Health Insurance, question about experiences.

[billp]

Hi All,

I was a medibank member for about 20 years, I recently changed because of price increases etc, all the normal stuff. Never really had a bad experience, but then again never really used it for anything other than extras.

I moved to HCF. We are getting the same extras cover, for a lot less. However having a conversation with a pharmasist friend, she has warned us that in emergency situations that don't cover much.
The example she gave was antibiotics not covered by the PBS, can't remember the name of the drug, but it is used to fight staff infections etc, and can put you out of pocket in the thousands.
HCF and NIB etc refuse to cover any of these costs, whereas the likes of the bigger companies are more likely to cover some costs?

Has anyone had any experience with this type of claim? Am I better off going back to a bupa or medibank, just in case? Our friend had nothing good to say about HCF and NIB etc. But if you read online reviews, all private healths are as bad as each other for not paying for one reason or another.

Interested to hear others thoughts on the matter.

[AndyP]

I really have little idea and keep blindly paying their expensive fees for the just in case.

[thecollective]

I really have little idea and keep blindly paying there expensive fees for the just in case.

+1, it's an absolute money pit, but it keeps the wife happy especially with the two young ones in mind.

PS. When I had my tonsils out I made a big claim, none of the drugs that I was given were covered by my insurance, cost me about $200+ out of pocket just for the medication

[jimandr]

I really have little idea and keep blindly paying there expensive fees for the just in case.

I'm the same. I suspect that if I had the discipline to put away the 170 per month in a separate account and not touch it I'd be well ahead.

I've only been to hospital a few times and always been satisfied with the medicare service, and you don't get much as an allegedly private patient in a public hospital.

I'm mainly still in it for the dental and optical extras.

However, now Billp has sown the seed of doubt, I might have a look at my policy to see if it covers what he describes. Personally, I doubt if any of them would, but I'll be back with an edit if I find success.

Surely Dr Google would know?

[AndyP]

+1, it's an absolute money pit, but it keeps the wife happy especially with the two young ones in mind.

PS. When I had my tonsils out I made a big claim, none of the drugs that I was given were covered by my insurance, cost me about $200+ out of pocket just for the medication

I would have thought that private health cover would help out with seeing specialists, like when I had surgery on my hip, but medicare is more useful, except for the hospital stay.

[thecollective]

I would have thought that private health cover would help out with seeing specialists, like when I had surgery on my hip, but medicare is more useful, except for the hospital stay.

I was the same when I got DVT. At the hospital I got everything for free through Medicare but as soon as the specialist found out I had private health he said it would be better if I visit him privately.

Strange thing was (went I visited him privately) none of the scans went through my cover; they were all Medicare and then I paid a small gap cost for the consultation

[Hatchman]

I really have little idea and keep blindly paying their expensive fees for the just in case.

Also a +1 here.
It has helped a lot with Mrs Hatch’s numerous hospital stays for her medical condition as 1. she would not have got in under Medicare and 2. there is no way we would have been able to afford the cost as a private patient. I saw the costs of what was being charged on some forms one day.

[Ron Burgundy]

Here’s my 2c.

Health insurance is very useful for elective surgery to avoid a waitlist, possibly some chronic illnesses that involve repeated hospital admissions or to avoid the tax if you earn enough. That’s it. For acute illness/injury you’re much better off in a public hospital. The care/quality is at least equal to the private system and for trauma particularly they’re light years ahead of private. You don’t get to choose your doctor in the public system but most people have no idea who’s good and who’s not anyway so it doesn’t make much difference. Plenty of the top doctors work in both anyway.

Extras cover is generally false economy. The extras cover is broken up into smaller components for a myriad of services that you’re unlikely to use all of and they rely on the feel good factor of you getting a little back a few times per year (so you feel like you’re getting a return unlike say home or car insurance) masking the fact that you’re getting fleeced. Even the pokies let you win occasionally but the house always wins in the end.

If you’re relatively young and healthy your premiums are propping up all the old timers who the funds are paying out on and may be better off without it.

All that being said I still have it because I don’t want my kids getting stuck on a waiting list for something elective and with the Medicare surcharge I may as well. Although if they or I ever needed trauma/acute care etc it’d be straight to the best and biggest public hospital within the timeframe needed.

[Captain Nemo]

Listen to RB, he’s in the game.....knows all about it, lol!

[backintheswing]

RB’s response is spot on.

Son recently tore his acl playing footy. Was a 6-8 month wait in public, but got in the next week with private. Chose the best knee surgeon in Brisbane too, was out of pocket about 3k all up.

[markTHEblake]

Never paid Hospital cover, i figure that since i have been married have saved $100k, in that time we have had 2 kids, couple of broken bones, and a hysterectomy all in public, and it was great.

Now i pay $400pm into a sinking fund for medical stuff, by the time I am 65, I will have $70k in that bank account. At some point I will begin using that slush fund to pay for private hospital.

[Daves]

It is insurance, not a savings plan, so best to treat it that way. In my mind you are insuring against a medical disaster(s) and/or also you own (lack of) financial discipline or position to put money aside for such things. And Insurance can be somewhat confronting at times, especially if it involves your own mortality. With Life Insurance you are basically betting that you are going to die younger than average! That is a bet we are happy to lose! ,not sure why we think differently about Health Cover?

We have been with HCF/MUIOOF for decades and are still on an older plan that covers more than usual. I have compared it to the market a number of times and also used the iSelects etc and it always comes out on top for us. But it will not suit everyone.

HCF provides details of your claim benefits each year along with the Tax Certificates. I assume all Health Funds do? You should review it accordingly, but remember this is a long term game and there will be ebbs and flows. In 2017/18 for example our benefits were half our premium. In 2018/19 they were double. So over two years we are actually ahead.

I tend to agree about Extras, I doubt whether you ever win on Extra cover cost vs claims scenario. But if you don't have funds aside to cover Kids dental, Optical etc, it can help ease the pain. Work out what you need cover for, and find the policy that gives you the best deal, or drop it completely and open a health savings account and start squirreling some rainy day money away.

Hospital cover is were the potential financial disaster looms, or worse a life and death situation. A Knee or Hip replacement easily costs five figures. My Dad paid $25k to have one when he dropped his Health Cover after having a Hissy Fit after he misread some correspondence. The other Knee Replacement was covered and cost him nothing. The Public waiting lists for these type of ops tend to be pretty daunting. But if you are younger, your risk profile is different and you need to factor that in. Like other insurances, you can vary the level of cover, your Excess amount etc to lower you premium, if it makes sense to do so.

[PeteyD]

2 hip replacements, one at 41 and one at 47. I think we are well in front, ignoring the kids stuff we have had over the years. Also the medicare surcharge adds up if you are in that bracket, and the lifetime thing if you are not insured from 30. Going private to get some stuff done with the kids has helped us too. The boss is a theater nurse at a large public hospital and she would not entertain the idea of not having private cover.