Be aware that medical insurance isn't the same as it is in the UK
Nov 9th 2007, 2:11 am
#1
Lost in BE Cyberspace
Thread Starter
Joined: Mar 2003
Posts: 9,397
Be aware that medical insurance isn't the same as it is in the UK
There are always threads current about Australian medical insurance.
Be aware that insurers here don't pay out nearly as much as they do elsewhere!
We are on almost top whack with our insurer (well, at 65 the pregnancy cover's hardly an issue...).
I've been unfortunate enough to have to have four operations this year and, despite insurance, it's costing a fortune.
For example, the last procedure billed me with $6150: Medicare paid $1956 and the insurer $609 - I had to pay the rest ($3584). (The hospital bills were all paid by the insurer, these were doctors' bills, blood tests etc).
The insurers say they will pay 100% of the bills - but in the small print it's only 100% of what Medicare hasn't paid and only refers to the Medicare scheduled fee. And the medicare scheduled fee is often a very small percentage of what the surgeon or anaestetist actually charges.
Despite being "fully covered" by private insurance and Medicare, this year I have had to lay out well over $10,000.
Those youngsters amongst us (those under 50 <g>) should be aware that getting ill in Australia is **** expensive regardless of private insurance!
Be aware that insurers here don't pay out nearly as much as they do elsewhere!
We are on almost top whack with our insurer (well, at 65 the pregnancy cover's hardly an issue...).
I've been unfortunate enough to have to have four operations this year and, despite insurance, it's costing a fortune.
For example, the last procedure billed me with $6150: Medicare paid $1956 and the insurer $609 - I had to pay the rest ($3584). (The hospital bills were all paid by the insurer, these were doctors' bills, blood tests etc).
The insurers say they will pay 100% of the bills - but in the small print it's only 100% of what Medicare hasn't paid and only refers to the Medicare scheduled fee. And the medicare scheduled fee is often a very small percentage of what the surgeon or anaestetist actually charges.
Despite being "fully covered" by private insurance and Medicare, this year I have had to lay out well over $10,000.
Those youngsters amongst us (those under 50 <g>) should be aware that getting ill in Australia is **** expensive regardless of private insurance!
Nov 9th 2007, 3:09 am
#2
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Joined: Oct 2005
Location: Perth
Posts: 3,453
Re: Be aware that medical insurance isn't the same as it is in the UK
Has anybody calculated whether on average it is better to just bank the premiums and use this for medical bills? (rather than pay out to insurance companies)
I suppos the medicare levy for those over $100K upsets the calculations.
There must be an algorithm somewhere for calculating whether it is better to be insured or not...!
I suppos the medicare levy for those over $100K upsets the calculations.
There must be an algorithm somewhere for calculating whether it is better to be insured or not...!
Nov 9th 2007, 3:29 am
#3
Ok this isn't so bad
Joined: Aug 2005
Location: Dundee (Scotland) now Bayside Brisbane
Posts: 4,824
Re: Be aware that medical insurance isn't the same as it is in the UK
Has anybody calculated whether on average it is better to just bank the premiums and use this for medical bills? (rather than pay out to insurance companies)
I suppos the medicare levy for those over $100K upsets the calculations.
There must be an algorithm somewhere for calculating whether it is better to be insured or not...!
I suppos the medicare levy for those over $100K upsets the calculations.
There must be an algorithm somewhere for calculating whether it is better to be insured or not...!
Nov 9th 2007, 3:33 am
#4
Account Closed
Joined: Jun 2007
Posts: 8,913
Re: Be aware that medical insurance isn't the same as it is in the UK
Has anybody calculated whether on average it is better to just bank the premiums and use this for medical bills? (rather than pay out to insurance companies)
I suppos the medicare levy for those over $100K upsets the calculations.
There must be an algorithm somewhere for calculating whether it is better to be insured or not...!
I suppos the medicare levy for those over $100K upsets the calculations.
There must be an algorithm somewhere for calculating whether it is better to be insured or not...!
We are not insured, wasn't worth it i thought. It's a rip off.
Nov 9th 2007, 3:42 am
#5
Joined: Jan 2005
Location: Asia Pacific
Posts: 4,922
Re: Be aware that medical insurance isn't the same as it is in the UK
There are always threads current about Australian medical insurance.
Be aware that insurers here don't pay out nearly as much as they do elsewhere!
We are on almost top whack with our insurer (well, at 65 the pregnancy cover's hardly an issue...).
I've been unfortunate enough to have to have four operations this year and, despite insurance, it's costing a fortune.
For example, the last procedure billed me with $6150: Medicare paid $1956 and the insurer $609 - I had to pay the rest ($3584). (The hospital bills were all paid by the insurer, these were doctors' bills, blood tests etc).
The insurers say they will pay 100% of the bills - but in the small print it's only 100% of what Medicare hasn't paid and only refers to the Medicare scheduled fee. And the medicare scheduled fee is often a very small percentage of what the surgeon or anaestetist actually charges.
Despite being "fully covered" by private insurance and Medicare, this year I have had to lay out well over $10,000.
Those youngsters amongst us (those under 50 <g>) should be aware that getting ill in Australia is **** expensive regardless of private insurance!
Be aware that insurers here don't pay out nearly as much as they do elsewhere!
We are on almost top whack with our insurer (well, at 65 the pregnancy cover's hardly an issue...).
I've been unfortunate enough to have to have four operations this year and, despite insurance, it's costing a fortune.
For example, the last procedure billed me with $6150: Medicare paid $1956 and the insurer $609 - I had to pay the rest ($3584). (The hospital bills were all paid by the insurer, these were doctors' bills, blood tests etc).
The insurers say they will pay 100% of the bills - but in the small print it's only 100% of what Medicare hasn't paid and only refers to the Medicare scheduled fee. And the medicare scheduled fee is often a very small percentage of what the surgeon or anaestetist actually charges.
Despite being "fully covered" by private insurance and Medicare, this year I have had to lay out well over $10,000.
Those youngsters amongst us (those under 50 <g>) should be aware that getting ill in Australia is **** expensive regardless of private insurance!
Since thats the difference between the medicare fee and the actual practitioners fee.
Sounds like you may need to reassess your actual medical insurance provider cover as we do have GAP cover.
Nov 9th 2007, 3:47 am
#6
Account Closed
Joined: Jun 2005
Posts: 9,316
Re: Be aware that medical insurance isn't the same as it is in the UK
Has anybody calculated whether on average it is better to just bank the premiums and use this for medical bills? (rather than pay out to insurance companies)
I suppos the medicare levy for those over $100K upsets the calculations.
There must be an algorithm somewhere for calculating whether it is better to be insured or not...!
I suppos the medicare levy for those over $100K upsets the calculations.
There must be an algorithm somewhere for calculating whether it is better to be insured or not...!
If your salary does not take you into the 1% levy zone then you are probably better off not getting private health cover (unless you are 30+ and think that you'll soon have a salary that takes you into the zone).
Nov 9th 2007, 3:54 am
#7
(It's not my real name)
Joined: Sep 2002
Location: Ilukapool. WA
Posts: 12,467
Re: Be aware that medical insurance isn't the same as it is in the UK
It's worth having the extras cover for the dentist, glasses etc...
One thing's for sure Medical insurance is bloody complicated over here, trying to figure out what's covered and by how much.
When my daughter had to go to hospital in an emergency we made the mistake of telling them we had private health, that cost us about 2 grand when otherwise we would have had to have paid nothing.
One thing's for sure Medical insurance is bloody complicated over here, trying to figure out what's covered and by how much.
When my daughter had to go to hospital in an emergency we made the mistake of telling them we had private health, that cost us about 2 grand when otherwise we would have had to have paid nothing.
Nov 9th 2007, 3:59 am
#8
Canuck/Aussie
Joined: May 2006
Location: BC, Canada
Posts: 4,547
Re: Be aware that medical insurance isn't the same as it is in the UK
What if you have private cover and elect for treatment in a public hospital? Do you still have to pay the gap then?
Just wondering because my daughter spent a day in the hospital and we chose to go public and didn't pay anything.
For us we would have been taxed by not taking it out so that's why we got private.
Just wondering because my daughter spent a day in the hospital and we chose to go public and didn't pay anything.
For us we would have been taxed by not taking it out so that's why we got private.
Nov 9th 2007, 4:02 am
#9
(It's not my real name)
Joined: Sep 2002
Location: Ilukapool. WA
Posts: 12,467
Re: Be aware that medical insurance isn't the same as it is in the UK
What if you have private cover and elect for treatment in a public hospital? Do you still have to pay the gap then?
Just wondering because my daughter spent a day in the hospital and we chose to go public and didn't pay anything.
For us we would have been taxed by not taking it out so that's why we got private.
Just wondering because my daughter spent a day in the hospital and we chose to go public and didn't pay anything.
For us we would have been taxed by not taking it out so that's why we got private.
Crazy, feeling like a fool for "admitting" to having private health.
Nov 9th 2007, 4:22 am
#10
Lost in BE Cyberspace
Thread Starter
Joined: Mar 2003
Posts: 9,397
Re: Be aware that medical insurance isn't the same as it is in the UK
Has anybody calculated whether on average it is better to just bank the premiums and use this for medical bills? (rather than pay out to insurance companies)
I suppos the medicare levy for those over $100K upsets the calculations.
There must be an algorithm somewhere for calculating whether it is better to be insured or not...!
I suppos the medicare levy for those over $100K upsets the calculations.
There must be an algorithm somewhere for calculating whether it is better to be insured or not...!
Over the long term maybe you *could* work something out - but what if you have a $100,000 operation just after starting?
Nov 9th 2007, 4:25 am
#11
Lost in BE Cyberspace
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Joined: Mar 2003
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Re: Be aware that medical insurance isn't the same as it is in the UK
In fact, I've just this minute received the latest statement from the insurer concerning this last procedure: $zero paid as gap - since Medicare paid nothing there's no gap.
Until you have to claim you don't realise that they don't cover what you are charged - only what Medicare deem as a fee: and medicare rates haven't been updated for yonks.
Nov 9th 2007, 4:26 am
#12
Canuck/Aussie
Joined: May 2006
Location: BC, Canada
Posts: 4,547
Re: Be aware that medical insurance isn't the same as it is in the UK
So, I am assuming we were entirely public patients so they couldn't use our private health care at all. Or at least I hope it works like that. I did this in the hopes of avoiding the gap.
So, if they ask about private health care can you just say you don't have it? That way you for sure won't have any extra fees.
Nov 9th 2007, 6:39 am
#13
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Joined: Feb 2005
Posts: 532
Re: Be aware that medical insurance isn't the same as it is in the UK
Well - it has to be cheaper than in Germany.
We currently pay about €15,000 per year for private cover (and no I did not put in too many zero's)' or about A$23,000.
I feel like being ill just to get value for money.
We currently pay about €15,000 per year for private cover (and no I did not put in too many zero's)' or about A$23,000.
I feel like being ill just to get value for money.
Nov 9th 2007, 6:45 am
#14
Crazy Cat Lady
Joined: Apr 2004
Posts: 65,493
Re: Be aware that medical insurance isn't the same as it is in the UK
We spent so much time working out the pros and cons of insurance and came to the conclusion it just wasn't worth it. The service we've had so far with Medicare has been superb and (I believe) superior to what we would have received in the UK if these particular things had happened there. I wouldn't dare say it would be the same for others but for us insurance just seemed a false economy.
We were planning on putting an amount in a different account each month and use that for emergencies but we still haven't got round to it.
We were planning on putting an amount in a different account each month and use that for emergencies but we still haven't got round to it.
Nov 9th 2007, 6:49 am
#15
Canuck/Aussie
Joined: May 2006
Location: BC, Canada
Posts: 4,547
Re: Be aware that medical insurance isn't the same as it is in the UK
We spent so much time working out the pros and cons of insurance and came to the conclusion it just wasn't worth it. The service we've had so far with Medicare has been superb and (I believe) superior to what we would have received in the UK if these particular things had happened there. I wouldn't dare say it would be the same for others but for us insurance just seemed a false economy.
We were planning on putting an amount in a different account each month and use that for emergencies but we still haven't got round to it.
We were planning on putting an amount in a different account each month and use that for emergencies but we still haven't got round to it.
If we weren't going to get penalized we wouldn't have gotten private health at all. Unfortunately we decided that we'd rather pay for private health than pay the surcharge for nothing.