When you elect to get covered by insurance how are pre-existing conditions dealt with? Can you wait until you need a surgery then get insurance?
If you have a condition the private health company requires 12 months payments before acting on that condition,
Select to expand quoteShifu said..
In Qld we pay a small levy on our electricity bills to pay for free ambulance for all. Very Socialist and a sweet, sweet deal.
It's almost as if when we all chip in we get a discount or something. How does that work?Select to expand quoteHarrow said..
I pay about $75 a week for hospital cover. If I didn't have the private health insurance, I would be paying close to this in the additional medicare levy surcharge anyway for not having private health insurance. Makes the decision pretty simple.
This is not the increased premiums you pay if you join late, this is additional medicare levy tax you may have to pay every year at tax time if you don't have private health insurance.
Imagine all the money we have to spend on private health care going into the public system instead. I know it's pretty crazy.
And what sort of a competitive private health system do we have when we all have to give them money? Where's the incentive for them to provide a better service? They have a captive market. What is this system? I feel like I'm taking crazy pills.
I'm waiting for some New Zealanders to comment. I lived there a year and their public system is, in my experience, better than our private. It's free for Australians. I've talked to some Europeans lately too and they are all shocked at our so-called free system.
Select to expand quotelotofwind said..
Look at Markie, he pays $170 a fortnight,
thats $340 a month,
. 
You're clearly not in finance 
Select to expand quotecauncy said..
If you have a condition the private health company requires 12 months payments before acting on that condition,
Well that's an option. A lot of problems don't require immediate surgery, I have the same hip problem as Mark but I haven't done anything about it for a few years now.
USA guys: what happens if you need surgery for say a heart problem?
Do you have to pay?
If you are single then it is a risk you can consider But be careful making decisions that affect other family members...
i I have had a number of emergency visits over the years that the public system would have left me with permanent mobility issues or worse. Having the choice of specialist covered by insurance has been a life changing choice.
My my wife now suffers from a debilitating condition that she will have for the rest of her life, her bills for various treatments per annum make my insurance look cheap. Finally being able to afford braces for my daughter through insurance will have a life long impact for her...
So so hell yeah to insurance...
Select to expand quoteBeaglebuddy said..
Well that's an option. A lot of problems don't require immediate surgery, I have the same hip problem as Mark but I haven't done anything about it for a few years now.
No, it does not work that way.....if you have an existing condition even after the waiting period it is not covered....you sign a statement when you take the cover that you don't have pre-existing....of course you can lie, and they may not catch you....but if they do ????
In your case in the public system you would be put on a list that depends on need and availability....best to go on list before you really need it.
Select to expand quotenods said..Beaglebuddy said..
Well that's an option. A lot of problems don't require immediate surgery, I have the same hip problem as Mark but I haven't done anything about it for a few years now.
No, it does not work that way.....if you have an existing condition even after the waiting period it is not covered....you sign a statement when you take the cover that you don't have pre-existing....of course you can lie, and they may not catch you....but if they do ????
In your case in the public system you would be put on a list that depends on need and availability....best to go on list before you really need it.
In my case I can have the surgery whenever I want but currently I haven't found the courage, I'm afraid some quack will turn me into a gimp 
Select to expand quoteMark _australia said..
USA guys: what happens if you need surgery for say a heart problem?
Do you have to pay?
Well when you have insurance which you are now required by law to have or pay a hefty fine, the insurance company pays for it minus your deductible and a probable small copay. If you have no insurance you would most likely get the surgery and if you are poor it will be free, if you have a job but no assets i.e. middle class you will likely have to go bankrupt to escape the debt. If you have considerable assets they will likely find a way to get their money from you.
Select to expand quotebigtom said...
Help out if you can
I insure my house and my car as it makes sense . I have also been told from an early aged this is what you need to do .
Now some how I have got to this stage in my life , being almost 40 with a wife and 3 kids and have never discussed health/hospital/medical insurance. Do I need it and whats the rough cost. If it matters were on one wage with a mortgage ,and is it another bill that could be avoided. If you go to emergency ,you don't get charged.
cheers
Mate, have you got life insurance ?
That's a whole new ball game but possibly more important then health insurance. Just throwing it out there.
kinda-sorta related,
income insurance -
generally the policy premiums are totally tax decuctible - but it must be a"stand alone" policy, and not attached to a superannuation policy.
so in effect it is a free policy.
when I couldnt work due to a few health problems and the subsequent operations, and recovery time - my income protection policy kicked in and saved our necks.
stephen
TO NEW SCOTTY LIFE INSURENCE , NO I DONT HAVE IT. I FIGURE THE MISSUS WILL SELL THE HOUSE AND DOWNSIZE AND PROBALY BE ALRIGHT
I DONT HAVE INCOME INSURENCE EITHER. HOUSE AND CAR ,THATS IT
BUT AFTER ALL COMMENTS I THINK ILL START TO LOOK INTO IT
AND THANKS TO ALL COMMENTS
You are able to have private hospital insurance only (no extras) and this saves a bundle (I pay $2000 a year for the family, I'm married with two kids).
You can even have hospital cover with one fund and extras with another fund if this saves you a dollar or two.
I dropped extras cover five years ago on accountant's advice and am well ahead.
I am a dentist so family teeth sorted, but the Australian Dental Association for a number of years now has been advising we advise our patients to drop extras cover and just bankroll dental expenses...the funds make more than a billion a year from extras premiums alone.
A few physio sessions, some new prescription glasses, a massage or kids orthotics don't really cost much...even my high end procedure being a crown ($1650) with the highest rebate I have ever seen being $1100, still leaves the client out of pocket in this case $550 AND the probable $2000-odd additional for the year's extras premium.
You can see they should have just financed the $1650!!!
Select to expand quotesn said..
generally the [income insurance] policy premiums are totally tax deductible ..[].....
so in effect it is a free policy.
Not free at all. But you do effectively get a discount on it equivalent to your marginal tax rate. So, if your top tax rate is effectively 49% then you effectively get a 49% discount on those premiums ('cos you'd have paid that 49% to the tax man but instead you're paying it to the insurer).
Also, pay the whole 12 months of premiums upfront in June and you'll get an immediate tax saving for the whole amount.
Select to expand quoteCambodge said..sn said..
generally the [income insurance] policy premiums are totally tax deductible ..[].....
so in effect it is a free policy.
Not free at all. But you do effectively get a discount on it equivalent to your marginal tax rate. So, if your top tax rate is effectively 49% then you effectively get a 49% discount on those premiums ('cos you'd have paid that 49% to the tax man but instead you're paying it to the insurer).
Also, pay the whole 12 months of premiums upfront in June and you'll get an immediate tax saving for the whole amount.
Oops - my bad.......
As I understand it, premiums paid to an income protection policy that is attached to a superfund are not tax deductions - and these premiums eat big holes in your superannuation.
It pays to have a close look at your super statement - and see where all the fees go.
stephen
Income protection through your super fund is NOT deductable because you effectively are already getting the deduction up front by only paying 15% tax on your contributions into the fund, so if you get another tax deduction at June 30 you would be double dipping - and we all know that's not on !! Although if you are paying less than 15% effective tax at the end of the year you probably are wasting your money taking IP through super.
One thing to watch though as you get older is the exponential rise in the premium if you are in "high risk" work. My super linked IP went from approx. $2500ish in 2014/15 to over $5000 last June. Not happy Jan and I have only used it for a total of 5 days payment back in 2006 after I had used up the compulsory 28 days of sick leave leaving the insurer to pay a total of a weeks wages.... I'm considering dropping it due to the hoops you have to jump through to claim it and the increasing cost each year - I've got quite a bit of sick leave and long service anyway if something breaks !
By the way I have heard of people claiming a deduction for super linked IP at tax time but I guess it's only an issue when you get caught
One thing to take into consideration
Your private health will have a list of surgeons
If you choose a surgeon at the top of their field then you generally have a decent top up to pay or they might not be on the insurers list, so you don't get who you want, better check
Something I was very conciouse about when my wife was in hospital was the integration of services between private and national health here in aus
In the uk private is generally private
I was surprised to see nurses treat both national health and private in their days work
Does priority go to the private patient or national health patient,
Personally I don't like to see people treated differently especially in a health matter when it comes to ones wealth compared to another
Select to expand quoteBeaglebuddy said..Mark _australia said..
USA guys: what happens if you need surgery for say a heart problem?
Do you have to pay?
Well when you have insurance which you are now required by law to have or pay a hefty fine, the insurance company pays for it minus your deductible and a probable small copay. If you have no insurance you would most likely get the surgery and if you are poor it will be free, if you have a job but no assets i.e. middle class you will likely have to go bankrupt to escape the debt. If you have considerable assets they will likely find a way to get their money from you.
The reason I asked that is you and/or mastbender were suggesting your healthcare was not that bad, as Aussies have to have health insurance. I was not sure as all I have to go on is movies like JohnQ hahahah but seems it is like that. In the US, it seems that a normal family with no insurance is fkd if somebody gets truly sick. Bit like overseas with no travel insurance, $10K a night and all that rubbish.
See everyone gets everything paid for here. A middle class person like u just mention would be looked after. No expense for them.
Our health insurance is only to get a choice of doc and private hospital etc.
The ancillaries like physio or dental are 75% covered to ease the load.
Plus obviously you get faster treatment, as per my example a windsurfer with a hip discomfort is waayyyyy below a old person needign a replacement so instead of a 3yr - 5yr wait I get it now and a private room and choice of docs etc. And I pay nil.
Select to expand quoteMark _australia said..
Beaglebuddy said..
Mark _australia said..
USA guys: what happens if you need surgery for say a heart problem?
Do you have to pay?
Well when you have insurance which you are now required by law to have or pay a hefty fine, the insurance company pays for it minus your deductible and a probable small copay. If you have no insurance you would most likely get the surgery and if you are poor it will be free, if you have a job but no assets i.e. middle class you will likely have to go bankrupt to escape the debt. If you have considerable assets they will likely find a way to get their money from you.
The reason I asked that is you and/or mastbender were suggesting your healthcare was not that bad, as Aussies have to have health insurance. I was not sure as all I have to go on is movies like JohnQ hahahah but seems it is like that. In the US, it seems that a normal family with no insurance is fkd if somebody gets truly sick. Bit like overseas with no travel insurance, $10K a night and all that rubbish.
See everyone gets everything paid for here. A middle class person like u just mention would be looked after. No expense for them.
Our health insurance is only to get a choice of doc and private hospital etc.
The ancillaries like physio or dental are 75% covered to ease the load.
Plus obviously you get faster treatment, as per my example a windsurfer with a hip discomfort is waayyyyy below a old person needign a replacement so instead of a 3yr - 5yr wait I get it now and a private room and choice of docs etc. And I pay nil.
The average deductible now days with Obamacare, runs about $3500 USD, so that means for the average person, the first $3500 comes out of your pocket.
Great deal eh? Hardly. And as time goes by, the deductibles, and the premiums are just going to increase because the government backed insurance companies are loosing money.
One of the main goals of Obamacare was to eliminate being turned down, or having to pay more for health insurance because of pre-existing conditions (you are already sick as a dog).
There was never any way that that particular goal was ever going to pencil out, it's still doomed to fail, just a matter of time.
I predict major changes to our healthcare system if Hillary or Bernie do not get elected.
Health insurance is such a mess. It's my opinion owing to my experiences and research that the primary reason for the spiraling costs of healthcare are lawyers and judges. The easy ability to sue and the absurd judgements given out for things that aren't even a doctors fault causes doctors to practice "defensive medicine" which means they call up expensive tests and procedures for trivial complaints. You have a headache? Oh let's get an MRI in the odd event it's a brain tumor and there is a tiny possibility of being sued.
All that and people are so damn fat everywhere, half the populations come down with diabetes and their joints and internal gizzards are failing from the stress of carrying around all the extra weight.
Select to expand quotepatsken said..
By the way I have heard of people claiming a deduction for super linked IP at tax time but I guess it's only an issue when you get caught
Correct.
www.ato.gov.au/Individuals/Income-and-deductions/Deductions-you-can-claim/Other-deductions/Income-protection-insurance/
"...You can claim the cost of premiums you pay for insurance against the loss of your income."
Therefore, you cannot claim IP when it's been paid for by your employer's compulsary super payments.
Select to expand quoteCambodge said..sn said..
generally the [income insurance] policy premiums are totally tax deductible ..[].....
so in effect it is a free policy.
Not free at all. But you do effectively get a discount on it equivalent to your marginal tax rate. So, if your top tax rate is effectively 49% then you effectively get a 49% discount on those premiums ('cos you'd have paid that 49% to the tax man but instead you're paying it to the insurer).
Also, pay the whole 12 months of premiums upfront in June and you'll get an immediate tax saving for the whole amount.
Correct, and.... If you make a claim the money you receive is treated as income and taxed accordingly, hence the premiums are deductible.
Premiums on loan protection insurance covers are not deductible (unless business use), but the claims are not considerable taxable income.
Real world example:
I am having a pretty **** year medically. found a parathyroid adenoma (benign tumour in the neck that will kill due to high calcium rather then spreading everywhere like malignant cancer does) And prostate cancer (I am 43) at more or less the same time.
The tumour in the neck was surgically remove a few months ago and the prostate cancer will be removed (if all goes well), in two weeks.
so far I have spent $18000 and I have another $15000 to go (minimum).
I have fully private top hospital cover for me and my family of 4. About $6000 a year.
my rebates total less then $5000 including Medicare. In fact the Medicare rebates make up more then half (significantly more).
In no way is the insurance worth it.
Start an account while you are young, put your "health premiums" in it. Do not touch it until you have health issues that need it.
do this and later in life you will have more then enough for whatever comes your way.
^ This is all too common and the reason private health is on the national agenda/radar. It feels like a scam. It really, really does.Select to expand quoteMark _australia said..
But costly yeah. $170 per fortnight for 2 adults 2 kids.
Better to have it and not need it, than need it and not have it. But gotta balance that with the $$$$ and yeah it is hard.
I hear you Mark. The peace of mind and all. What is that worth?
But the cold maths just keeps getting under my skin.
You pay around $4,500 per year.
That's $45,000 over 10 years.
If you put that money in, say, an offset account against your mortgage @ 5% then you would have saved another $11,000 over 10 years.
(Assuming you didn't have to use the money for repairs. You of course did. Normal).
But the point I'm getting at is that $55,825.02 that is now in your offset account returns a saving of $85.82 per fortnight. If you hadn't pulled any money out of that savings account (in reality you will pull some out of course) your fortnightly costs are now half. And you can go injure yourself up to $55k.
I get that insurance is not supposed to be an expense that you come out ahead. Of course not. But does anybody come out ahead? Ever?Select to expand quoteReevesy said...
so far I have spent $18000 and I have another $15000 to go (minimum).
I have fully private top hospital cover for me and my family of 4. About $6000 a year. my rebates total less then $5000 including Medicare. In fact the Medicare rebates make up more then half (significantly more).
Reevesy didn't either.
The costs appear to be absurdly high, and we are all both literally and actually forced to pay them.
I've yet to get any money back from my private health insurance that was more than the premium for a single month. And I'm probably speaking for nearly everyone. Why is it so expensive?
Its expensive because of the frictional costs, the admin and inefficiency and profit and having an undersized system. If we trained way more doctors and built way more hospitals, there would be over supply and it would get cheap. But we dont so a surgeon earns $450kpa. Not so long ago we paid all for all sorts of things in our tax that were then provided free, medical, university, trade education, infrastructure like bridges, roads and power stations. Now we pay for all of that stuff separately plus profit to the companies running them plus inflated prices because the lack of investment has resulted in scarcity and pushed prices up. Rant=off.
I'm in the camp of being pro insurance. Had a shoulder issue. Tried to work it out through Physiotherapy but it kept popping out. Saw a specialist that does top footy players and cricketers. Shoulder done, as good as new in less than 3 months start to finish. The waiting list on the public healthcare would have been 2 years plus. Only reason I waited 3 months is that a friend got me in to someone who was considered to be one of the best of the best so it was worth waiting for.
Out of pocket was $150.
Select to expand quoteevlPanda said...
^ This is all too common and the reason private health is on the national agenda/radar. It feels like a scam. It really, really does.Mark _australia said..
But costly yeah. $170 per fortnight for 2 adults 2 kids.
Better to have it and not need it, than need it and not have it. But gotta balance that with the $$$$ and yeah it is hard.
I hear you Mark. The peace of mind and all. What is that worth?
But the cold maths just keeps getting under my skin.
You pay around $4,500 per year.
That's $45,000 over 10 years.
If you put that money in, say, an offset account against your mortgage @ 5% then you would have saved another $11,000 over 10 years.
(Assuming you didn't have to use the money for repairs. You of course did. Normal).
But the point I'm getting at is that $55,825.02 that is now in your offset account returns a saving of $85.82 per fortnight. If you hadn't pulled any money out of that savings account (in reality you will pull some out of course) your fortnightly costs are now half. And you can go injure yourself up to $55k.
I get that insurance is not supposed to be an expense that you come out ahead. Of course not. But does anybody come out ahead? Ever?Reevesy said...
so far I have spent $18000 and I have another $15000 to go (minimum).
I have fully private top hospital cover for me and my family of 4. About $6000 a year. my rebates total less then $5000 including Medicare. In fact the Medicare rebates make up more then half (significantly more).
Reevesy didn't either.
The costs appear to be absurdly high, and we are all both literally and actually forced to pay them.
I've yet to get any money back from my private health insurance that was more than the premium for a single month. And I'm probably speaking for nearly everyone. Why is it so expensive?
The costs are in part thanks to our anally retentive government and the amount of laws they push out covering the medical industry.
Dental here is ludicrous because a dentist has to have two surgeries and two assistants to comply with the laws. It costs in excess of a million bucks just for the equipment to set up a dental practice, not to mention the fact that you're covering the cost of two dental assistants for every visit.
There is one thing packer was right about. Pollies spend their lives adding new useless laws all the time and perhaps it's time to force them to repeal a law when they add a new one.
