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Cover for pre existing condition

Cover for pre existing condition

Old Oct 13th 2019, 8:39 am
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Default Cover for pre existing condition

Hi everyone,

I am moving over to Melbourne on a 482 TSS Visa in a month or so. A question I have which I cannot find for the life of me is:
I have a minor heart condition and will be getting private health insurance throughout my stay in Aus. As my condition is pre existing, do I need to have it covered in my health cover for the first 12 months? As during this period I cannot claim against it. I ask as it appears it costs more to have cardiovascular included in my cover as this is an "extra". When the 12 months is up I'd then update my cover to include it.

Hope that makes sense.

Thank you,

Sam
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Old Oct 13th 2019, 11:25 am
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Default Re: Cover for pre existing condition

Originally Posted by Samyted View Post
Hi everyone,

I am moving over to Melbourne on a 482 TSS Visa in a month or so. A question I have which I cannot find for the life of me is:
I have a minor heart condition and will be getting private health insurance throughout my stay in Aus. As my condition is pre existing, do I need to have it covered in my health cover for the first 12 months? As during this period I cannot claim against it. I ask as it appears it costs more to have cardiovascular included in my cover as this is an "extra". When the 12 months is up I'd then update my cover to include it.

Hope that makes sense.

Thank you,

Sam
Hi Sam, welcome to BE

Re: cardiovascular cover, if you upgraded your policy after 12 months to include this then you'd still have to serve the 12 months waiting period, so that would leave you without cover for 24 months. There may be an insurer than would waive this but you'd have to ask each one individually. This website will give you more information, and there's a 'comparison' tool that you can use, see left hand side of the page. This is a government website https://www.privatehealth.gov.au/hea...ng_periods.htm

The website has further information on private health cover for people in Australia temporarily, such as those on a 482 visa. Significantly in your case, if you're from a country that has a Reciprocal Health Agreement with Australia, you can recieve necessary, emergency medical treatment free in a public hospital. I'm assuming you're from the UK which does indeed have such an agreement, which means that although you won't be covered by your private insurer for any cardio events arising from your pre-existing condition in the first twelve months, if you need emergency treatment that should be covered under Medicare, see here https://www.privatehealth.gov.au/hea...seas/index.htm

In fact, I'd advise you to have a good read of the entire website, it has some really useful information. Hope that helps a bit.
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Old Nov 30th 2019, 11:48 pm
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Default Re: Cover for pre existing condition

Originally Posted by Samyted View Post
As my condition is pre existing
Hello.

May I ask what health insurance company you are with or going with?

I found it very hard to get cover for a pre-exisiting condition.

And twice my claim was rejected due to this pre-exisiting condition.

So I cancelled my health insurance, as it was costing me a lot of money each month, and I wasn't getting anything in return.

I suppose now I am getting older than I should look into getting it again.

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Old Dec 1st 2019, 12:13 am
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Default Re: Cover for pre existing condition

Originally Posted by PittwaterPrincess View Post
Hello.

May I ask what health insurance company you are with or going with?

I found it very hard to get cover for a pre-exisiting condition.

And twice my claim was rejected due to this pre-exisiting condition.

So I cancelled my health insurance, as it was costing me a lot of money each month, and I wasn't getting anything in return.

I suppose now I am getting older than I should look into getting it again.
That doesn't really make sense. You only had to serve the waiting period and all pre-existing conditions are covered.

All Australian domestic health insurers HAVE to provide cover for pre-existing conditions. Doesn't matter what the condition is or how long you've had it, they're not allowed to penalise you (by refusing to cover you or charging you a higher premium than anyone else) for having it. The only thing you need to do is serve out the waiting period then you can claim for any condition at all. Australian private Health Insurance is based on Community Risk not an individual's risk - hence no medicals or health questionnaires are needed to take out cover.

You can complain to the Commonwealth Ombudsman if you believe you've been refused cover.
Note that this only applies to Domestic Health insurance - Travel Insurance and Life Insurance have different rules.
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Old Dec 1st 2019, 12:31 am
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Default Re: Cover for pre existing condition

Originally Posted by NickyC View Post
That doesn't really make sense. You only had to serve the waiting period and all pre-existing conditions are covered.

All Australian domestic health insurers HAVE to provide cover for pre-existing conditions. Doesn't matter what the condition is or how long you've had it, they're not allowed to penalise you (by refusing to cover you or charging you a higher premium than anyone else) for having it. The only thing you need to do is serve out the waiting period then you can claim for any condition at all. Australian private Health Insurance is based on Community Risk not an individual's risk - hence no medicals or health questionnaires are needed to take out cover.

You can complain to the Commonwealth Ombudsman if you believe you've been refused cover.
Note that this only applies to Domestic Health insurance - Travel Insurance and Life Insurance have different rules.
Great post Nicky, very informative and spot on
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Old Dec 1st 2019, 12:41 am
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Default Re: Cover for pre existing condition

Originally Posted by NickyC View Post
That doesn't really make sense.
.


It may not make sense. But that is what happened.

After my two claims were rejected on the grounds of a pre-exisiting condition, I had to pay over $5000.00 for treatment, and still pay $100.00 a month for the health cover.

So I cancelled my health insurance and not had any now for 15 years.



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Old Dec 1st 2019, 12:47 am
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Default Re: Cover for pre existing condition

Originally Posted by NickyC View Post
You only had to serve the waiting period.
.



There was no 12 month waiting period. That was waived.

It was some special push in the early 2000's to get more Australians to sign up, and the waived waiting period was promoted as a incentive to sign up.

They also said that anyone who signs up before they are 30, will pay the same amount for XXXXX number of years, but that turned out not to actually be true for a friend of mine
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Old Dec 1st 2019, 12:47 am
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Default Re: Cover for pre existing condition

Originally Posted by PittwaterPrincess View Post
.


It may not make sense. But that is what happened.

After my two claims were rejected on the grounds of a pre-exisiting condition, I had to pay over $5000.00 for treatment, and still pay $100.00 a month for the health cover.

So I cancelled my health insurance and not had any now for 15 years.
How long after you took out private health cover was it when your two claims were denied? Edit, scrap that question, I didn't see your previous answer. Which private health insurer did you use?

Under the government's Lifetime Health Cover policy, if you wish to get private health cover again you'll find that your premiums will have a significant additional loading, as you haven't held private health cover continuously.

Last edited by spouse of scouse; Dec 1st 2019 at 12:50 am.
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Old Dec 1st 2019, 12:49 am
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Default Re: Cover for pre existing condition

Originally Posted by PittwaterPrincess View Post
.


It may not make sense. But that is what happened.

After my two claims were rejected on the grounds of a pre-exisiting condition, I had to pay over $5000.00 for treatment, and still pay $100.00 a month for the health cover.

So I cancelled my health insurance and not had any now for 15 years.
Well then here you go, you should definitely report them:
Pre-Existing Conditions Rule - Commonwealth Ombudsman
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Old Dec 1st 2019, 12:59 am
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Default Re: Cover for pre existing condition

Originally Posted by spouse of scouse View Post
How long after you took out private health cover was it when your two claims were denied?
Hello

I had the cover for about 18 months before making a claim.

And I argued my case with them for quite a few weeks, but they would not budge.

I had to give up in the end, as I was exhausted and unwell, and arguing with them was making me stressed and feel worse.

These insurance companies will find a way to wiggle out of anything I reckon. I know a guy who had his car and house roof damaged in the December 2018 Sydney hailstorm. He has only just been given the go-ahead to get his car fixed, and they are still playing merrybuggers with him over his roof.




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Old Dec 1st 2019, 1:00 am
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Default Re: Cover for pre existing condition

Originally Posted by Dreamy View Post
Well then here you go, you should definitely report them:
I wish I had known I could. A bit late now.

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Old Dec 1st 2019, 1:01 am
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Default Re: Cover for pre existing condition

Originally Posted by PittwaterPrincess View Post
Hello

I had the cover for about 18 months before making a claim.

And I argued my case with them for quite a few weeks, but they would not budge.

I had to give up in the end, as I was exhausted and unwell, and arguing with them was making me stressed and feel worse.

These insurance companies will find a way to wiggle out of anything I reckon. I know a guy who had his car and house roof damaged in the December 2018 Sydney hailstorm. He has only just been given the go-ahead to get his car fixed, and they are still playing merrybuggers with him over his roof.
Follow Nicky's advice and complain, although I'm not sure about any statute of limitations for these claims. Which health insurer were you with?
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