There are a number of dormant topics about private health insurance, whether it is value for money, and selecting the ‘right’ fund for one’s needs. None seem appropriate homes for this topic.
I do not recall ever having seen a question about location and how that affects the value in advice or comparisons. As is common with most aspects of life those living anywhere but the major metro areas seem to be disadvantaged by rules and legislation that make sense in inner cities and sometimes all the way to outer suburbs, where life is different and amenities suddenly start to drop off.
This article might be one sided but is reality to those interviewed.
Other demographics that ask the question about value. My elderly mother maintains ‘gold’ private health but lives in the western suburbs of Melbourne and is disabled. My sister, faced with mum’s annual $3K asks what value mum gets from this membership. Footscray area is bereft of private hospitals with emergency admissions and ambulance will only transport to closest hospital. Hospitals aren’t interested in admitting people in their 90s and won’t provide required procedures due to risk. So low value of health insurance also intersects with the aged, particularly pensioners, and people living in metro areas with poor health infrastructure. The difference between poor metro and remote is the added burden of the tyranny of distance for regional members.
I had top hospital cover, but lived remote. About 10 years ago I needed care, in a hurry. The ambulance bypassed the local hospital and got me to one with a doctor. I was assessed as needing more care than they could offer, but the public hospitals (including Brisbane) had no beds available. They tried further afield with no luck, then I volunteered that I had private health cover and the relief was obvious. From there everything went like clockwork. RFDS, ambulace, The Wesley private hospital. There were still some gaps to pay on imaging, but about $5k was paid by the fund.
More recently I was flown by RFDS to Rockhampton, but there was a public bed available and I didn’t need to use private health.
Extras - my fund has “no gap” arrangements, but they are all in Brisbane, Gold Coast etc. If you didn’t claim for services, this rolled over. However this is no longer the case. I needed two pairs of glasses, but could only claim for one, despite not getting any for 3 years. It is becoming less economical due to annual & life-time limits, and services I don’t use or can’t easily access. I pulled Mr Z out of Extras as most services were provided “free” under his Health Care Plan - eg Physio, or he didn’t need them.
The Qld public system is choked and unable to deliver. Mr Z had an urgent specialist need, but his referral was passed through 4 public hospitals who all said they were unable to assist. Closer to home we were able to get into a private specialist within a fortnight and procedure cost about what we were paying for top hospital for a month (we are no longer in hospital cover). I am happy to pay for occasional treatment, because we have saved about $7k a year by not keeping hospital cover. He has contributed for 20-30 years and never used it. Some of that because being remote, services were not there, or you got the same service public or private in the same bed.
Relative cost varies quite a bit depending on where one lives. The nearest private hospital to me is about 1500 km, and there are no private specialists here as far as I know - just dentists and ‘allied health’ practitioners …
I pay around $280 a month for family cover - top everything, with one kid working and over 18, which puts the cost up a bit over a simple family with dependants. When I moved here, my private health costs reduced considerably from what they were in the ‘big smoke’.
Out of interest, I checked the ‘rough online quote’ back from the fund I am with - noting that I am on a grantfathered cover. The rough new quote for here is around $350 a month. The same cover in SA is $520, VIC is $580, NSW is $540, QLD is $560, WA is $500, TAS is $530. It’s interesting in that NT isn’t the only place where ‘outback’ is - WA, SA, QLD, and NSW all have remote areas to varying degrees, where there are few if any private hospitals or non government specialist services let alone allied practitioners, but with my fund doesn’t seem to distinguish between ‘Perth’ or ‘Fitzroy Crossing’ in WA for example - theres plenty of others in the states mentioned. I suspect other funds are similar.
While the rate here is a lot cheaper - am I getting value? I can’t remember the last time I made a private health claim - but I have, it just wasn’t here - ‘when in pain, take the plane’ …
Whether one has private health cover or not, going private if one lives outside the major cities has advantages. The cost and convenience of travel is a significant consideration, and more so for those with lesser means. Being able to better choose when and in which large city one is treated is another. For some familiarity seeing the same specialist and to use the same extended services is reassuring.
For proactive health care needs, non urgent and elective procedures putting off for regional patients can contribute to worse outcomes. Personal circumstances vary. We’ve always been fortunate enough to be able to travel to access specialists etc. Ours may be a different point of view. The considerations in respect of the value basic private health cover may or may not offer, whether one lives in a capital city or far away are similar.
If there is an exemption to be provided for higher income earners in regional Australia, where is the equivalent benefit for those on lower incomes? The lack of choice and access is more likely to affect those not able to freely travel. It’s our observation of those in the extended family waiting in the queued and variable priorities of the QLD public health system.
Note:
The ABC pointed out for the Medicare levy,
The surcharge begins when single people earn more than $90,000 per year, or a couple earns more than $180,000 per year.
It’s also important to understand the relative costs of public vs private delivered medical services, independent of where one has travelled from. YMMV.
