Difficult to Truly Compare Health Insurance Policies

[RooFlyer]

The consultant in BUPA said Medicare does funny stuff in their policies.

Well, they would say that, wouldn't they? (Assuming you meant Medibank, the health insurer - apols if not)

__________________

I did a review just before covid for alternative health insurers just to make sure I was on a good wicket. As observed here, its very difficult to compare like with like. But I realised that if you have a few miles on the clock, its better to focus on the terms of the hospital cover, not the extras. Dental or optometrist out-of-pockets will pale in comparison with Hospital ones, if you get the wrong hospital cover. A I said, a couple of surgeries will pay for the cost of a top policy for many years.

Anyone else getting premium cash backs from their insurer as a result of lower demand during covid?

 

[CaptainCurtis]

Anyone else getting premium cash backs from their insurer as a result of lower demand during covid?

I received some cash back from Bupa a few months ago - marginally short of one months premium.

 

[MARTINE]

Well, they would say that, wouldn't they? (Assuming you meant Medibank, the health insurer - apols if not)

__________________

I did a review just before covid for alternative health insurers just to make sure I was on a good wicket. As observed here, its very difficult to compare like with like. But I realised that if you have a few miles on the clock, its better to focus on the terms of the hospital cover, not the extras. Dental or optometrist out-of-pockets will pale in comparison with Hospital ones, if you get the wrong hospital cover. A I said, a couple of surgeries will pay for the cost of a top policy for many years.

Anyone else getting premium cash backs from their insurer as a result of lower demand during covid?

I got $500 last week - MP

 

[Pushka]

Well, they would say that, wouldn't they? (Assuming you meant Medibank, the health insurer - apols if not)

__________________

I did a review just before covid for alternative health insurers just to make sure I was on a good wicket. As observed here, its very difficult to compare like with like. But I realised that if you have a few miles on the clock, its better to focus on the terms of the hospital cover, not the extras. Dental or optometrist out-of-pockets will pale in comparison with Hospital ones, if you get the wrong hospital cover. A I said, a couple of surgeries will pay for the cost of a top policy for many years.

Anyone else getting premium cash backs from their insurer as a result of lower demand during covid?

Medibank Medibank. Medibank. Well, I expect it's true because at that time he didn't know which fund I was talking about and that was the only one he specifically mentioned. He said something like -the inclusions are all pretty much the same unless you are with MediBANK as that has some unusual features.

No cash back from Qantas.

 

[Lynda2475]

I use a MP's 'Members Choice' dentist in Hobart and am perfectly happy with them - I have my particular dentist (same for 10 years now, before that someone else in the practice before they retired), not just any dentist in the practice.

Good for you, happy coincidence your dentist of choice happens to be a partner, I checked and mine is not nor are my next 3 alternatives. I have zero desire to move away from my lovely dentist who is the only one I know capable of giving pain free injections.

Your comment about disgruntled workers and sub-standard care is simply ridiculous and again, commenting about something you have no experience with.

No I asked around, no one I know here in Sydney is happy with the insurer owned practices; where there are constant staff changes. I dont do franchises.

I like choice and to know easily upfront before choosing a provider how having that option determines the true value of the policy.

My BIL is an optometrist and owns a share of 4 independent practices. When Medibank tried to get him to partner they came in like woolworths does to farmers and tried to bully them into shorter consults for lower pricing. As that would be a disservice he told them where to go. I guess if you are concerned you might lose business you might cave, but if you have a very loyal customer base they stay for the quality service.

You don't have to use the Medibank Private nominees.

I know this, but unlike other providers who state upfront on their website how much less they re-bate for no partners Medibank Private do not. If the difference isn't material, why not be upfront and honest. I sent feedback last night when they asked if the FAQ answered my question; and drafted a note to my local member about the misleading conduct from the largest insurer.

If you want to check how much MP will rebate you for a particular service from a non Members Choice provider, why not just call them and ask? Might surprise you, and might end up being an attractive policy for you.

It is a total PITA to wait for business hours. I am in back to back meetings most of the work day, so dont have the luxury of being able to wait on hold with a shopping list of codes because of their misleading conduct. It doesnt give me a good feeling, so Ive eliminated them.

You love them, they work for you that is great for you, my mileage varies dramatically. The competitive landscape and cost of living is much lower in Tassie vs Sydney CBD.

In respect to Hospital cover, the only private hospital in Hobart is their nominated one for cheaper out-of-pockets, so that works well.

Im not concerned with the hospital part, as those lists are readily available and I've been able to verify my preferred private hospitals are partner for every insurer I am looking at.

Boy, if getting Woolies/QFF points is in any way on your mind re health cover, you are using the wrong metrics.

LOL I never said this was for me, but if Pushka decided to go with Bupa anyway because that policy worked best for her, why wouldn't she also make sure she got the sign-up bonus?

I am however considering the joining offers from some providers that give between 6-12 weeks free premiums over the first 12-18 months (not the ones with stupid gift cards) when evaluating the cost because that is material if the coverage is otherwise equal.

Hence my disappointment when you realise some brands like AAMI which have good extras policies offering 70% rebates for any provider are actually NIB by another name and my current policy eliminates y eligibility that their 6 weeks free offer. I have emailed my NIB corporate contact and asked for the latest corporate offer for Silver Plus and if they can match this offer. If not I have 3 others (excluding medibank) which are looking quite promising.

WCMO is clearly different to what CYO.

 

[Lynda2475]

Most offer Silver and Gold with no obstetrics but cover all the usuals like joint replacements and cataracts. BUPa tried to cut those out in 2018 which is when I left them and moved to Qantas (NIB). Look for the Plus

There are a couple of decent Silver PLUS (as opposed to the basic silver) policies that include all the major stuff except pregnancy/fertility, weight loss surgery and anything above minimum in hospital psychiatric services which Im seriously considering as saves at least $150 a month over gold. Which would help fund the gap on glasses and dental coverage.

But some silver plus also exclude dialysis for kidney failure (which one has no way of knowing if that might occur as both my nanna and cousin have had kidney cancer - one kidney removed each) so those ones are out; as is the one that excludes cataracts.

There needs to be legislation requiring all funds PDSs to clearly state up front the rebates (% plus cap, or $ plus cap) for the most common dental, physio, optical item codes for both partners and non partners (if there is a difference).

Those who offer a % generally better than those who have a fixed rate. I laughed that a few only offer $40 for a dental check-up seriously? No Macquarie St dentist is going to do a check-up for less than double that.

 

[tdimdad]

“Self insuring” for extras is worth exploring for the occasional claimant.

That's what I've done. Dropped off the extras and have had the hospital cover only for a couple of years.

I checked all my extras claims over a three-year period vs what I've paid as premiums and was losing money. Optical & dental (including major dentals to the cap nearly every year) was my usage pattern. I'm financially better off when I keep my teeth in an adequate health with a decent routine.

And yes, attempting to compare any insurance is a huge pain in the backside. An industry getting away with such a level of obfuscation and obstruction towards consumers should be outright criminal.

BTW, last year I managed to drop my home/contents insurance policy from the 'loyalty tax' level to the 'new customer' rate. I did a price comparison, realised that after the next annual renewal I'd be paying nearly 30% surplus just because. I hate calling in but did it anyway and it resulted in then nearly matching the rate (came to within like $2/month) "because of your long tenure".
--> I might do the same with the health fund, seeing if their newcomer rate is lower than my premium and try to wrangle the rate down from there.

 

[tdimdad]

BTW, for those why might be using their extras mostly for dental work, there are also non-health funds which operate in a different manner: by "joining" them you get an outright discount at the dentist.

My plan costs $79/year for a single and my dentist belongs in their network (of course, would not make sense otherwise to "join" the plan). I seem to break even most years but if I had something bigger, I'd be ahead after the discounts.

 

[MEL_Traveller]

I ditched extras ages ago. I *think* I’m out in front. I’ve got my glasses prescription so can get lenses and frames overseas cheaply. In australia you can often order on line. But I don’t get new frames annually.

Dental... I try and get regular check ups overseas if possible, fraction of the price. And same applies to any work that needs doing (you need a good dentist in somewhere like Bangkok, and this is where recommendations come in handy! My parents saved $14000 on bridge and crown work by going overseas… and still perfect today after 7 years! The implants themselves were done here in Australia, claiming back under extras.)

Dialysis is an interesting one. My health provider said this isn’t *normally* something that happens overnight. So if you start down that path, that’s the time to upgrade your cover and serve the 12-month waiting period! Then you’re covered! Same applies for some of the other major things.

 

[MARTINE]

I ditched extras ages ago. I *think* I’m out in front. I’ve got my glasses prescription so can get lenses and frames overseas cheaply. In australia you can often order on line. But I don’t get new frames annually.

Dental... I try and get regular check ups overseas if possible, fraction of the price. And same applies to any work that needs doing (you need a good dentist in somewhere like Bangkok, and this is where recommendations come in handy! My parents saved $14000 on bridge and crown work by going overseas… and still perfect today after 7 years! The implants themselves were done here in Australia, claiming back under extras.)

Dialysis is an interesting one. My health provider said this isn’t *normally* something that happens overnight. So if you start down that path, that’s the time to upgrade your cover and serve the 12-month waiting period! Then you’re covered! Same applies for some of the other major things.

End Stage Renal failure with no dialysis for a year - pick up some funeral insurance too!

 

[MEL_Traveller]

End Stage Renal failure with no dialysis for a year - pick up some funeral insurance too!

But is that possible from ‘perfectly healthy and functioning’ to ‘end stage’ in less than a year?

I think what the advisor was trying to say is that the decline into requiring dialysis would usually be slower, not overnight. So you’d usuaully have notice, and could adjust your level of cover accordingly. Not sure how accurate that is though!

 

[Pushka]

End Stage Renal failure with no dialysis for a year - pick up some funeral insurance too!

There's usually indicators that advise in advance if kidney failure is imminent so likely time to wait for a package upgrade. Usually 12 months. Mine gets tested monthly with the usual basic kidney tests. That will change, eventually or maybe not, to 6 monthly.

 

[MARTINE]

But is that possible from ‘perfectly healthy and functioning’ to ‘end stage’ in less than a year?

I think what the advisor was trying to say is that the decline into requiring dialysis would usually be slower, not overnight. So you’d usuaully have notice, and could adjust your level of cover accordingly. Not sure how accurate that is though!

Many people with chronic renal disease are unaware

 

[Pushka]

Many people with chronic renal disease are unaware

I guess if people have regular annual checkups then it isn't an issue. Dare I say that most people who bother to take out health insurance are the types to have regular checkups?

 

[MEL_Traveller]

Agree with all the points! I have regular check ups, it’s not like the insurance advisor was a medical specialist, they were just tying to be helpful! Their advice seemed ok at the time and it saved me money downgrading from gold to silver plus!

I guess there would also be public dialysis available. Not like it’s an all-or-nothing scenario.

 

[knagelli]

I am with AIA ( currently have silver plus) and after having read all the comments above , I am planning to look for alternate options as our cover will be going up by almost 5% month on month. As I understand everyone's criteria is different but are there any decent options which the comparison sites/avenues are not showing us. Appreciate your inputs/suggestions.