Tell the government if and why your health insurance isn’t worth the money 321



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500,000 Australians dumped or downgraded their private health insurance last year and now Health Minister Sussan Ley wants to know why.

Official figures show Australians are looking for cheaper cover with exclusions and excesses, and now the Turnbull Government has launched a national public consultation that will ask people about their views on private health insurance and how they think it can deliver better value for money.

According to Minister for Health Sussan Ley, there is a flow-on effect from Labor’s successive cuts to the value of the private health insurance rebate, which included means-testing and restricting indexation to CPI, not premium growth.

This meant hundreds of thousands of Australians prepaid their policies for up to three years in 2012 just before the first of Labor’s cuts came into effect in order to delay their impact.

“I’m deeply concerned the true pain of Labor’s multi-billion private health cuts is only now being felt by consumers as their prepaid policies expire and bill shock kicks in,” Ms Ley said.

“A longer-term trend of premium increases above inflation across successive governments also suggests there is a something wrong with the regulatory foundations of our private health system.

“Either way, consumers are angry, confused and I’m concerned that simply shopping around is no longer enough to get the best value for money.

“Private health insurance is a fundamental part of our health system for Australians of all ages and income types, with half the population having some form of cover.

“We need to ensure this hard work isn’t undone by Labor’s cuts and the increasing flood of ‘junk’ policies that offer nothing more than a bed in a public hospital.

“This Government is committed to recalibrating the private health system so that value for money for consumers returns to being its core focus and we’re interested in the views of everyday Australians on how best to do that”.

Ms Ley said any changes needed to be delivered by conceding the Medicare and public hospital systems remained “universally” accessible to all Australians and private health was seen as complementary to services

“It’s important we’re able to ask consumers what they expect from their private health insurance and there’s plenty of room to do that without moving towards US or UK models that exclude sick people and make it only available to the rich, which we don’t support.

“Consumers can have their say via our online survey:”

Consultation will run until Friday 4 December 2015.

Have your say here

Tell us, are you paying too much for your health insurance? Is it worth the money?


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  1. Some of it could be because it is too hard to manage on a pension, with the cost of everything rising something has to give and people normally cut out the things they can survive without

    8 REPLY
    • I agree but also you pay out all this money and you are still a lot of money out of pocket after you make a claim. My husband has just had his eyes done and we were out of pocket $2000.

      1 REPLY
      • If you are on a pension there is no point in being privately insured.. Everything is free.

    • You pay a fortune. You have a huge gap to pay after you claim. From personal experience, I had day surgery at our local community hospital. As I had private insurance I was charged as a private patient and copped all sorts of extra charges, had I been a public patient it would be free. It cost me about $300. I have taken advantage of Private Insurance to jump queues and have surgery at Private Hospitals but there is a huge gap often, one surgeon charged $500 above the private hospital refund and there were extras for every other part of treatment as well, anaesthetist, hospital, equipment hire, ankle cast. We had to let our extras cover go as we couldn’t afford the cost. The gap on most claims anyway was greater than 50%.

    • Barbara Easthope Never had extras, decided years ago it was a waste, 2 kids braces & all the extractions etc & i got a pittance . Better to put money in bank. ALL the day surgeries in our area are private.

    • I am battling to keep my private insurance, but I am seriously thinking of cancelling it, the gaps we now have to pay are exorbitant, the excess is exorbitant, I honestly dont think private health insurance is worth it any more, if I have to go into hospital now I can no longer afford the gap payments, so unfortunately I will have to use the public system which is also a worry

    • Rhonda Preece Was that cataracts , Julia Gillard reduced that to a pittance as it was costing too much, I got caught , my friend had hers done at a day surgery attached to Private Hospital, so i decided to get mine done , not long after. I knew how much she paid so never enquired about cost, Rebate was nothing like my friend got, cost me around $1800 per eye

    • Yes had to let it go as if we paid it we still had a big bill after and if the government can’t see that they are more stupid than I thought but then they would have some scheme running so they get it all back

    • I don’t think the Govt, can afford to subsidise Private health any further, Tax payers, workers are keeping a lot of people

  2. Because like all Insurance, you pay and pay. When you put in a claim you don’t get what you deserve or any at all. There is no reward after certain amount of years with no claims. After you reach, say 80 you don’t get the money you have paid back, even if you have never had a claim. You have to pay huge excess to make claims. Insurance is the biggest rip off of all times, medical, car, house and contents.

  3. aside from the sheer cost of premiums my biggest issue, and what finally drove me out of private health insurance after many years … was the huge out of pocket expenses incurred in some (illness/medication related) dental care and some ophalmological investigations of an urgent nature. Despite top scale health insurance with ancillary cover I was $2k out of pocket on each occasion…. by a fund who was quite happy to buy someone with a serous back injury a pair of running shoes and could see “NO DEMONSTRABLE VALUE” in a physiotherapist supervised swimming program.

    2 REPLY
    • I found out many years ago, Extras was a waste of money, Have been huge gaps ever since Medicare came in, My husband had 39 Operations over his life time ,a number in ICU, the out of pocket costs were huge, but we never considered getting out of it, I did office cleaning t night to get by. as he wasn’t working. Medicare has a number of problems , don’t do some NEW procedures at Public as costs too much, and they use lower grade materials for pins & screws etc. IF you pay the extra charge of $600 for the theatre ,you get done a lot quicker in public, I proved this, most of the hold ups are in the theatre, as Medicare only pays $200 . I told them my daughter had private cover ,after 2 weeks of waiting for exploratory , she was in theatre within the hour, They wouldn’t transfer her to Private hospital, had to come home ,see our GP to get recommended to a specialist, to find out she had stage 4 cervical cancer. GP took one look at blood test from Hospital ,picked it straight away.

  4. Agree with Judith and Libbi cost is to high when you are on an aged pension or even in the working force we all don,t earn what you polices do and that is where everything is wrong we work just as hard as you lot some of us work well into the night every night so get over yourselves and come out into the real world you would not have a clue

  5. the gap between treatment cost medibank refund and private health refund cost us $2500 for a 4 day in private hospital and thats with top cover if i had gone public it would have cost nothing and got the same doctor

    2 REPLY
    • The one good thing about private insurance is you can normally have a procedure within 7 days . In some cases it’s a matter of life and death ..

  6. It’s not that it’s not worth it,it’s just the average person can not afford it.

    2 REPLY
    • Costs are Increasing but benefits are not and the Federal Govt allows price increases of double or tripple the CPI. If everyone opted out of private Health insurance the Medicare system would collapse, wake up Sussan Ley

  7. Insurance, are we all aware that insurance health or otherwise, is just gambling. When you take out insurance you are making a bet with a big bookie masquerading as someone who cares about your health or property. With health insurance you are betting that you are going to fall ill, the insurance company is betting that you will remain well. Most of us are doing our best to look after our health in doing so we are assisting the insurance company to win the bet, so we lose our money.

    2 REPLY
  8. Its a easy way out blame the last goverment its not all their fault , stop giving to all these ones that are coming here , they get health care card and think what that entitlement is not only medical , leave the age pension alone if you carnt fix it Sue go back to farming im sure you would find it a damm sight harder

  9. Out of pocket expenses are ridiculous when your paying for private health cover. And it is ridiculously expensive to pay each month.

  10. When I started in the disability pension I dropped the hospital cover as I could not afford it but kept up the ancillaries but I am wondering if it’s worth it as there are less and less things I can claim now and the dental cover is a laugh now it’s supposed to be 80 per cent refund ! Now I am lucky to get half !
    I have been with the same benefit for over 40 years but since the changes across the whole Benefits scheme
    It does not cover everything any more even though I have top cover

  11. When the going gets tough you look at ways to save money. Unfortunately health insurance is something that chews up funds with often little return. Out of pocket expenses for some procedures are outrageous, and leave you wondering just why are you paying insurance, and I’m not talking elective procedures here.

  12. We had private health cover for over 50 years, it was great when we were younger and bringing up our kids, but things kept changing and after a major operation about 8 years ago we were left with huge out of pocket expenses. We decided we could no longer afford it, so now aged in our 70’s we’re on the public health system. In all the years we were covered my husband never used it once, but there is no loyalty from the companies.

    2 REPLY

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