

I’m sure that people (generally) that go to private hospital have a great experience, then they see the huge bill, breathe a great sigh of relief that their insurance will mostly cover it but never realise that could have had the same procedure for nearly as quick for no cost at the public hospital down the road, meaning the insurance was never really needed.

Anyway a bad experience at a public hospital doesn’t mean they’re always bad and a good experience at a private hospital doesn’t mean they’re always good, so it’s difficult to trust anecdotes. I worked at the Health Quality and Complaints Commission many years ago and they both get complaints. I wouldn’t be worrying about quality of care.

This leaves wait times and potential costs of the private system with and without insurance.

Private health insurance cover often doesn’t cover as much as people would hope. I haven’t looked at it for years, but while they were pretty good at covering the cost of staying in the hospital, they were not so good at covering the costs of the procedures. Medicare will cover 75% of the “scheduled fee” and the insurer will then cover the remaining 25% (generally only more if you highly expensive cover). The problem is the scheduled fee, like the general GP co-payment has not kept pace with the minimum fee a specialist will actually get out of bed for so you end up out of pocket even before the “excess” the insurer has.

I’m happy to just pay private if I don’t want to wait. Being proactive with your health can help in some situations, so you can get a referral before your elective issue is critical. It is very unlikely you will need care that only a private hospital can give that will cost many tens of thousands. If it was likely premiums would be even higher. There’s also a hybrid model where you can get a private procedure in a public hospital for a reduced cost.

I used to keep track of how far ahead I by not having health insurance, but stopped over a decade ago when I was well over 20k ahead. Add another ten years of fees and investment growth to that.

I’m going to finish with some anecdotes (which as anecdotes, you shouldn’t base you decision on) to illustrate some experiences that have filled me with a warm inner glow about the public system.

Last year my son broke his little toe (sticking out sideways). From leaving home to getting back again was five hours. This was assessment – x-ray – fixing toe – follow up x-ray – assessment – paperwork. He got crutches and a moon boot and didn’t cost a cent. I don’t see how you could reasonably expect better than that.

I get regular screening colonoscopies (which never cost anything). The first one, they thought it was urgent enough the public system paid for my procedure in a private hospital. The private hospital lacked the necessary equipment to remove several very large polyps and I just had to go to the public hospital eight weeks later.

My mum always goes private even though she can’t really afford it. When sick one time while visiting we took her to the public hospital here. She was so impressed (and surprised).

SUMMARY: I wouldn’t yell at you if you got private health insurance but it’s very likely not worth it

MrThatsDifferent

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Re: Health insurance Australia
« Reply #17 on: July 16, 2020, 04:08:28 PM »
I got PHI cause of taxes and the barefoot investor recommended it if you make over a certain amount. The mistake I’ve made is not getting the cheapest plan. However, I get two dental check ups and some of my contacts paid for and none of that is cheap, so I’m happy. Oh and discounts on massages.

Alchemisst

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Re: Health insurance Australia
« Reply #18 on: July 22, 2020, 07:40:37 PM »
Is dental cover worthwhile? I read that they only cover up to a certain amount like 1k per year, which doesn't really help if you have something major done which can cost 10k+

happy

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Re: Health insurance Australia
« Reply #19 on: July 23, 2020, 03:40:13 PM »
Is dental cover worthwhile? I read that they only cover up to a certain amount like 1k per year, which doesn't really help if you have something major done which can cost 10k+

You'd have to read the policy. Mine covers per item, so if you needed  more than 1k's worth in a year, they would pay it. Some things only pay once per calendar year though.

lollylegs

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Re: Health insurance Australia
« Reply #20 on: July 23, 2020, 03:48:48 PM »
I gave up health insurance several years ago. Since then DH has had a weeks stay in ICU after a car accident, several ER trips and all treated promptly and no cost. I have friends who had cancer diagnosis, same treatment, the ones with health insurance have had huge bills to pay, those without pay nothing. We pay for our dentist and physio visits just like we would pay any other bill.

I do feel like its a bit of a gamble as no one knows whats in the future but its a gamble with the odds in our favour.

jk5954

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Re: Health insurance Australia
« Reply #21 on: August 24, 2020, 05:06:07 AM »
I got health insurance for the first time this year as I was due to go over the MLS. I just got the cheapest junk insurance I could find which according to my calculations should be a bit less than what I would pay in tax if I didn't

I used to be on my Parent's policy (nearly 10 years ago now) and my optometrist always said not to bother with extras.

My wife is on a much high level of coverage (we are on singles cover through different providers) and if we ever get pregnant I will reassess and look to join up with my wife on a family plan.

Alchemisst

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Re: Health insurance Australia
« Reply #22 on: August 30, 2020, 03:14:34 AM »
I got health insurance for the first time this year as I was due to go over the MLS. I just got the cheapest junk insurance I could find which according to my calculations should be a bit less than what I would pay in tax if I didn't

I used to be on my Parent's policy (nearly 10 years ago now) and my optometrist always said not to bother with extras.

My wife is on a much high level of coverage (we are on singles cover through different providers) and if we ever get pregnant I will reassess and look to join up with my wife on a family plan.

I thought those sort of expensive things were the main reason to have health insurance, starting to doubt that if its not really beneficial, what is the point/ advantage of having insurance?

jk5954

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Re: Health insurance Australia
« Reply #23 on: August 30, 2020, 05:20:45 AM »
I got health insurance for the first time this year as I was due to go over the MLS. I just got the cheapest junk insurance I could find which according to my calculations should be a bit less than what I would pay in tax if I didn't

I used to be on my Parent's policy (nearly 10 years ago now) and my optometrist always said not to bother with extras.

My wife is on a much high level of coverage (we are on singles cover through different providers) and if we ever get pregnant I will reassess and look to join up with my wife on a family plan.

I thought those sort of expensive things were the main reason to have health insurance, starting to doubt that if its not really beneficial, what is the point/ advantage of having insurance?

When you say expensive things do you mean the optometrist? Or, if we get pregnant?

Alchemisst

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Re: Health insurance Australia
« Reply #24 on: August 30, 2020, 06:58:03 AM »
Yeah I meant like the things the post above mentioned; significant injury or illness, cancer etc.

MrThatsDifferent

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Re: Health insurance Australia
« Reply #25 on: August 30, 2020, 01:40:18 PM »
I find the main insurance is useless but I do use the extras. I use the extras for: contacts, dental,cleans, massages, gym membership, and pharmacy mostly.

catprog

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Re: Health insurance Australia
« Reply #26 on: November 25, 2020, 01:20:19 AM »
There's also the loading to consider if you opt back in to private at a later date.

2% each year for 10 years. So it works out at about 20% loading per year you don't have it.

Abundant life

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Re: Health insurance Australia
« Reply #27 on: February 10, 2021, 11:14:44 PM »
We have PHI mainly for the waiting period in the public system. Seen friends waiting 18 months in pain for a hip replacement. Unable to sleep as every movement is painful.

We took it out in 2000 while DH was waiting for a gall bladder operation in the public system. He was on the waiting list 3 months, then 6 months, then 9 months, then 12 months while he felt sicker and sicker. After 12 months the PHI kicked in for his pre existing condition, and he felt so good after the surgery. We then got the reminder from the public system that it would be 15 months ...

A few friends have paid out of pocket for surgery. One friend $8K, but the doctor asked if that was all he had as there might be unforeseen things. Another friend's heart by-pass was $60K, and even with PHI it was $20K out of pocket at the San quite a few years ago.

If you only have the OAP you just have to suck it up. A friend is waiting for a kidney stone op and is in pain, passing blood when he urinates, and unable to sleep or be active. They say 3 months, but who knows? If he had $8K to spare (which they don't) he could be attended to straight away.


happy

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Re: Health insurance Australia
« Reply #28 on: February 13, 2021, 12:25:07 AM »
This.

It may depend also where you live ( as I previously said) as to the length of the waiting times. Access is not  geographically equal even though according to all the policies it is supposed to be. 4 days ago I watched my previous mechanic ( I thought he was retired but he was covering for the guy who took over his business who went away for a few days) struggle to walk on 2 incredibly arthritic knees which must have been bone on bone with very little cartilage left. He's a tough cookie, but I could see he was in a lot of pain and made a sympathetic comment about him needing a couple of knee replacements - he's been on the waiting list for a while ( didn't say how long) but doesn't know when he will get them. In the meantime he has severe quality of life issues. If he could afford to pay, or had private cover he'd be much better off.

I still think choosing not to have PHI is a reasonable option if thats what you prefer, but it had better be coupled with a bucket of money invested at least at the level of what a premium would cost you, starting whilst you are still young. Its easy to feel bulletproof when you are young but none of us can predict the future and in 30 or 40 years time you might need something expensive.

Model96

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Re: Health insurance Australia
« Reply #29 on: February 13, 2021, 03:49:14 PM »
This.

It may depend also where you live ( as I previously said) as to the length of the waiting times. Access is not  geographically equal even though according to all the policies it is supposed to be. 4 days ago I watched my previous mechanic ( I thought he was retired but he was covering for the guy who took over his business who went away for a few days) struggle to walk on 2 incredibly arthritic knees which must have been bone on bone with very little cartilage left. He's a tough cookie, but I could see he was in a lot of pain and made a sympathetic comment about him needing a couple of knee replacements - he's been on the waiting list for a while ( didn't say how long) but doesn't know when he will get them. In the meantime he has severe quality of life issues. If he could afford to pay, or had private cover he'd be much better off.

I still think choosing not to have PHI is a reasonable option if thats what you prefer, but it had better be coupled with a bucket of money invested at least at the level of what a premium would cost you, starting whilst you are still young. Its easy to feel bulletproof when you are young but none of us can predict the future and in 30 or 40 years time you might need something expensive.

If you are FIRE decide to self insure and stick with the public health system, then yes obviously you need to decide how that changes your needs in respect to your emergency funds.
When I was still working, I saw Income Insurance as far better value than private health insurance so that may be an option worth exploring if you are relatively healthy. For example Income Insurance is cheaper, simpler, tax deductible etc.