People who have private health insurance have the peace of mind that comes with knowing they are covered for the best available medical treatments when and if they need them.
Private health insurance also:
« Gives you the option of being treated by your own doctor.
« Means shorter waiting times for surgery.
« Allows you more control over when and where you are treated.
« Takes the strain off the public hospital system and frees up government funds to upgrade hospitals.
« Helps with services not covered by Medicare such as chiropractic, dental, physiotherapy, optical, dietary advice and some alternative therapies.
Sunday, September 13, 2009
About the Australian Health System
Australia’s health system is one of the best in the world – a unique mix of public and private health care designed to make sure all Australians are well covered for their needs.
But with an ageing population, the increasing cost of caring for more people with chronic conditions, and continuing medical improvements, the demands on our health system are increasing. Medicare is the basis of our public health system. It’s a first-class scheme. But it was never meant to meet these demands on its own.
Private Health Insurance also plays a key role in covering Australian’s needs. In fact, more than a third of all hospital treatments are performed through private health cover. If private health insurance wasn’t there, there would be huge pressure on Medicare. We need a balanced, viable heath care system, with public and private cover working together.
There are nearly 600 private hospitals operating in Australia and they treat more than 4 out of every 10 admitted hospital patients, representing nearly half of all days of hospitalisation.
But with an ageing population, the increasing cost of caring for more people with chronic conditions, and continuing medical improvements, the demands on our health system are increasing. Medicare is the basis of our public health system. It’s a first-class scheme. But it was never meant to meet these demands on its own.
Private Health Insurance also plays a key role in covering Australian’s needs. In fact, more than a third of all hospital treatments are performed through private health cover. If private health insurance wasn’t there, there would be huge pressure on Medicare. We need a balanced, viable heath care system, with public and private cover working together.
There are nearly 600 private hospitals operating in Australia and they treat more than 4 out of every 10 admitted hospital patients, representing nearly half of all days of hospitalisation.
Terminology
Gap
This is the difference between what your specialist charges and what Medicare and your health fund will pay for a particular service. Some specialists have an arrangement with a health fund and don’t charge a gap fee, but whether or not you have to pay some of the costs will also depend on your level of cover.
LHC (Lifetime Health Cover)
LHC applied to everyone born after 1 July 1935 and it sets your premium rating for life when you first take our private health insurance. For each year you remain uninsured after the age of 31, there is a penalty increase of 2% on top of the normal premium.
IFC (informed financial consent)
Before you agree to medical treatment or a surgical procedure, your doctor should discuss all charges you may have to pay out of your own pocket. This is called informed financial consent.
MLS (Medicare Levy Surcharge)
This is a tax paid over and above the 1.5% levy we all pay. It applied to singles without private health insurance who earn over $73,000. MLS also applied to couples earning a combined income over $146,000 (increases by $1,500 for each child after the first).
30% Rebate
This is the amount paid by the Federal Government toward the cost of your private health insurance. For every $1 you pay in premiums you are entitled to 30 cents back. You can take this as a reduction presentation of a receipt from your fund, or a tax deduction at the end of each financial year. The rebate increases to 35% for people aged 65-69 and 40% when 70 or over.
Excess
This is the amount you agree to pay for hospital services in exchange for lower premiums. In some cases you will contribute each time you go to hospital and in other cases; you only have to pay a set amount each calendar year. For example, if you agreed to a $250 excess you will pay the first $250 of your hospital costs if you’re admitted as a private patient. Some policies only charge the excess if you’re admitted to hospital overnight rather than having day surgery.
Co-Payment
This is where you agree to pay a part of each hospital service you use. If your policy has a $50 co-payment clause, for example, you will pay $50 each day towards hospital accommodation. In this case a week in hospital would cost you $350.
Waiting Periods
Health funds have set waiting periods before you are entitled to certain benefits. These waiting periods will be clearly stated in your policy and will only apply to some services. If you’re thinking of starting a family and you’d like to use one of the deluxe birthing suites in a private hospital, it pays to adjust your health insurance well in advance because there’s a 12 month waiting period for obstetrics. If you’re going to hospital at any other time it’s always best to call your health fund to check your eligibility.
General Treatment Cover
These are the ‘extras’ offered in your health policy. Coverage may depend on your type of policy and your health fund but they generally include a variety of services such as physiotherapy, dental, optical, podiatry and some alternative therapies.
This is the difference between what your specialist charges and what Medicare and your health fund will pay for a particular service. Some specialists have an arrangement with a health fund and don’t charge a gap fee, but whether or not you have to pay some of the costs will also depend on your level of cover.
LHC (Lifetime Health Cover)
LHC applied to everyone born after 1 July 1935 and it sets your premium rating for life when you first take our private health insurance. For each year you remain uninsured after the age of 31, there is a penalty increase of 2% on top of the normal premium.
IFC (informed financial consent)
Before you agree to medical treatment or a surgical procedure, your doctor should discuss all charges you may have to pay out of your own pocket. This is called informed financial consent.
MLS (Medicare Levy Surcharge)
This is a tax paid over and above the 1.5% levy we all pay. It applied to singles without private health insurance who earn over $73,000. MLS also applied to couples earning a combined income over $146,000 (increases by $1,500 for each child after the first).
30% Rebate
This is the amount paid by the Federal Government toward the cost of your private health insurance. For every $1 you pay in premiums you are entitled to 30 cents back. You can take this as a reduction presentation of a receipt from your fund, or a tax deduction at the end of each financial year. The rebate increases to 35% for people aged 65-69 and 40% when 70 or over.
Excess
This is the amount you agree to pay for hospital services in exchange for lower premiums. In some cases you will contribute each time you go to hospital and in other cases; you only have to pay a set amount each calendar year. For example, if you agreed to a $250 excess you will pay the first $250 of your hospital costs if you’re admitted as a private patient. Some policies only charge the excess if you’re admitted to hospital overnight rather than having day surgery.
Co-Payment
This is where you agree to pay a part of each hospital service you use. If your policy has a $50 co-payment clause, for example, you will pay $50 each day towards hospital accommodation. In this case a week in hospital would cost you $350.
Waiting Periods
Health funds have set waiting periods before you are entitled to certain benefits. These waiting periods will be clearly stated in your policy and will only apply to some services. If you’re thinking of starting a family and you’d like to use one of the deluxe birthing suites in a private hospital, it pays to adjust your health insurance well in advance because there’s a 12 month waiting period for obstetrics. If you’re going to hospital at any other time it’s always best to call your health fund to check your eligibility.
General Treatment Cover
These are the ‘extras’ offered in your health policy. Coverage may depend on your type of policy and your health fund but they generally include a variety of services such as physiotherapy, dental, optical, podiatry and some alternative therapies.
Tuesday, May 12, 2009
Budget News 
Most Important – Nothing happens ‘til July 2010 in regards to your health insurance.
So don’t panic!!!!
The Government has a bill stalled by the Senate, which is aimed at means-testing the rebate. The bill actually contravenes a promise made in writing by the Prime Minister before the last election, in which he stated NO changes would be made to the Private Health Insurance rebate if he won the election. What will happen if the Government gain control of the Senate is that the promise will be broken and higher income earners will be severely disadvantaged. If many people decide to drop private hospital cover, we will be heading back to the days of the early to mid-nineties when private hospital cover membership descended to a severely dangerous level.
From July 2010, the private health insurance rebates will reduce, for singles earning over $75,000 and couples/families earning over $150,000.
The Medicare Levy Surcharge, imposed on people who do not have private health insurance, will increase for singles earning an excess of $90,000 and for couples/families earning in excess of $180,000.
Comment here if you have any queries and we will be in touch!
Most Important – Nothing happens ‘til July 2010 in regards to your health insurance.
So don’t panic!!!!The Government has a bill stalled by the Senate, which is aimed at means-testing the rebate. The bill actually contravenes a promise made in writing by the Prime Minister before the last election, in which he stated NO changes would be made to the Private Health Insurance rebate if he won the election. What will happen if the Government gain control of the Senate is that the promise will be broken and higher income earners will be severely disadvantaged. If many people decide to drop private hospital cover, we will be heading back to the days of the early to mid-nineties when private hospital cover membership descended to a severely dangerous level.
From July 2010, the private health insurance rebates will reduce, for singles earning over $75,000 and couples/families earning over $150,000.
The Medicare Levy Surcharge, imposed on people who do not have private health insurance, will increase for singles earning an excess of $90,000 and for couples/families earning in excess of $180,000.
Comment here if you have any queries and we will be in touch!
Thursday, May 7, 2009
PHIIA
John Small is a founding Director of PHIIA (Private Health Insurance Intermediaries Association) founded to develop, administer and maintain the highest standard code of conduct for people seeking health insurance.
JSHA - Longest running health insurance advisor in Australia.
In these days of racing into the latest technologies and buying straight from the web, we actually believe a complicated and important product like health insurance needs us. Why? Because we provide service, in the truest sense of the word.
We know the products (and there are lots of them, many hundreds in fact) we care for our clients and make sure we are providing them with the best advice, and we make sure they know what they are getting.
Not many offerings from the web can boast that.
We claim that title until a successful challanger appears.
In these days of racing into the latest technologies and buying straight from the web, we actually believe a complicated and important product like health insurance needs us. Why? Because we provide service, in the truest sense of the word.
We know the products (and there are lots of them, many hundreds in fact) we care for our clients and make sure we are providing them with the best advice, and we make sure they know what they are getting.
Not many offerings from the web can boast that.
Tuesday, May 5, 2009
John Small Health Advisory
Why use a broker?
Get personal attention and expert advice –
FREE OF CHARGE!
Buying “on-line” DOES NOT save you money – rather it gives you the WRONG product more quickly!
Get personal attention and expert advice –
FREE OF CHARGE!
Buying “on-line” DOES NOT save you money – rather it gives you the WRONG product more quickly!
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