Private Health Funds.

[Skids]

My youngest Jess has just turned 22 & been 'removed' from our family health cover.
So time to adjust/change insurance.

I joined Medibank when I was 15, it was one of the first things my old man told me I had to do when I started my apprenticeship. I ticked along with them for about 30 years. When working for Rio Tinto, they had employee benefits that included paying 60% of your private health cover, as long as you had top hospital and extras, lovely.
I changed employers to Sandfire in 2010 and they had a corporate package thing with HBF, so I transferred over to that. It didn't turn out to be what I thought so I went through one of those finder mobs, which led to me having HCF as my provider until now.
I just changed to QANTAS (NIB) as the 100,000 points to switch works in well for our 2024 trip to the USA.

I'm at the fun age now where dental is pretty important (just had my 1st crown done), optical (who in their 50's doesn't wear glasses) and probably a knee replacement down the track. I have to have a colonoscopy every couple of years now too... gee it's fun getting older.

Looking through the information on all these funds is a pretty time consuming and confusing task to say the least. I was wondering if there are any Nicksters with some good health fund experiences and who you may recommend.

Thanks.

[think positive]

I’ve been with nib for a while, i pay yearly so I don’t have to think about it, every year I check around and I stay with them because it’s economical, now my kids are working they are with bumps for the best deal for their age. Honestly I only have it for the tax break, and both girls need it too, ones in IT the other a teacher, not sure when it kicks in but I really believe you should have ambulance cover and they get that too.

Dont have extras, my knee jabs are not covered in Oz yet, hubby is having heaps of dental, but I worked out the cost, it’s still better to bank the money andget interest rather than pay and not need it. I had my hand op at a private hospital and was oop about $3 k I think, but the boost to the next level was way more than that. Hubby has had experimental treatments in the past and it cost a bit, hopefully since they work people can now access them under public Heath, people who could not afford it, because it’s life saving.

Kids didn’t need braces, but even then the cost of the extras and waiting periods, I’d just pay for it, even when hubby had major surgery at Geelong hospital after we hit a certain amount I kept getting cheques from Medicare. It’s a pretty good system, well compared to other countries anyway!

[stui magpie]

I'm with NIB, have been for years. they're pretty good, pay out well provided you don't use it a lot in any given year.

Used it when my son had a non-malignant tumour in his knee that needed surgery, both kids braces, daughters wisdom teeth removal (day surgery) and for me regular dental and irregular physio and/or chiro when my back or neck/shoulders play up.

Also had elective surgery on 3 umbilical hernias during a small gap in lockdowns in 2020. Would have been on a public waiting list for 2 years, instead just met the surgeon my GP referred me to, organised it at the Private Hospital he worked at, done and dusted within 2 weeks. Overnight stay in the hospital, even got a glass of red with dinner, about $1500 out of pocket.

[Skids]

Dont have extras, my knee jabs are not covered in Oz yet, hubby is having heaps of dental, but I worked out the cost, it’s still better to bank the money andget interest rather than pay and not need it. I had my hand op at a private hospital and was oop about $3 k I think, but the boost to the next level was way more than that. Hubby has had experimental treatments in the past and it cost a bit, hopefully since they work people can now access them under public Heath, people who could not afford it, because it’s life saving.

I did think about that a few years ago, but I don't think it's worth the risk now. We pay circa $5k/yr.
A crown is around $1600, glasses for the 2 of us would be $1,000. The colonoscopy would be close to $10k and a knee replacement over $20k. I can't imagine what emergency heart surgery would cost if you needed it??

Dad just had his prostate out, that would have been over $20k.

I think you could run the risk of having minimal cover up until your late 30's.... I couldn't run with that option now.

[roar]

Emergency heart surgery is free, as is all the emergency stuff. Well, paid for by our taxes.

[think positive]

Emergency heart surgery is free, as is all the emergency stuff. Well, paid for by our taxes.

Exactly. And $1,000 for glasses? Shoulda gone to spec savers!

Colonoscopy is $480 oop, 3 week wait, then specialist fee of $290 short visit, $390 long visit, oop fee $100 for either amount. That’s from last month!


Not sure where your getting your figures from skids,

[Skids]

2 x pairs of glasses and a pair of Sunnys each... would be over $1000. I think my last pair of prescription sunnys were $400 if you bought them outright.... that IS specsavers.

Just looking at the colonoscopy quote (HCF) now. $3400, medicare pays 37%, so that leaves about $2300 total?
I had to pay first $500 for the hospital and the fund picked up the balance.
Maybe it's different here in the west? If I went through the public system, because it wasn't classed as urgent, there was a 12 month wait.

From their web page...
HCF pays 52%
Medicare pays 37%
You pay 11%
Cost based on: participating private hospital; Nil excess; doctors participating in an HCF gap arrangement
Total service cost
$3,400
Your cost
$377

[Skids]

Not sure where your getting your figures from skids,

The greedy specialists that live in the big beach front houses.

[eddiesmith]

With Bupa, not sure if it’s any good and haven’t changed my cover for about 15 years!!!

Mainly on it for the wait times more than anything, as a very active person playing a lot of sport I could t risk it. See so many without suffering in pain for months or even years to get fixed up.

Should probably look into changing things around but just cbf! Some of the things I’m covered for are quite funny and zero use to me

[think positive]

2 x pairs of glasses and a pair of Sunnys each... would be over $1000. I think my last pair of prescription sunnys were $400 if you bought them outright.... that IS specsavers.

Just looking at the colonoscopy quote (HCF) now. $3400, medicare pays 37%, so that leaves about $2300 total?
I had to pay first $500 for the hospital and the fund picked up the balance.
Maybe it's different here in the west? If I went through the public system, because it wasn't classed as urgent, there was a 12 month wait.

From their web page...
HCF pays 52%
Medicare pays 37%
You pay 11%
Cost based on: participating private hospital; Nil excess; doctors participating in an HCF gap arrangement
Total service cost
$3,400
Your cost
$377

what used to be the altona hospital does them, my daughter went public, she only has basic health insurance, and the oop was under $500 aside from the after care specialist appointment

[think positive]

dp

[Dark Beanie]

Had a colonoscopy earlier in the year.
Cost was $500, through a private day hospital.
Don’t have private health insurance, treated the cost as a preventative health measure.

[Skids]

So ne real recommendations then... they're all pretty much of a muchness?
I did just discover that one of our employee benefits is a corporate rate (9% discount) with Medibank Private which is quite appealing.


I found this info on an accountants page...

We're probably regarded as being in the 'good income' bracket, so the tax savings aren't really a factor. I'm more influenced by the pros & cons below I guess.

If you make a good income, can afford a high-level private plan with minimal gap costs and value good benefits, services and a sense of security then maybe a comprehensive private plan makes sense for you. But as a higher income earner, you probably won’t see a tax advantage (and Federal Government rumours suggest that private health tax advantages might disappear completely for higher income earners).

Pros

Quality of care in our public hospitals usually rivals that of private hospitals.

Public hospitals often have a broader spectrum of equipment and specialists in each location, which means that patients can undergo multiple tests, scans and procedures in one place.

Many procedures and operations require no out of pocket expenses from the patient.

Cons

Waiting times can be long. This can be real issue for people waiting for operations such a knee or hip operations where quality of life is severely diminished.

You have no choice when it comes to when or where your treatment, consultations or operations are. If you are unable to make a date sent to you, you may drop to the bottom of the list again.

Under-funding is evident where some waiting rooms are slow, understaffed, overcrowded. This can commonly result is a 2-4 hour wait.

Medicare does not cover general care, such as dental treatment or optometry.

[think positive]

[quote="eddiesmith"]With Bupa, not sure if it’s any good and haven’t changed my cover for about 15 years!!!

Mainly on it for the wait times more than anything, as a very active person playing a lot of sport I could t risk it. See so many without suffering in pain for months or even years to get fixed up.

Should probably look into changing things around but just cbf! Some of the things I’m covered for are quite funny and zero use to me

[stui magpie]

What's with the colonoscopies?

I do the free bowel cancer check every 2 years but it's never been suggested to send Captain Nemo and the Nautilus up the clacker.