red7

Hi all,

I've just been searching this forum and frying my brain with Google searches to try and figure out if getting hospital cover from a private insurer is worth it or not (I already have extras for dental and emergency ambulance etc.). I just want some really basic estimated figures to decide and I can't seem to find this anywhere. I am on an 820 (Temporary resident) visa. I'm 33, with no current health problems.

I'm confused about what percentage Medicare will pay/rebate if I DO have insurance and if I DON'T have insurance - is it the same (about 30%)?

I have read about private healthcare and understand about out of pocket expenses. I also understand the pros and cons of private. But I'm confused about the cost of treatments, period.

It seems that for emergency hospitalisation by ambulance and emergency treatment, where obviously you can't phone your provider ahead of time to choose a hospital, it's pointless to insure yourself, as you will just be taken to the nearest public hospital to receive treatment as a public patient.

I'm most confused about scenarios such as an emergency (e.g. broken arm) or a non-emergency (e.g. hip replacement) or long-term treatments (e.g. cancer) - in each case, how much is a person WITHOUT private insurance likely to pay? Are we talking a few hundred dollars? A few thousand? A few hundred thousand?

Hope you can help!

quoll

Medicare pays the same rebate regardless.

If you have treatment in a public hospital as a public patient it will cost you nothing but you might have a heck of a long wait to get treatment. The gap for private patients (out of pocket expenses) is anyone's guess but potentially a few thousand depending on your insurance cover, the hospital you choose and the specialists you choose but you'll be treated a lot quicker for elective procedures.

If you are a high earner you will be slugged the Medicare surcharge on top of your basic Medicare contribution.

geoff52

Had to laugh. At the age of 33 a non emergency hip replacement.

verystormy

Depending on which state, you may also be hot if you call an ambulance. In WA that is anything from $700 up to the skies the limit.

Dorothy

Don't laugh. A colleague of mine broke his hip in a bike accident in his 30s. Hips don't last forever and he had to have it replaced in his early 40s.

geoff52

A situation such that of your colleague can obviously arise.

Having worked with a orthopedic surgeons the majority of non emergency hip replacements are usually done on elderly patients (not a 33 year old) who have over the years eroded their hip joint and need hip replacement to walk pain free.

carcajou

Yes - the whole point of having insurance as a young person is for stuff you can't predict.

I am under 40 my wife (younger than me) and I have private cover, we pay $260 a month for it (combined).

Second the earlier poster who mentioned in WA about ambulance cover, which is not included in either Medicare or basic private cover - you have to purchase it separately as an add-on. Other states are different and I believe QLD has a surcharge on some utility bill that covers everyone (could be mistaken). So research your state's ambulance policy very carefully.

While you are looking at medical insurance I also recommend you take a look at life insurance, since the amount you can get covered for decreases with age.

red7

Thanks all for the great info!

The hip replacement was just an example I used because I know it's quite a common procedure and one that maybe someone reading my post would have had (or know someone that has). I hope I don't need one just yet! But exactly as Dorothy and Carcajou pointed out - you never know what's round the corner.

About the ambulance, I already have extras cover and that includes emergency ambulance (that was one of the first things I sorted out when I arrived in AU, I don't like nasty surprises!). But I am also in QLD, so Medicare covers that cost also.

I was thinking more about if I broke my arm, for example. Obviously I can't wait a year for treatment. Will this all be covered under Medicare?

I suppose the real kicker would be the example of cancer. I know it's relatively unlikely (and I don't like filling the forum up with doom and gloom, either) but I have lost 2 friends under 30yrs old to cancer, so it's certainly something I'd like to safeguard against. Is this when I would incur long waiting lists for treatment as a public patient?

quoll

Cancer doesn't generally incur a long waiting list, unless, perhaps it is one of the slower growing ones like prostate. I don't actually know of anyone who has had cancer who has gone private for its treatment. Even if you have private health cover you don't have to go private for treatment, it's really just the elective things that people are most likely to use their private cover - gall bladder removal, tonsil removal, things like that although my son was considering going private when he struggled to get a surgeon to reattach his pectoral muscle (took him 3 months of trying to find a surgeon who would do it and it was done under Medicare)

carcajou

red7, as you are in QLD I suppose it doesn't matter, but if you go intrastate be very, very careful about ambulances - "emergency ambulance cover" is defined as "priority 1" - meaning life-threatening emergency as defined by whomever is manning dispatch that day. A broken arm or leg would not count as "priority 1" and would not attract the emergency ambulance coverage. What I just wrote, was an example given to me by ambos themselves.

Additionally to what quoll wrote, where you live also matters. I live in the regions and my experience with the public health care system has not been positive - we want to have the additional options that private care provides us. Private doctors all have different arrangements - I go to the private GP here, which is not covered under my private cover, but I still get a 50% Medicare rebate.

Pollyana

Glad you find it so funny. Nothing to laugh about as far as i can see, arthritic pain every day of one's life is hardly fun.

red7

Thanks everyone! I've weighed it up and think the basic cover is probably worth it. Thanks for all your help!

Bloodyseppo

Not sure what an 820 visa is exactly, but most temporary visas do not allow you to be covered by Medicare do they? I had to provide full private cover for myself when I was on a 457 visa.

renth

I've been here 14 years and I still don't understand private health insurance (apart from denying that you have it when you are in A&E).

spouse of scouse

Laughing my head off at that Renth, how true it is