Thread: Health Insurance

Insurance is protection against risk. The real question is how risk averse are you? What risk will you bear for the cost of the premium?


I maintain basic cover, hospital and some extras. I have the occasional muscle / back pain, and it covers a good chunk of the physio / chiro and remedial massage. For my coin, I think I get good value. Keep in mind there are also tax implications as well, which may help influence your decision one way or the other.

Someone I know, (but someone's situation I know a lot about - being purposefully vague here), has had a tough time mentally, and has had a significant stay in a private mental health facility, with the bills racking up a reported $30K for the duration of the stay.
Private mental health stays are considered a hospital visit, so only a small excess is payable by the patient. I joked that it wasn't a hospital stay, but more of a 'mental health holiday'. The facility itself is reported to be quite nice, with one-on-one psych and medical attention on demand, as needed. By the sounds of it, I'd stayed in worse 4 star accommodation in my time!
The alternatives in the public system is much worse, heavily over burdened, and has a less intensive availability to the clinicians who are able to help resolve the problems.


Another acquaintance had a heart attack, got rushed thru a triple bypass and was afforded the services of the best cardiologists and scans and implants that could be used. Once again, a very sizable bill, and a great outcome after the fact, but definitely a level of service the public system could not match.

I have health insurance. From a financial point of view it probably is not worthwhile for most people.

But this will depend on your individual circumstances and health.

The main advantages I have found are rapid admission to hospital for non-emergency surgery. A couple of examples:-

1. Diagnosed with melanoma, on a Monday saw the surgeon for the first time - "You have private insurance, don't you? How about Wednesday this week, check in at 0600?"

2. Optometrist says cataract operation needed within four months "or you won't be able to drive". Waiting time at the public hospital nine months, at the private hospital, two weeks.

3. Diagnosed with hernia - surgeon offers private hospital operation in two weeks, or public hospital in six months.

Some operations have had nasty gap payments, particularly for anaesthetists, others have been no gap.

Mitch summed it up nicely.
I've had it for over twenty years and hardly made any claims.
The ex is a nurse, she dropped hers years ago.
As she said, in an emergency everyone is treated the same.
Financially I'd be far better off not having it, it's a carry over from being self employed and trying to cover my backside.
And having a relatively risky hobby at the time of mountain biking. I wanted my Osteo if I did a shoulder, wrist, etc

I really hurt my back in the late nineties and everything came out of my pocket over the next eighteen months to get me going again. My business really suffered too, so rightly or wrongly I signed up once past that.

I am having to have booth my knees replaced ( by best knee surgeon in Brisbane) & got an estermate from doctor this week to have them done . To have one done is $3682 & my private health fund will pay $1609 & with Medicare the gap is $634 but if I have booth done at same time it is $6554 , my private health fund pays $694 & with Medicare the gap is $4776. If I have one done I only have to pay the gap but having two done together I have to pay up front $7554 then go to Medicare & my private health provider . I asked my doctor why & he said these are the rules set by the health funds so I asked them & they blame the doctor. So looks like I will be out of pocket $4776 in stead of two lots of $634 but they booth need doing & I can not put up with the pain between the surgeries. I thought my health fund would been happy that I was sparing them the cost of two hospital stays & two theatre costs plus two lots of physio's . I have been with my provider for over 50 years & this is the 1st major clam I have had .
So I guess I was having two OP's I would say yes it is worth it but having booth at once it isn't , but if I didn't have it I would be up for over $10k with doctors fees physio ,anaesthetists & hire of equipment I will need at home after surgery . Also the fact I can have the them done as soon as I want them done & not wait for the Public System is a PLUS.
A friend of mine ( who has no private health insurance) is having to have a hip replacement she has been on the list for over 12 months now & still has no idea when she will have the OP . Also my wife has had quite a few health problems with three bouts of cancer & I would have hated to put her through the public system of having to wait , early detection , early treatment & that's a plus.

So after saying all this I would sat it does pay to have Private Health Insurance as you can have the OP when you want & you do get some money back. Lets face it we are all getting older & you never know when you are going to have major surgery & if you don't have the funds than you will need to borrow it & pay it back & the interest could out strip the cost of Private Health Insurance. You also get to choose your doctor can't do that with the public system .

SO THATS MY TWO BOBS WORTH. for what it is worth.

Wow thanks everyone that's certainly a lot of interesting information to take in. After listening to your personal journeys (which we thank-you for sharing). I think we'll be keeping it, the wait time without it is a bit scary. I guess in the grand scheme of it all if we pay health insurance fortnightly or a lump sum in the long run it really doesn't make that much difference

I have private insurance for tax reason to avoid Medicare levy surcharge and also the government policy lifetime health cover started 2000 that penalised one without private health insurance, with 2% loading after 30years of age

My quadruple bypass was done under public health, and I'm still standing! Only cost was the drugs I left the hospital with.

Bloke I was driving for a few years ago had his hip done. Old school feller, wanted to pay cash. Took 3 weeks to find a surgeon that would accept cash. Op cost around $12k all up. His friend had the same op a few months later, been in private health for 20 odd years. Out of pocket expenses were $13k!
I'd rather put money into the mortgage, and pay for any medical bills out of the equity

My mum had a knee replacement a while back - on the public system - in a public ward at no cost. The person next to her was on top hospital cover in the same hospital in the same ward with the same medical care - work done by the same doctor on the same day. My Mum's bill zero and patient next to her was about $2500.

Likewise the guy across the road had a heart attack and was taken to local emergency - entered as a private patient and given a big co-payment bill - if a pubic patient then no cost and no waiting time as it was an emergency.

I have ditched my private cover as it just was not delivering - dental/optical was a joke.

Every ones circumstances are different but for me health insurance is a waste of money.

Garry