Health care conundrum...

[mrogers]

Hi all. Having arrived in oz 3 weeks ago I have recently started to look into health cover.

Medicare versus Private.

Can you tell if me how I understand it is correct.

Public hospitals are exactly the same as UK apart from the Ambulance is chargeable?

Dental is fully chargeable.

If the above, how I understand it, be correct, anyone from the UK who was happy with the NHS would of happily opted for the same.

But because the Ambulance is not included people feel they need basic hospital cover in case they need an Ambulance?

 

As the more I read the more the government encourages you to have private insurance and penalises you as you get older by charging you extra each

year you leave it not getting private health cover.

Its as if they offer you and give you Medicare, but at the same time don't want you using it and rather you have private.

We don't get a choice in the UK for the NHS, so what is so bad about it here in Australia that everyone feels they need a choice of hospital and doctor?

 

Now onto Dental charges, as they are solely paid for by the individual, major dental cover seams to be a must as an extra.

Apart from having basic hospital cover and major dental do you really need anything else? Does medicare not take care of you if you come down with some illness, or break a leg?

 

Also, with private insurance, as it seems not to be too cheap, I also cant get my head around how your insured, but still pay. The whole amount is not covered in many cases. Infact, some only cover just over 50%, paying an higher premium I found some up to 80% rebate. But then the cost of cover per year is that much, in many instances it is higher than your allowance per person per year. And the same on the lower premiums, you pay less for the cover, but then pay more for the treatments.

If your paying basic hospital for Ambulance cover, and want major dental with 80% rebate I have not found any that are less than $2000 per year for a family.

These are also the basic prices which only reimburse you around half or slightly more.

Or am I missing something, am I wrong, do you get more back and am I not understanding the system correctly?

Coming from the UK its a lot to get your head around.

 

Thanks for reading and hope it makes sense, it does in my head :-)

[verystormy]

Healthcare here is complex and often changes each year.

 

Private cover ver can be important for a number of reasons other than tax and dental.

 

First, yes it is important for tax, otherwise you get slugged with the Medicare charge. Yes, it is silly, but that is the way it is.

 

Dental costs here can be huge, so dental cover important. We have a 90% rebate policy. The policy is expensive, but has given us a lot of money back. For example, my wife had to have a new crown fitted to a tooth. The total cost, including removing the old one, was about $3500. A check up with the result of the dentist saying you need a filling is going to be heading towards four figures.

 

A short trip in an ambulance with no real treatment cost me $700. So I was pretty glad I was covered.

 

Now, the hard part.

Not everything for normal health care is covered by Medicare. For example, physio is not covered unless you are an in patient. Same with many scans and tests.

Waiting lists can also be incredible for public services. My doc was very worried that I might have bowel cancer a year ago. So wanted me to have some urgent tests. However, the public system wait time was at least 18 months. That would have been probably fatal for this disease. But, I was able to be seen the same week with private.

[ali]

We have private health cover - both the consultants I saw charged an initial fee then nothing else, I wasn't charged for 3 hospital stays or operations, but I was able to choose my Dr and the date I had the operations - for one I had the consult on the Tuesday and had the operation on the following Friday.

[mrogers]

Thanks for this. So the wait time for life threatening diseases are of the concern to medicare and you could long be incurable or worse by the time you are seen. And the dental costs you mentioned are ridiculous, i didn't realise they where so expensive. I will need 2 veneers in the next few years so I suspect that could be 5 figures?

May i ask which insurance your have for 90% rebate as that is very good indeed.

[verystormy]

W use Bupa. Have used a few others over the years, but they have proved the best for our needs. But they are expensive. We have the very top level cover and it is over $200 a month for two of us.

 

But, always go through with them in detail what is covered and see how that meets your needs. For example, veneers might be seen by some as cosmetic and not covered.

[mrogers]

Ah, that is good to know so dental major still may not cover them. Thanks, I'll look into that

[mrogers]

Regarding the Medicare Levy, have I got this correct. Say my earnings are $75K and there is no other income, so the levy is 1.5% which would be $1,125.00.

If I have private health insurance would I not be charged the Levy on max tax bill?,

Meaning what ever my health inurance cost minus $1,125.00 ?

As if that is the case then it does not seem that bad at all.

 

Thanks again and sorry for more questions

Mark

[Guest Guest6235]

When you put it like that @mrogers if you didn't get P.I and had a bill of $1,125 p/a compared to paying over $300 p/m like some do then that doesn't seem that bad. I know the salary you mentioned was an example but you have to think can you shell out $250-300+ p/m on insurance & have enough left over to enjoy things. I think we may get some sort of insurance but not sure what. I've thought if we can save so much a month on top of money we have saved already then by the time my daughter may or may not need braces then we would have the money for that. Also when was the last time you needed an ambulance. Only playing devils advocate as it's something we really need to look into. @82rhoads mentioned the other day they use a company called HBF & hardly pay anything for dental costs, I asked how much they pay for this service p/m but has not replied.

[Bridges]

I too am slightly confused by the whole medical system. I get that medicare cover you for most things but wait times can be long...i think regardless of medicare or pi you still have to pay for tests/scans etc, please correct me if I'm wrong.

 

Here is my main query, say for example I go to the docs and they decide i need tests doing but wait times are long, can I then go and get pi and go down that route or would it then be classed as a pre-existing condition and therefore something the insurance wouldn't cover, very stormy you may be able to help with this. Hope things are ok with you BTW.

 

Keefo, at the moment we are also covered by HBF. We have opted for the extras package only which means ambulance, dental, major dental, and physio cover only, we do not have any hospital cover as yet - it is $65 per month for family of three (which reminds me, best add the new bambino to it!) Not sure if that helps any...

[mrogers]

@Keefo I think what you say makes sense. I think for now we are going to opt for full dental and maybe emergency ambulance and leave the hospital convert for now as we have 11 months before we have to make a decision on that before we get penalised. Like you say, can we spare $250 plus a month on something you get free with medicare anyway.

[ali]

@Keefo I think what you say makes sense. I think for now we are going to opt for full dental and maybe emergency ambulance and leave the hospital convert for now as we have 11 months before we have to make a decision on that before we get penalised. Like you say, can we spare $250 plus a month on something you get free with medicare anyway.

 

Do any of you wear glasses? You save quite a lot on optical (childrens glasses aren't free here)

[mrogers]

No, thankfully not which will save us some on the premium

[Guest Guest6235]

I too am slightly confused by the whole medical system. I get that medicare cover you for most things but wait times can be long...i think regardless of medicare or pi you still have to pay for tests/scans etc, please correct me if I'm wrong.

 

Here is my main query, say for example I go to the docs and they decide i need tests doing but wait times are long, can I then go and get pi and go down that route or would it then be classed as a pre-existing condition and therefore something the insurance wouldn't cover, very stormy you may be able to help with this. Hope things are ok with you BTW.

 

Keefo, at the moment we are also covered by HBF. We have opted for the extras package only which means ambulance, dental, major dental, and physio cover only, we do not have any hospital cover as yet - it is $65 per month for family of three (which reminds me, best add the new bambino to it!) Not sure if that helps any...

Wow thank seems a good price for that, thanks....does major dental work include braces on the policy.

[Guest Guest6235]

Don't take my word for it @mrogers I'm not clued up on the whole thing, I was just throwing scenarios into the mix. I've seen before on here that you just can't pick and chose what to have, what I mean is if you choose you want dental you also have to include some lesser insurance cover in it also.

[Guest Guest6235]

Do any of you wear glasses? You save quite a lot on optical (childrens glasses aren't free here)

We'll need to look into it Ali (pardon the pun) my wife and I don't but you never know my daughter might have to.

[Druid]

I too am slightly confused by the whole medical system. I get that medicare cover you for most things but wait times can be long...i think regardless of medicare or pi you still have to pay for tests/scans etc, please correct me if I'm wrong.

 

Here is my main query, say for example I go to the docs and they decide i need tests doing but wait times are long, can I then go and get pi and go down that route or would it then be classed as a pre-existing condition and therefore something the insurance wouldn't cover, very stormy you may be able to help with this. Hope things are ok with you BTW.

 

Keefo, at the moment we are also covered by HBF. We have opted for the extras package only which means ambulance, dental, major dental, and physio cover only, we do not have any hospital cover as yet - it is $65 per month for family of three (which reminds me, best add the new bambino to it!) Not sure if that helps any...

 

Anything pre-existing is not covered for 2 years when you take out hospital cover, i know, i have a lower back condition and ended up at the doctors, he sent me for a scan, then i looked into upgrading my HBF to hospital cover to cover the operation, no joy, now i have to wait two years, still be quicker waiting for HBF than going down the medicare route

 

I paid $60 for the hospital appointment, $27 of which i got back from Medicare, i didnt pay the scan as it was a bulk billed facility.

[verystormy]

The Medicare levy is a hard one to deal with. But my advice is that most of the insurers offer a minimum cover policy that ensures it meets the requirements to be exempt. But, you need to ask the question to the company about any particular policy as not every policy does. It gets a lot more complicated for those on temporary visas such as 457.

[Guest Guest6235]

Anything pre-existing is not covered for 2 years when you take out hospital cover, i know, i have a lower back condition and ended up at the doctors, he sent me for a scan, then i looked into upgrading my HBF to hospital cover to cover the operation, no joy, now i have to wait two years, still be quicker waiting for HBF than going down the medicare route

 

I paid $60 for the hospital appointment, $27 of which i got back from Medicare, i didnt pay the scan as it was a bulk billed facility.

Whereabouts was the bulk billing facility Druid? I've seen on here that a lot of Docs etc don't do bulk billing in WA or are hospitals different.

[Druid]

Loads of doctors do bulk billing, i found most of the doctors in the older suburbs, more of the community doctors do bulk billing, when you see a doctors and he refers you for tests, ask him if the testing facility is bulk billed, if he says no, ask him for a referal to a bulk billed facility, once you have a referral form, you are not obliged to use that facility anyway, you can go home and google other facilities and find a bulk billed one, as long as you have a referral form any facility will take you.

[Guest Guest6235]

Cheers. How misleading though to have read that a lot don't do it in and around Perth. This is good to know.

[Druid]

Cheers. How misleading though to have read that a lot don't do it in and around Perth. This is good to know.

 

Thats because all the doctors in the newer subirbs are greedy, Western Radioligy are bulk billing fir cat scans x rays etc

[Guest Guest6235]

Just looked on Bupa website as the HBF one kept freezing up and on there policy (not basic) you could only claim on orthodontics up to $400 p/a & $1300 for the lifetime of the policy. Imagine paying the monthly fee then getting a $6k bill and can only claim $400.

[Alphagirl]

Hi mrogerso! I have also come from the UK, about 5 weeks ago. I contacted ' Comparethemarket ' & when they rang back, they quoted me $169 a month & told me that after 12 months I would have a much lower quote, but for each year after, there would be a 2% loading, the same as native Australians. Still unsure I went to Hbf & was given a quote for $289 a month! However, she did tell me something of value, & that is when you come to Australia to live, for the first 12 months you are deemed to be an ' Overseas Visitor.' Then came the bombshell! She told me that the status of ' OV ' meant I could not shop around for the cheapest insurance. I can only get private cover by using BUPA, ie. none of the health insurance companies will cover OVs. They quoted me $229 per month. After 12 months apparently, the cost will dramatically reduce. If anyone out there knows differently, please let me know as I'm tearing my hair out!!? I could perhaps swallow it if it weren't for the fact that you would not be able to claim for any pre existing ailments. MEDICARE, by the way, only covers for accidents & emergencies, as my card says ' Reciprocal ' across it. ? Hope this helps!