Insurance Vs just paying the dentist etc

[Guest Adelaide_bound]

Wondered if anyone with experience of health insurance and having to claim etc could advise really - me and hubby both wear glasses (and need new ones currently!), or contacts (me) and want to get our eyes lasered down the track. We also both have pretty ropey teeth. Other than that we are in fighting fit health, never really ill or have anything wrong with us.

 

I've been doing quotes for health extras only and it seems that I can't really get a plan that would cover us for anything near the cost of even a single crown if we should need it, so am thinking its simply not worth getting the insurance? But don't know if thats just my cynical insurance hating side coming out at all, so was wondering if anyone had their thoughts on it.

 

We definitely don't want hospital cover, and the quotes I've been given generally come back at the $100/month for us both mark (there are a few down at around $40/month, but they only give $100 for dental and $100 for glasses a year which wouldn't really cover anything at all, so not worth it apart from ambulance cover imho). So thinking if I saved the $100/month in the saving account (which currently has a good interest rate on it), it might be more worthwhile than a plan where I can only claim $500 for a crown (from doing a bit of research it looks like a crown would cost in the region of $900/crown), once a year and only 85% of the cost of check ups and minor fillings anyway, so I'd still be paying out for those. So if we needed more than one crown we would be in the same place as if we didn't have the insurance anyway from what I can see - or am I really wrong about pricings?

 

Anyone who's had tooth work done, I'd really appreciate any comments

 

Cheers

[Diane]

We don't have private insurance. I had my eyes lasered here and you can claim a large chunk of the cost back against tax anyway. Eye tests I seem to remember we got a free one each year for our son. Possibly for me too (sorry been a while since I've needed one). You could look into something like Smile dental insurance - that seems very reasonable price wise and have had good reports from people who have used it - their website also gives a good listing of prices of treatments both without and within the scheme.

[Guest Adelaide_bound]

Many thanks for that Diane - didn't know eye lasering was tax deductible - god I love this place! lol

 

Knew about the free eye tests - its meant to be once every two years, but basically Spec savers/OPSM etc will just do one for you whatever, just ask the optician if they bulk bill

 

Cheers, will research smile then

[Diane]

Many thanks for that Diane - didn't know eye lasering was tax deductible - god I love this place

 

I didn't know either, but the clinic I had my eyes done at mentioned it which was great. It counts as a medical expense, and if you keep all your medical receipts (worth checking with an optician if this includes optical) over the year, then something like 20% of the cost over a certain limit is tax deductible. I had a search and found this http://atotaxrates.info/tax-offset/medical-expenses-tax-offset but have to admit the tax office pages always have me scratching my head! We use an accountant!!

[Guest Guest12727]

An interesting dilemma.

I am coming from the point of view of someone who has always had insurance and guess I just don't want to rely on the public health system. We have Basic hospital ($500 excess) and top extras 70 with Medibank Private Benefits to us are:-

Extras

My husband and I also wear glasses/contacts and visit dentist regularly. With our insurance we get a pretty good deal with optical and dental cover. OH got new glasses and didn't pay a cent. I get contacts without paying a cent for about 3/4 of the year until I reach the limit. We all visit dentist every 6mths (son included) and pay nothing for a check-up and clean and polish. Pay a bit for fillings / x-rays etc but not a huge amount. I had a crown replaced and the gap wasn't extortionate.

Also had physio, podiatry etc - but rebates on these aren't great (the 70 bit on our cover dictates the rebate level we get - we chose to pay less per month and pay a bit more if we use a service).

Hospital

Son has had 2 ops since being here and were both done in private hospital without us paying a cent for hospital care, including overnight stay (the excess doesn't apply to children - yipee), or for the anaesthetist. Surgeon gap was about $300 including initial consult. Both surgeon and anaesthetist were in some system with MP where the gap is covered or reduced. The most recent op was last year. We saw the surgeon one week and he was booked in for the op the next. It wasn't an urgent procedure and I am sure it would have taken months or years in the public system.

At least we know if we need something doing we can get seen pretty swiftly.

Rebates and Tax

There is a reduction on private health insurance of 30% paid by the government. If you don't have private health insurance you pay extra medicare levy on income.

Make sure you factor this into your calculations.

A couple of times I have priced other companies, but never seem to get as good a deal as with MP.

[scooterdan]

We used to have just Extras cover for dental.... Cancelled it when we used it as we realised what we got back was basically nothing compared to the cost of insurance!!

 

We now just put the money we would spent on premiums in a savings account... If we don't need any major dental it's a nice savings boost too!!

[scooterdan]

Also 'Extras only' is not claimable at tax time!! So in essence pretty useless there too....

[NicF]

We have hospital and extras cover with Health Partners. I'm not convinced by the hospital cover but the extras seems good value so far. Three out of our family of four wear glasses and we've all had new glasses this year, and the kids and my OH have all had work done at the dentists. There are limits on things but if you use the Health Partners providers you get a discount on the amount over the limit. It's not too expensive for cover either, but I haven't done the sums to work out if it is actually worth having yet though.

[scooterdan]

All eye tests are covered by Medicare and glasses are always 2 4 1 somewhere and not all that expensive compared to premiums all year!

[NicF]

All eye tests are covered by Medicare and glasses are always 2 4 1 somewhere and not all that expensive compared to premiums all year!

 

I am very short sighted and always get extra thin lenses in my glasses. The last pair I had I saved something like $400 having insurance. According to the health partners website we pay $28ish a fortnight for extras cover for a family of four, which comes out at about six months worth of payments for the saving on my glasses. I haven't priced up the same lenses elsewhere yet, but I suspect I could get the frames a bit cheaper and the lenses would be about the same. My oldest son has also had glasses this year, although his weren't anything like as expensive as mine. We've also saved a few hundred dollars on the dental this year as well, although I haven't priced this up at different places either. So far though we seem to be getting our money's worth.

 

Whether it's worth getting extras or hospital cover will depend a lot on your individual circumstances and it will not be the same for everyone. If you earn a lot having hospital cover will also prevent you having to pay the extra Medicare levy, but you have to earn about $160k a year I think before this kicks in. I can highly recommend the Health Partners extras for anyone living near enough to there own centres - this is where you get the most benefit from the Health Partners cover in my opinion.

[Guest Guest12727]

I am very short sighted and always get extra thin lenses in my glasses. The last pair I had I saved something like $400 having insurance.

 

Me too. My glasses normally cost around $700 a go. Oh to be able to walk into Specsavers and get their deals, they don't really apply to the likes of us sadly, but OH did.

 

Yes, Medicare surcharge of 1% kicks in around $80k for a single and $160k for a family.

 

There is also the Lifetime Health Cover (LHC) reduction which aims to encourage people to take up private insurance at a younger age (31yrs). The older you are when you take it up, the less you get back from the Government. There is exemption from this for recent migrants, who are treated as if 31yrs for rebate purposes as new migrants.

 

However, this is all under discussion by Governments and rules liable to change pretty soon.

[adelaidenow]

If you don't have any cover at all, and need an ambulance, you will get picked up and taken to the hospital, and then get a bill for several hundred dollars!

 

I would recommend ambo cover as a minimum for each and everyone, unsure of costs, but its minimal. Private medical insurance does cover this, I think, on all policies.

 

 

But as usual, read the T&Cs

[Guest Adelaide_bound]

Cheers guys, some things to think about there, I'm not sure fir the low earning couple we are currently it would be that good, for now anyway. We've missed the age loading thing as too old and been here too long, and definitely not interested in hospital cover so we will see - will probably get sa ambulance cover at around $60 for the year, definitely if we don't get full extras cover. Thanks for the opinions, all helps

[Diane]

Do do DO get ambulance cover! Get it now. Don't put it off. You never know what's round the corner and it costs so little in the big scheme of things. Can you imagine if something bad happened and one of you was rushed to hospital? The last thing you'd need is a huge ambulance bill. Go to a post office, fill out the form, pay over the counter. Really easy to do, even if you do end up getting private cover down the road. Do it now (please!).

[lorluc]

Do do DO get ambulance cover! Get it now. Don't put it off. You never know what's round the corner and it costs so little in the big scheme of things. Can you imagine if something bad happened and one of you was rushed to hospital? The last thing you'd need is a huge ambulance bill. Go to a post office, fill out the form, pay over the counter. Really easy to do, even if you do end up getting private cover down the road. Do it now (please!).

 

 

YES!!! Do it! We had never had to call an amulance ever in the UK...within 3 months of being here, we had to for my son. Nice bill came through later...think it was around $600? this was 8 years ago now...

 

Also, i think having medical cover also depends on family circumstances. Remember extra cover also includes physio, chiro's etc....

 

We use the cover for usual things like glasses (4 of us have them in the family), but my daughter was a regular netball player and had to have physio weekly for months, trust me that cost soons mounts up! She also had to see a chiropractor for weeks as well... Now my son is a regular football player so fingers crossed i wont need it, but i'm relieved its there.

 

Also take into account the pharmacy option. If you are prescribed medication that is not on the PBS system, it will cost! My daughter recently got prescribed meds that is not covered and the cost was around $70! My insurance paid the difference between this cost and the standard PBS price (around $38 i think). So if any family members are on regular meds, maybe check out if they are covered under the PBS system.

 

I think the premium for our family is around $120 a month but i know that includes $35 my 23 year old pays for her extra's...so for 2 adults & 3 children (17,14 & 9) the cost is $85 per month. So if i saved that over a year that would be about $1020....wouldnt have covered our use if i had done it that way.

[Diane]

Dental insurance is NOT car insurance. They don't raise your rates based on usage or claims.

 

 

If your copay is $25 why in the world would you pay $100 out of pocket to see your dr? And those pts with self pay still pay alot more than those of us with a copay.

 

 

 

How does it work in India, where you are located then Anthony?

[John Browning]

Got to agree with you there, but two things

 

a) Factor in the Private Health Cover Rebate that you get with your Annual Tax Return

 

b) Don't forget to stash the cash you are not paying into some sort of term deposit that you can access if / when the need arises

 

 

John B

 

PS Regards Specs..... I'm finding that ordering prescription specs from the UK is a hell of a lot cheaper.

[Misplaced]

Just to play the devil here -

 

Many are suggesting not taking out Private Health cover but to put the money away in a quick access deposit account. Which is good advice but as has been stated it does depend on your own/family circumstances.

 

However, when it comes to Ambo cover everyone is saying get it and get it now!

 

What I am struggling with here is "What is the difference" why not just put the money in a deposit account as suggested with Private Health cover?

 

Just seems contradictory :-/

[Diane]

Just to play the devil here -

 

Many are suggesting not taking out Private Health cover but to put the money away in a quick access deposit account. Which is good advice but as has been stated it does depend on your own/family circumstances.

 

However, when it comes to Ambo cover everyone is saying get it and get it now!

 

What I am struggling with here is "What is the difference" why not just put the money in a deposit account as suggested with Private Health cover?

 

Just seems contradictory :-/

 

Ambulance cover costs about $140 a year for a family of four (you can google SA Ambulance for exact costs) - whereas if you were in an accident of any sort, and an ambulance was called for you, you could easily end up getting a bill for a few thousands.

[cliffy]

Ambulance cover is quite cheap and as stated previously an absolute necessity. http://www.saambulance.com.au/ProductsServices/Ambulancefees.aspx

If you think of the considerable costs of a retrieval, perhaps by helicopter, in an emergency and the fact that you may be unable to decide youself whether or not to use the service at that time, you will see how essential it is.

Initial attendance at a Motor Vehicle Accident is covered by SA Govt. but not further costs or a call to your home or any other place, whether made by you or for you.