Seven handy tips to alleviate some of the confusion around choosing a private health insurance policy (or not) and how to save money if you do.
I am really curious as to hear others comments with respect to Choiceâs tip being âIf youâre looking for a policy that covers you for both hospital and extras, consider one fund for hospital and one fund for extras as it often means you get a better deal.â
Just wondered how this works? When we seek medical services, do we hand over two health insurance details? What other things do I need to consider?
Love to hear others views and experiences regarding this approach.
Thank you in advance.
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Welcome to the forum @markamaiden. I have moved your question to this topic as the recommendation from Choice you are asking about is really a hack and therefore falls under this topic rather than starting a brand new one.
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Welcome @markamaiden, to answer, hospital cover is precisely that - it only applies for procedures when admitted to a hospital or day surgery. âExtrasâ is a seemingly random cafeteria of services that are not related to hospital procedures and sometimes not even directly to health per se (eg gym memberships). Thus there is a clear demarcation where one or the other would apply.
Have an illness that will require anything hospital, it will be your hospital cover. Otherwise it might be covered by an âextrasâ policy. The two will never intersect. If in doubt office staff can advise case by case.
Hospital funds are banned from paying for anything out of hospital. For hospital cover consider whether you are required to use their list of providers (surgeons, hospitals, and so on - their accountants are in charge) or whether you can go to your provider of choice, although how much the provider charges and how much the fund pays will vary; and if the latter whether those providers have known gaps (eg out of pocket amounts) or not. All funds do not have contracts with all hospitals nor with all surgeons for known gaps. Some cheap hospital cover is not much more than medicare cover as it is limited to public hospitals although you can chose your surgeon. Some funds have contracts with virtually all hospitals and a great many surgeons. As for lab work, if it is done pre or post admission there is no cover; if the same procedure is done in-hospital there can be cover.
âExtrasâ is a cafeteria of benefits that usually includes various levels of cover for dental, eye glasses, chiro, hearing aids, some health appliances, and so on. They vary greatly.
I keep both with one fund for convenience. Keeping track of two funds with their increases every year can be time consuming, and as with any insurance they may not all be the same, although the government pretends they are with its mandated bronze-silver-gold, then plus blah blah âstandardâ naming. In balance changing from one to another does not usually incur wait times for benefits unless the new fund has better benefits than the old - then most will only pay your old fundâs benefit levels until the wait time expires.
I hope this went at least some way to answer.
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We often highlight situations where companies do the âwrongâ thing, and insurance companies specifically, but hereâs a good news story for one health insurance customer. You could call it a hack, I guess. Canberran receives $45,000 ambulance bill from Tasmanian government after rolling her ankle on hiking trip - ABC News
Canberran receives $45,000 ambulance bill from Tasmanian government after rolling her ankle on hiking trip
She had contacted her private health insurer immediately after receiving the invoice, and after months of back and forth, the insurance company covered the entire bill.
(my emphasis)
I donât know whether itâs normal for private health insurance to cover ambulance, and what restrictions and conditions normally apply, but obviously this particular incident was an extreme case of âambulanceâ.
I canât help but think that state and territory governments should really get their heads together and come up with a single, national, standardised reciprocal arrangement for covering ambulance service charges.
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In Qld the levy was added to your electricity bill but the levy was repealed in 2011 and the Ambulance is now a free Qld Govt service. Qld residents are covered Australia wide and if they receive an invoice from another State or Territory, they just need to forward the invoice to The QAS who will pay the bill.
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