Do we need private medical insurance?

[Guest AngPhil]

Justa quick question really. I can't get my head around medicare and private medical insurance.

 

Do we need private medical insurance? What does medicare cover? What is excluded?

 

Any help or advice would be apprecited.

[Guest Jo&Phil]

I would say 'yes, you do need private medical insurance' as medicare isn't the same as the NHS.

 

You can purchase different ranges of covers based on your individual circumstances ..........there are lots of different providers including BUPA who you may already know about as they're also in the UK. There are also comparision websites like iSelect.

 

You'll also need Ambulance Cover which is relatively cheap (around $100 per year) for the household.

[Jessica Berry]

As a couple with no kids we have 'extras' cover which covers chiro, physio, podiatry, ambulance cover, opticians, dental as well as other things. We always use far more than we pay for in terms of our monthly costs so for us it is definitely worth every cent. If you don't need to use any of these things then you may not get your moneys worth, but then for example you can't plan for a broken tooth or a filling as with insurance it is for the 'just in case' times. As an example at some point I will need a crown replacing (one of my front teeth!!), if I pay myself it will cost $1200 but under our extras cover they will cover approximately $800 of the cost, so in that one visit I will nearly have covered the cost of the extras cover for a year for both of us.

[wizzywozza]

Personally I wouldn't bother. Save your money for other things. Medicare is perfectly adequate, and if you have anything serious you will certainly get treated far more quickly than you would in the UK. I had private cover for a year back in the 90's and the only thing I used it for was a free pair of glasses ....... never had to use it for a medical incident at all. My family have been through the gamut of medical treatments over the last 21 years here and never had any problems with the Medicare system at all. In fact last year when I needed gall bladder surgery I was asked when I would like it done! Saw all the specialists/consultants and MRI operators within a few days and all turned out hunky dory. They operated on the day I requested and the care at Flinders Medical Centre was excellent.

 

My son had an op at Flinders Private a few years back (on Workcover) and I was appalled at the lack of enthusiasm in the nursing staff ...... they really had a couldn't care less attitude .... one even interrupted our visit with our son to sit on the spare bed in his room to watch her nightly soap opera! I was gobsmacked!

 

Ambulance cover is a really good idea though.

[NicF]

You don't need private health insurance - my OH's nephew and his wife don't have it but it can make things easier if you have any health issues. We took it out mostly for extras cover as this gave us things like dental cover and glasses cover which will be invaluable for us. You should definitely get ambulance cover though as you have to pay if you ever need an ambulance and it can cost in excess of $800.

[Guest Guest5035]

Coming from someone who has been here 21 years, had a son born here, two children who had braces, had the normal teeth problems, normal health problems, normal eyesight problems, two minor operations, two ct scans, a wife with exactly the same as above plus womens health scares, (will not divulge)......etc etc.....NO YOU DON'T NEED FULL PRIVATE HEALTH COVER, only get ambo and extra cover, (glasses,physio etc etc).

 

Stevo

[Jessica Berry]

I would also add to Wizzywozza's post that my partner had to have a minor op at Noarlunga public hospital and we were so impressed with the care and attention he received it was excellent. I compared it to the care my brother received when he paid privately twice in the UK and apart from having his own room, the care in the public sector my partner received here was way above the care and service my brother got when paying in the UK.

Edited October 13, 2012 by Jessica Berry

[Diane]

As above, we don't have any private cover. Ambulance cover is available through the Post Office, costs about $130 for a family of four for a year. We don't have any extras cover, just pay for anything we need, and a lot of the cost is claimable back from Medicare even if you see someone privately.

 

Here's the link for Ambulance cover with costs, you will also find costs of ambulances on there for those without cover http://www.saambulance.com.au/ProductsServices/AmbulanceCover.aspx

[NicF]

Just a point on this whole Medicare being as good as private thing, my son needs to see a uroligist. It's not covered by the private health cover because it's an existing condition so we are having to go through the Medicare public system. If we were able to go private we could have seen someone by now. As it is we are waiting for the Womens and Childrens hospital to contact us with an appointment, which could be months away.

 

It's a bit like in the UK - for none urgent issues having private health cover means you get seen much quicker. Doesn't necessarily mean the care you get will be any better, just sooner.

[Guest Guest5035]

Just a point on this whole Medicare being as good as private thing, my son needs to see a uroligist. It's not covered by the private health cover because it's an existing condition so we are having to go through the Medicare public system. If we were able to go private we could have seen someone by now. As it is we are waiting for the Womens and Childrens hospital to contact us with an appointment, which could be months away.

 

It's a bit like in the UK - for none urgent issues having private health cover means you get seen much quicker. Doesn't necessarily mean the care you get will be any better, just sooner.

Correct me if i'm wrong, but can you not go "semi private" using a private doctor using the medicare hospital, this is what i have known, cost me $500 total from diagnosis to all clear an 4 weeks.

 

Stevo

[Guest AngPhil]

Thanks everyone for the replies. We have got ambulance cover, but hadn't got round to doing the private cover yet. I didn't really understand the medicare system at all, am I right in thinking it is similar to the UK, but you just pay towards the cost of your treatment? It maybe worth getting the extras as I have a horrible feeling both kids will need braces!

 

Thanks again.

[star123]

also can i ask - what is this medicare levy i keep hearing about??? something to do with tax implications??? confusing or what???

[sally1968]

As with Wizzy and Diane, we've never had health insurance or extra's cover - simply take out ambulance cover. Roy had to have a hernia op a few years back and from intially seeing the GP to him having surgery was just over 2 weeks! The only cost to us was for the initial consultation with the specialist and we got some of that back from Medicare. This was all done at Noarlunga and was first class. I have also had some issues involving the need for day surgery and have to have a small procedure again. Saw the specialist on Tuesday this week and could have had the procedure done on 25th this month if I'd wanted.

 

Supposed what I'm saying is unless you have underlying and on-going medical conditions I wouldn't bother. You can even get eye tests once every 2 years for free on medicare! Both Roy and I have glasses and get new ones about once every 2 years - cost really depends on how much you want to spend on your frames - but there is no way we spend as much as we would do on extras cover.

[Misplaced]

This is a very interesting thread.

 

What would be the advice if someone has a health condition that is controlled but requires surgery every 12 - 15 years?

 

Cheers,

 

Misp

[Sallyh]

My twopennorth is that we have private cover with extras, 2 of us have had operations this year and both times we wouldn't have had the surgery if we didn't have the cover. One was tonsils (easy-as getting that dealt with privately, could have had it done the same week we saw the doctor except we had other commitments so waited 2 weeks) and my own surgery probably wouldn't have happened on medicare because it would have been too low priority. Both times I have felt really glad that we had the cover, and I couldn't have forseen either of them last year. No way we can afford to do what other friends of ours do, which is to access treatment privately from savings. I am pretty certain that can be a better use of your money, but if you don't have that money, you have to decide either health ins or medicare only. For our family, the insurance is the right option.

[JimandBarbinAus]

Having worked in both sectors I would say the only difference is speed, private you get seen quicker, its no better than the public service. I never realised the eye tests were free with medicare every 2 years?! Would that be at any optician or set locations ????

[ajford]

Hi, we have extra cover with bupa for things like glass, dentist. Medicare is quite adequate I had major surgery this year I paid a gap fee for the surgeon Medicare paid the rest. Thinking all I paid about $300 I was seen by the doctor and had the surgery within within 6wks. Could of had the op sooner but had to arrange it around hubby being home. In my opinion Medicare and the oz health service is brilliant.

 

Lisa

[sally1968]

Having worked in both sectors I would say the only difference is speed, private you get seen quicker, its no better than the public service. I never realised the eye tests were free with medicare every 2 years?! Would that be at any optician or set locations ????

 

As far a I know any optician - we currently use Specsavers but have used Big W in the past and also a another small opticians previously too. You just need to have your medicare card and there is no gap at all!

[Guest Chris_J]

The guys I work with tell me it's worth getting private cover as it goes up every year after you're 30 by 2% per year.

[Guest Chris_J]

Until you get it that is.

[Lazy Cow]

What would be the advice if someone has a health condition that is controlled but requires surgery every 12 - 15 years?

 

You'd obviously have to check, and I might be overly cynical here, but I think most insurance cover excludes existing conditions. I seem to remember being asked about our health when we went from Extras cover to full Hospital cover.

 

We took out Extras cover because I was worried about braces, my son's hobbies etc and we went to full-cover because I had a horrible feeling that it might be handy to cover cardio-vascular issues now my OH is an oldie lol.

 

One thing that might be worth checking - migrants applying for health cover, whether Extras or Hospital, used to qualify for a lower rating (ie.if you were 40 they'd rate you as a 30yo) if they applied within two (?) years of arrival. This meant lower premiums but I don't know whether they still offer that incentive nowadays.

 

LC

[Guest PixieC]

Ambo cover is a must. Other stuff, is your choice, can you wait for non emergencies to be delt with? What I think is especially important is this, the private hospitals work for the Drs who give them their patronage. The public hospitals work for whomsoever turn up as a patient, no matter when or what condition they are in. It is possible to be a private patient of a consultant in a public hospital (be careful of the details of what you will pay for) to me this is the best option. I would save the equivalent of the private insurance premium each month to an aside account and supposing you are reasonably in good health this will pay eventually for stuff you need done. Anything that is urgent is delt with publicly and very well so. I have worked in both systems and find that there is a lot of ignorant snobbery about public health.

[Guest Xhako]

You may HAVE to get private medical insurance for your visa to be approved! We had to prove we were covered for our 457 (at least until we could register with Medicare) but we got a premium which is $94 per fortnight.

Good luck...

[Guest rooney74]

Hi All,

 

Is Medicare similar to NHS and do you have to pay for it?

i heard people on a 457 visa are entitled to Medicare.

 

thanx

[cliffy]

I agree, Ambulance cover is an absolute must, from the day you set foot in Australia, and it does cover you if you go into other States.

We have no private cover, as my husband has complex medical problems and the best care for this is in the public system any way.

We have often seen doctors, and had scans privately, and paid the difference between their fee and Medicare.

Private health cover does not include visits to specialists for a consultation and most of these will see you in their rooms without waiting to be seen at the main hospitals.

When we have privately covered either a day surgery procedure or a short stay in a private hospital, we have paid a lot less that we would have spent on Private Health.

It is like all Insurance, its a risk, can you afford to self insure!!!