Currently the cheapest junk plans seem to be $88/month after a rebate (male 30), from compare the market. The entry level surcharge at the entry level income of $93k is (0.01*93k) $930.
Comparing these on a yearly basis the junk plan is $1056 compared to the surcharge tax of $930.
Therefore one should not get PHI purely for financial reasons at the entry level income of $93k( no one should get PHI with income less than $93k or 186k couple for purely financial reasons). There are additional incentives once you get to 31 and every year after that but they are less important
So what income should you get PHI at, purely for financial reasons?
By my maths using lowest level PHI It should be (1056/0.01) roughly $106k for singles.
So there is a section of the community 93k-106k that even though they get stung with the tax they are better off, purely financially.
Obviously even those 'junk' policies have some material value, perhaps you get first choice of doctors or something, or the option to prioritise surgery.
But people that are prioritising financials that much (and buying a bottom tier coverage) will then be stung with huge out of pocket private fees, or go public anyway.
I guess getting PHI to minimise costs and going public anyway it's what they would do. I'd rather just pay the MLS if it wasn't a *considerable* saving.
Yeah the crazy thing is that in a lot of cases simply presenting your phi card during a medical visit will cost you more due to copays, deductibles etc.
It's a broken system only kept alive due to tax and other incentives. The fundamental issue is that insurance companies cannot legally charge a 60yo more than a 30yo. Even though a 30yo costs them less. That's why they have all these work around incentives with the government to try and make it work.
The age based loading is not less important. Add 40% to the junk policy price if you’re 40 or older. My last reading of it a while ago you had to be on something like $150k to be ahead.
I’m right in that $105-115k bracket and pay pretty much 90/m on PHI (32M). Works out a tiny bit cheaper to have PHI then to not. The kicker is 1 or two dental visits, physio sessions, therapy/counselling, etc. I save easy $500/year on those things with the cheapest plan Bupa offers. I’m about $700+ better off each year. I’m 100% for public health system but money is money and the public health system fails so hard at elective surgery so the hospital cover is so so worth it.
Whats the cost of the levy?
When you shop around for insurance, think of the price as (annual cost-levy=actual out of pocket cost)
Its not so terrible then.
Same. Idealogical reasons. Public free healthcare is a must have for our nation and the strong encouragement for everyone to go private will only turn us into America and their horrific system over time. I'd rather pay additional taxes to the public system.
As an American that escaped,I can't agree with you more.
Every time I see a move in that direction I shudder.
It's a sad state of affairs over there. (I think I've been asked to donate to a dozen go fund me's for healthcare.... this year. No idea how many in my life time.)
I’m well aware it’s general revenue. I just see every dollar private health gets is another dollar in their war chest to lobby governments and weaken Medicare.
The push to get everyone onto private involved defunding the public free services so everyone would start feeling like they had no choice. It's planned. Shouldn't be this way. Hard to unwind 10+ years of actively trying to make the public service look shit so people go private.
100% mate. I'm a biomedical engineer and the budget constraints in the public system are a joke considering the amount of tax we pay plus the Medicare levy. That's why I don't pay it, but I agree with you it's all set up to be this way. Guess they'd rather fund more overseas wars
Same boat, and it's actually so nice to see others that think a bit further than our own families. I rarely need to go to the doctor so I'd much rather see my money go to the commons to help others than some insurer's pocket.
I’m with you. If we all withdrew our cash from private health insurance and funded the public system we’d see a far better more equitable service that which would challenged the private system in to irrelevance and ultimately oblivion ..
Instead people pay thousands to a private company to act as a conduit between you and healthcare, it’s illogical.
Same here. Household income is about 200K p/a.
I believe that every individual and family that enters into private health cover weakens the public health system as a whole, and that's the absolute opposite of what we should be doing.
I know that this isn't strictly logical given the way things are structured in our tax system etc but I just don't feel like we should be buying into the idea that the quality of healthcare you receive should be tied to your ability to pay. It's grotesque.
Further still, I worked for a US company for 4 years that provided top-tier private health cover for my family by default as part of my package. It was during this time that we had our first child and there were a few bumps in the road for us health-wise in the years that followed.
I had the opportunity to experience either using or not using my private health cover, and in most cases we were better off not using it. The only thing I ever got out of that stupid gash out of my salary was a few massages per year and free TV in the hospital room.
I find the entire concept diabolical to be honest. One in, all in. We all deserve the same standard of care when we need it. Anyone selling the idea of user-pays healthcare in this country should be given a stern talking to - it's not the way forward.
What we need to collectively do is lobby the federal government to take over financial responsibility for all healthcare not just Medicare and aged care. Hospitals are the states problem and it's a giant dumpster fire.
Be careful.what you wish for. The NHS is an example of a similar system to what you describe, and it is also a lumbering dumpster fire lurching to a demise
That's intentional government policy though, the solution is to just not have that policy. i. e. Not intentionally undermine the public healthcare sector, maybe even try to improve it.
"We've intentionally ruined it, and now it's bad, see it doesnt work."
Private health care in Aus is also a dumpster fire. Sure its more accessible if you have money, but they charge incorrectly, fail to follow through with documents/referrals, refuse care, are rude to patients, the same as the public system, minus the charging incorrectly.
The only reason I have it is due to being quite a sickly person in general and having many of my issues not covered by Medicare. As much as I hate the idea of private healthcare I also enjoy being alive and functional lmao! It’s so frustrating being forced to endorse a system when you can see the damage everywhere around you.
Same here, man. I would much rather my money goes to Medicare for a service I wholeheartedly believe in, than some garbage private company that goes out of their way to deny people medical care.
It's honestly shocking to me that the government disagrees with me and will punish me in multiple ways for doing so.
Yeah I am too. I hate that the government subsidises and effectively props up a private sector, when they could literally put the same amount of money directly into the public system that benefits everyone. There must be some serious corruption going on here.
But after landing a new job on $97k I had to bite the bullet. The tax system penalises you too hard for not having it.
I'm 39 and had to cop the LHC of 8% as well.
The fact that our Government incentivises PHI is a disgrace and allows the insurers to provide essentially junk for your premiums.
In a free market, I'm paying for your service/product because of the value it provides to me, there should be no interference from Government to drive uptake of your product.
The whole MLS PHI waiver should be scrapped, and the threshold for increased MLS should incrementally impact only the top most earners in the country. Atm they're trying to incentivise [half the country to take out PHI with the threshold sitting at $90k](https://www.salaryexplorer.com/average-salary-wage-comparison-australia-c13#disabled) which is a substantial amount of money to push into the insurers pockets.
I feel the same but still have private insurance (as a couple) more for my wife's health reasons.
I had an emergency op last year and was admitted into public A&E. The nurse gave us an option to charge it all to our private insurance - I believe this keeps more money in the public fund?
I actually like paying Medicare levy. I can afford it and those of us who can should contrubite. I don't mind private options existing in additional to public systems, but I don't like that you can get away with paying for the public system just because you add some private additions.
The ambulance will take rich and poor to the same public emergency room.
Same here. I grew up in the US and private insurance was the primary reason my parents had no economic mobility. we were always beholden to their employer and we were always fighting with our insurance to cover shit they were supposed to cover. I grew up always knowing that, because I was born with a (fairly common) health condition, I'd always need to make sure I prioritised getting good health insurance over anything else (studies, travel, different career paths, etc).
I'll never forgive private insurance for the needless suffering they inflicted on my family and continue to inflict on many others. I'll happily pay more for Medicare if it means I'm not contributed to such a vile industry.
When you see a cancer, you need to excise it quickly and take aggressive action to prevent its spread.
My thoughts exactly. It may get to a point where my partner and I can't afford not to have it, and that'll be the only (or at least, primary) reason we get it.
My thoughts exactly. It may get to a point where my partner and I can't afford not to have it, and that'll be the only (or at least, primary) reason we get it.
This and anything that I can't get done in time under public health, I will happily fly to Thailand and pay myself to do it if I need to, ie: Dental. That said, I do have insurance for Death and Disability through Super.
Medicare is strongest when we all pay into it. I'm happy to pay the levy because I am young and healthy and financially secure, but I have not always been and will not always be. A strong public health system helps everyone.
You avoid the surcharge though. When your surcharge gets to 6 or 7 thousand per year ON TOP of the $10k you’ve already given them in your levy, it seems stupid not to get it.
Whether you can “afford” it or not, most reasonable people would avoid wasting their own money when given the opportunity. $7k is a lot of money to waste on some bullshit surcharge no matter how much you earn, especially considering you already pay a massive levy by that point which probably way outweighs how much you cost Medicare
A private hospital will send you to a public hospital if things go wrong in surgery. Private health has fewer resources, is more expensive, and lets people pay their way to the front of the line when other people have worse conditions and should be prioritised.
Since surgeons work both; the more people who goto private hospitals, the more the surgeons are pulled away from the public hospitals. The longer everyone has to wait for the queue jumpers.
The Medicare levy partially goes to the future fund which funds the NDIS Atleast… The less money that goes to the insurance companies the weaker they become, it’s the only way to starve the beast.
crowd mysterious wakeful reminiscent full plucky cooing march divide fuel
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
With the Medicare safety net private can actually cost Medicare much more than public. This is certainly the case in my field of radiation therapy where a private patient probably costs Medicare 5 times or more than in public. The argument is that private is getting treatments closer to the patient without the government needing to build and operate the centre.
But radiotherapy is a bit unique because it's not covered by private health insurance because it's outpatient
🙋🏼♀️ I don’t go to the doctor / specialists enough to justify the monthly fee and out of pocket fees. I’m also pregnant and it made more sense for me to pay out of pocket for private fertility treatment than to get PI as there wasn’t much difference out of pocket. Im also not regimented enough to take advantage of PI though my health would probably be better off ie I am well overdue for the dentist and optometrist. Im also just not educated enough on the other benefits to be totally honest so I go without.
Public. I’ve had positive experiences having surgery in both the public and private systems but am opting to go public because quite frankly would rather put the money towards a longer period of mat leave than a private birth experience.
I had a brilliant birth in the public system - including staying for five nights (I didn't want to but there was an abundance of caution due to him being 2.4kg) and our own private room w a double bed. Those seemed to be the two things people waxed lyrical about in private.
My actual birth experience was exactly what I wanted and they followed my birth plan to a tee, can't recommend enough
I have replied elsewhere in this thread but my wife had two fairly difficult pregnancies, both with caesareans, one private and one public. The public one was much better and we saved 3000 + the cost of insurance itself.
Flat out reality is that private birth is only effective for births where nothing goes wrong.
If pretty much ANYTHING goes wrong, they're rushing you to the nearest public hospital who will actually deal with the problem.
Tbh, private insurance actually became useful after kids. They are added for free, so now there are 4 of us on the same policy, for the same money. After dentists, eye check-ups, OTs etc, we finally used most of the money. Before kids it wasn't worth it.
Agree. We’re also a family of four. 1 child wears glasses. They both obviously go to the dentist. Other child has needed two procedures, for some reason the GP put us on the public waitlist for one, it was an 18 month wait just to see the specialist. I got a new referral to a private specialist and we were seen in 3 weeks and had the procedure done not long after. It meant my child was out of their pain quicker and we freed up the space for someone else on the public waitlist.
I recently went to the dentist after far too long and was faced with the potential of a root canal. I thought, gee, that is a lot of cash but over the past 5 or 6 years of my wife and I not having to pay phi it is not a lot.
Not op, but yes for myself and several family members. Never more than a couple of weeks wait for surgery, top notch chemo and palliative care when mum was on her way out, one of my surgeries was next day even. Dads elective non urgent was the longest wait at 6 weeks.
Have you?
My brother has all the bowel cancer symptoms, he’s been marked as a category 1 (highest) via public system. He’s been waiting since early September for his colonoscopy and has another month wait to go…..
Let's say you have home and contents insurance. Your TV gets damaged. Aside the excess, the TV gets replaced.
The insurance company doesn't say, we only contribute 16% toward that TV, and you pay the rest. Oh, and by the way, you have to pay for the petrol and lunch of the delivery driver.
Yes. Which you agree to when you purchase the insurance. Which you can also reduce to zero, or almost zero.
Health insurance doesn't present you with a known figure when you sign up to it. Sometimes it is nothing, but more often you will only find out the gap figure when you go to make a claim.
I’m totally against private health insurance, and agree with your previous comments, but this comment just isn’t true. For extras, all health insurance documents I’ve looked at while doing my own research shows either the fixed amount the insurer will contribute to each service, or the percentage they will cover. Given that private providers can charge whatever they want, it’s up to you to find out what the fees are and work out if/what gap there may be. For hospital, there’s limits like every other insurance.
Anybody expecting to get more out their insurance than the premium they pay doesn’t understand insurance. For one, if this were the case the insurance industry would exist. Secondly, insurance isn’t about extinguishing risk, it’s about spreading the costs of those risks over time into a (mostly) predictable monthly or annual premium.
In saying all this, private health insurance is a total rort and the double helix relationship with Medicare is pathetic and I think we can all agree on that.
Weirdly enough, you can expect to come out ahead with health insurance depending on your circumstances. Most insurance (like car insurance) is risk rated, so for example young men pay more because their likelihood of crashing is statistically higher. But PHI is community rated - insurers have to charge the same price for the same policy to everyone (excluding a partial adjustment for age). This is why they never ask if you’re a smoker - they can’t change the price for risk factors like that. There’s plenty of cases where your risk outweighs the cost even at just a demographic level - older people, women in their early 30s...
Yes, and most of the cheapest options with dental don't really give much benefit.
I get 2 checkups/cleans a year, they cost $70 each and I have never had a single issue with my teeth (touch wood).
To get 2 free dental checkups with PHI, it'll cost more than $140.
Insurance for things like routine dental, glasses, physio, is factored into the cost. You're just paying for it indirectly, it's like a subscription service.
You'll very likely be worse off financially over the long term.
Because it offers you nothing and is basically a scam unless you have chronic health issues.
I know the Medicare care levy doesnt all go to the public system but I still rather support it.
I have chronic conditions and it’s still borderline useless and confusing af to navigate.
Had no diagnosis for endometriosis- too bad, period pain counts as pre-existing so surgery will be delayed.
Your coverage covers everything except the expensive stuff so you’re actually out of pocket $13,000, not including your monthly payments on top.
Treatment was far poorer than I’ve ever experienced in public.
Very hard for me to justify private health insurance.
My partner has endometriosis, and honestly her private health cover has been a blessing for us, and for the specialist/surgeon she has gotten, and hospital coverage for the many surgeries. Before that was public, and was a horrid experience trying to get anything done.
For myself though, I am glad I have stayed off private health
This is extras you're talking about though, nothing to do with the Medicare levy surcharge which you pay if you don’t have hospital cover. Two distinctly different things when it comes to tax.
Nothing was covered, i was out of pocket for dental and when i broke my thumb and had to see a hand surgeon. They basically stated because i chose to see them then it was on me to pay them. I cancelled on the spot.
Yep had it last year, came down with shingles really bad got in my had to see an opthamologist multiple times told can’t claim an outpatient visit what’s the point if it doesn’t cover seeing a private specialist.
I’m ideologically opposed to having to pay for private healthcare but I also have a chronic illness and without private health I would be on waiting lists 5-7 years long in most places. I attended a private ED the other night, paid $250 and was seen within 20 mins, given a bed and medicated within 45 mins. My friend is an ED nurse at the public tertiary hospital and said with my presentation, I would have been in the waiting room for hours and then likely in a corridor for a day or two.
Ideology and reality are sadly miles apart currently and the gap continues to grow.
I am so opposed to the scam of private health insurance. The fact junk policies exist enrage me, it’s literally a penalty imposed by the govt to knowingly line the pockets of private companies with ZERO return. However, the more I earned, I felt forced so am now the holder of said junk policy. A hypocrite, I know. I do write to my local MP often enough about this that he doesn’t respond anymore…
Edit: to continue my rant, the fact couples have a significant tax advantage is equally infuriating. Someone who earns say $150k and is single is worse off than someone who earns the same amount but happens to have a partner even if they don’t actually financially support them in any substantial way.
What tax advantage do couples have? Are you talking about how 2x $75k incomes are taxed less than 1x $150k, or is there some way I can use my partner to reduce my tax?
Well over that. Haven’t had it for 20 years once I figured out it was a con. Funnily enough I will never have it because the lifetime loading that is supposed to convince me to get it means I will never get it now. Screw paying an extra 40% premium for the next 10 years.
PLEASE get ambulance cover, even if you don’t want more comprehensive private cover. Too many people assume Medicare will cover emergency ambulance if they ever need it.
Policies vary by State, but in general only Qld and Tas residents have free ambulance for non-concession card holders. For everyone else it costs ~$1000 per trip (can be much more, sometimes less) - compared to just ~$50 per year for ambulance cover.
I loathe that parasitic industry. It’s a disgusting tax, get fined by the government for not buying a private service? WTF?
I’m losing money and it might get ‘wasted in government bureaucracy ’ but I’d rather 1c go to actual people’s needs via taxes than the private scum get my money for nothing on a junk policy I won’t use.
Here. Cause it's a complete rip unless I'm missing something? Pay 99999 per month for premium, then need glasses and they kindly chip in 100 bucks once a decade. Cool story. Rather save my 99999 and spend the 100. Pops had private health his entire life and swore by it - still died in the same palliative care system, still had to go to the public hospitals to get specialist care. I've got 2 kids, both were birthed in public hospitals and had very risky traumatic births leading to emergency ceasars, nicu for weeks the whole deal, haven't paid a cent, had a private room the entire time, wife and kids are healthy and happy years later.
Idk.. . Other than dental, or getting physio or massages, personally I just don't see the point or the value?
The value is in not having to pay the Medicare levy surcharge if you earn above a certain amount. That's why OP asked about people earning above 90k (or 180k for a couple, plus allowances for kids).
It’s purely the chance to skip the waiting list.
Eg , need a new knee or hip? 2-3 years on the public waiting list- a couple of weeks on private.
Want a vasectomy or your wife’s tubes tied? I was told I’d be in menopause before I’d reach the top of the public waiting list. Got them done the next week on the date i picked with private.
Kids need grommets in their ears? 2 years public or 2 months private.
It’s not right or ok, but that’s why we have it.
People seem to think that waiting lists are a line. They are not. They are triaged very regularly. If you are waiting 2 years for treatment then you are not as bad as someone else.
Be me, aged 43 and I Needed a hip replacement. Was going to take 5 years in the public system so I signed up for gold private cover, waited the year waiting period, had the surgery and then cancelled my cover after the surgeon gave me the all clear. Cost me $2800 all in.
I’ll need another hip surgery on my other one in a couple of years and I’ll do the same thing again.
It's still hit and miss. I have an appointment scheduled with a urologist at a private hospital, earliest I could get in with him when I got the referral in October is late January 2024.
That’s pretty understandable; non urgent health care professionals basically don’t work all of December and early January. It’s a pretty shitty time of the year to try and get surgery done.
I pay around $200 a fortnight to cover myself, my husband and our daughter. We've only received around $700 worth of benefits this year but it means we don't have to pay the Medicare Levy Surcharge which is around $4,600 for us so we're close to breaking even.
The other benefit is being seen fast for some elective surgeries. I've had a few surgeries in the private system and was able to be seen and operated on within a few months and it only cost me $500. At the time, the public system wait was over a year. On the other hand, I had my kid in the public system as the private out of pocket was ridiculous for obstetrics.
It can be very hit and miss and does depend on individual circumstances. Even a basic policy can save tax if you're earning over the thresholds.
So the dental part is why I got rid of my health insurance. Went for a minor surgery (<2k) told that I can only claim 10% because it's not the 'insurance prefered' dentist. No health insurance company tells me what specialist I can see!
We earn a tick under 180k as a couple so haven't needed to get private health. I don't think we will get it when our income does go over 180k. As others have said, the cost of private health is not worth the benefits received.
As a side note, why are the thresholds not rising with inflation? If I recall it was a 80k threshold in 2010 and now 90k in 2023. Seems it should be much higher if it followed inflation?
1. Private health insurance is becoming unsustainable. It used to offer some value, but as the years went on, the premiums kept going up, the value kept going down.
2. I am ideologically opposed to private health insurance, and the rebate system was only brought in by a conservative government to try and destroy Medicare.
3. When I had a serious accident and spent a week in the trauma ward, the only advantage I got from private health care was a toiletries bag and a voucher book for the cafe, which I couldn't use because I was fasting most of the time. I still had to share a room.
> You'd be better off saving your tax bill and donating to a health focused charity
Except PHI is priced to be JUST under what the MLS is anyway (how convenient), so the charity won't be seeing much...
Big reason for me is that when I've historically had PHI and something has gone wrong (had to have all wisdom teeth removed by a maxillofacial surgeon under general anaesthetic, as one example), the PHI level I could afford at the time meant the insurer paid significantly less than the premiums I'd been paying to that point, and I was still very out of pocket.
PHI are no better now than they were then, and now we have even more heavily inflated premiums for very little benefit. When I compare the cost vs benefit for what I'd actually *want* PHI for, I'm better off just saving that money myself and holding onto it for when I need, rather than lining the pockets of another corporation bent on making money as their highest priority.
Between the cost of premiums for what I would actually want covered from PHI, and the ridiculous lifetime loading because I haven't had it for a few years, I am at least 2-3k better off annually, even considering the MLS, than I would be otherwise.
Even considering the most basic hospital cover to not bother with the MLS, I'd still be paying the PHI more.... and I honestly don't think they deserve any of my income. Would much rather pay the MLS and help the public system.
280K+ HHI. Deeply ideologically opposed to private health insurance and the slow creep of American neoliberalism in our healthcare system.
My high school history teacher once asked, “how can you support a government that can’t support the health of its own people?”
And it’s stuck with me ever since. Will take the surcharge levy every time vs buy into a system designed to destroy our public healthcare.
A lot of comments regarding the support of free public healthcare system.
Beside the Emergency Departments, does the Australian free healthcare system still exist?
SW Qld all Drs have stopped bulk billing and the public wait times for my daughters minor procedure is 12-18 months.
Yes and after several years of my family going through it I’m a huge advocate. Dozen surgeries all less than a couple of weeks wait. Amazing chemo treatment and related surgery then in home palliative care for the old lady. Next day surgery for me when I needed it.
Data says Average wait time for elective surgery is only 40 days.
Urgent is way faster.
12-18 months would be a ridiculously out of the norm wait time unless it’s a deviated septum from cocaine use or a total hip replacement that’s non urgent… even then it’s like 150 day average. Look up the institute of health and welfare for data.
Bulk billing is another issue in that the government hasn’t raised the rate in a decade and the GPs aren’t getting enough to live on.
On $120k... never had private health insurance and don't intend on getting it.
Would rather pay the additional levy than contribute towards corpo's and their shareholders, especially for something we have for free that is world class.
Two reasons, I can’t justify the $5-700 a month and I refuse to participate in the increasingly US centric model of health care being all about profits.
I didn’t have health insurance until about 5 years ago and I am so thankful to have it now. I was diagnosed with an in-situ melanoma (not staged) and within 6 days it was removed. At the same time, I knew someone with stage 1 skin cancer who was put on a waitlist, they had to wait almost 2 months for treatment. For me, the mental torment of having to wait that long would have been debilitating. Everyone is different - I chose to pay for peace of mind.
I don't currently and at the rate we use services currently it's not worth it.
There's no way known that the extras present any value for my family currently.
I find myself better off allocating 5% of take home to healthcare costs and saving it if I don't use it.
Even if I did start earning $90K, I can’t justify paying health insurance.
I regularly keep up to date with my dentist appointments which cost me $200 every 6months.
My optometrist is bulk billed.
And I see my gastroenterologist once every year through the public system.
I don't have it because it was too confusing working out if it was cheaper or not. Plus, most funds that I compared that were cheaper than the amount I would pay in tax had pretty low rebates for a lot of things.
If I had gotten it when I was a healthy 20 year old as hospital only cover it probably would have made more sense.
Ideologically opposed and I went without it for many years but medical costs were rising and I'm getting older. Sorry for letting you lot down on this one
If you hold out for a long as you can then that still kept money out of Bupa's pocket, so thats worth it. If you're actually in need of private health treatment it makes more sense to have the insurance, versus the swaths of people pushed into PHI because of the MLS waiver who don't even need private health treatment.
Have the cheapest to avoid Medicare levy which costs more than holding crap private health that covers nothing. It’s a total rort but the difference is about $700 a year so despite hating it in design…I’m on the bandwagon. The thing is, even if you have good private health insurance and pay day $3500 a year for it….if ever you actually need to go to hospital, you then pay a heap out of pocket anyways. Whereas if you go via Medicare - there’s no gap/no cost. So that 3500 is basically almost just a ticket to further costs if you actually utilise it. Maybe when im older I might reconsider…im in my late 30s so I accept the risk for now.
An observation. Health expenditure can be very “lumpy” or concentrated.
I’ve had friends who were against it for the good reasons outlined in these posts but then found themselves with very high bills for elective surgery or even if they wanted a choice of surgeon.
One of them ended up going on private insurance and suffering for a whole year (waiting period) with a condition as the public list was just too long.
I don’t like the private health direction but the reality is that a one-off $20,000 hospital bill will wipe out any imaginary savings over a large portion of your lifetime from not going private. That plus now of course you’re penalised of household income is above the threshold so it makes no sense.
Why would I get public healthcare, when I'm fit and healthy and live in Australia which has one of the best public healthcare systems anywhere in the world.
I didn’t have health insurance..household income is $250k+.. had it for years and years and never used it.. one month went to the hospital 3 times for myself and kids.. I could have used it then bout would have had to pay the $500 excess or $0 if I went public.. decided then and there it was worthless.. back then it was $4500 a year and going up rapidly every year.. I would rather give my money to the government then insurance company executives and shareholders at the end of the day
$210k household, pay Medicare, I have been told private would be cheaper but last thing I want is Aus going the way of USA, we already gave up power, telco, roads, etc Private=profit
I never thought about it before now tbh. I have no idea what the difference between private and public(?) is. Costs? Benefits? No clue. Probably should look into it I guess.
My partner's low income brings our combined household under the threshhold. But similar to what others have expressed, I want to do my part to smother an American-style system in the cradle.
i have it but i hate it
i never use it, its completely useless, i have basic cover just to avoid thousnads in tax.
im idelogically opposed to it
but the government is also corrupt since that money wouldnt nec go into health anyway.
if they ever force people into gold plans to avoid the tax ill ditch it all togeather
Up until you're 40-50, take all the money you'd spend on healthcare and invest it. And get yourself some extra Insurances for TPD etc.
Then use that fund to fund the private health if you're showing signs of NEEDING VOLUNTARY procedures.
Into 7 figures, no private health looked into it once and to get decent coverage I’d have spent 90k so far on private, I’ve spent half that amount on braces (for the kids) and elective surgeries in the past 15 years, anything emergency the public system has done immediately including heart work on my son and removing a bad kidney in my wife.
For trips to emergency with myself or kids I’ll generally front the $300 for a private hospital because I can which reduces frivolous cases in the public ER, ER, X-Ray and a MRI cost me just under $1000 for a fractured rib still way in front though.
My wife has it because she’s got a series of medium level health issues (endometriosis, sleep conditions and a couple of other things) but I simply don’t get the benefit out of it.
I’m quite healthy, the only thing that gives me grief are my teeth, but I can still cover that out of pocket better than what Insurance can.
I had it back when I was earning 80k, had to have a biopsy on my eye, was told eye surgery would not be covered. Paid $4k out of pocket. Cancelled it the same day.
I'm way above that with no PHI.. despite my accountant reminding me every year! It's partly because I'm lazy and partly because many quotes I've seen end up being higher than the Medicare levy surcharge anyway. I should get it soon though....
As with all other commenters, our household income is $220k, we won't take out PHI because we don't believe in funding insurers over our public health system. I believe the PHI/MLS waiver should be removed.
Admirable that a lotta people want to support Medicare with the surcharge in place of private health care, but consider that if you or a family member unexpectedly require surgery/specialists/emergency help, you might be bumping less fortunate people from long public waiting lists (depending on urgency) or contributing to the current horrific waiting times in public hospitals by not accessing care that was available to you and not others.
That and if you’re a private patient in a public hospital then the hospital receives more for your admission, allowing them to fund other endeavours. No one expects to be ill or require care, but a lot of us don’t prepare at all for it, and we should.
Wish we could have better public funding, but we have a mixed public private system and it’s not going anywhere.
As a public health care worker, insurance was the way to go for me (below the surcharge limit) and even then I put it off for a while. Otherwise not much in the private system for me — don’t like it ideologically, prefer the culture and work ethic and care that was always provided to me in public system when I was younger, am healthy, and too lazy to access many services regardless
Bunch of underinsured folks in this thread thinking they’ve figured out how to game a corrupt system or some other ideological theory.
Private health insurance is worth every dollar. People don’t have issues grasping this with their cars and assets, but for whatever reason feel differently when it’s their own physical body/health.
When I last looked into it, the cheapest eligible health insurance policy cost more than the tax reduction I would receive for holding it.
So there isn't a net financial advantage to purchasing private health insurance.
Currently the cheapest junk plans seem to be $88/month after a rebate (male 30), from compare the market. The entry level surcharge at the entry level income of $93k is (0.01*93k) $930. Comparing these on a yearly basis the junk plan is $1056 compared to the surcharge tax of $930. Therefore one should not get PHI purely for financial reasons at the entry level income of $93k( no one should get PHI with income less than $93k or 186k couple for purely financial reasons). There are additional incentives once you get to 31 and every year after that but they are less important So what income should you get PHI at, purely for financial reasons? By my maths using lowest level PHI It should be (1056/0.01) roughly $106k for singles. So there is a section of the community 93k-106k that even though they get stung with the tax they are better off, purely financially. Obviously even those 'junk' policies have some material value, perhaps you get first choice of doctors or something, or the option to prioritise surgery.
But people that are prioritising financials that much (and buying a bottom tier coverage) will then be stung with huge out of pocket private fees, or go public anyway. I guess getting PHI to minimise costs and going public anyway it's what they would do. I'd rather just pay the MLS if it wasn't a *considerable* saving.
Yeah the crazy thing is that in a lot of cases simply presenting your phi card during a medical visit will cost you more due to copays, deductibles etc. It's a broken system only kept alive due to tax and other incentives. The fundamental issue is that insurance companies cannot legally charge a 60yo more than a 30yo. Even though a 30yo costs them less. That's why they have all these work around incentives with the government to try and make it work.
The age based loading is not less important. Add 40% to the junk policy price if you’re 40 or older. My last reading of it a while ago you had to be on something like $150k to be ahead.
I’m right in that $105-115k bracket and pay pretty much 90/m on PHI (32M). Works out a tiny bit cheaper to have PHI then to not. The kicker is 1 or two dental visits, physio sessions, therapy/counselling, etc. I save easy $500/year on those things with the cheapest plan Bupa offers. I’m about $700+ better off each year. I’m 100% for public health system but money is money and the public health system fails so hard at elective surgery so the hospital cover is so so worth it.
Extras cover is a separate issue. I agree that I end up saving money because of my extras cover, but that’s irrelevant to the Medicare levy surcharge.
Extras is a payment plan. Very few people benefit more than they put in over a sustained period.
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It's like I'm looking in the mirror 😂
I was the same until I bit the bullet at 33, and am now paying 6% extra for the rest of my life
The 6% extra will be removed after 10 years of coverage
I bought it on the last day of the financial year hoping it wasn't pro rata. It was.
Are you me? 😆
Whats the cost of the levy? When you shop around for insurance, think of the price as (annual cost-levy=actual out of pocket cost) Its not so terrible then.
I'm deeply ideologically opposed to private insurance. I'll probably bite the bullet eventually but I hate that it exists at all.
Same. Idealogical reasons. Public free healthcare is a must have for our nation and the strong encouragement for everyone to go private will only turn us into America and their horrific system over time. I'd rather pay additional taxes to the public system.
As an American that escaped,I can't agree with you more. Every time I see a move in that direction I shudder. It's a sad state of affairs over there. (I think I've been asked to donate to a dozen go fund me's for healthcare.... this year. No idea how many in my life time.)
If one doesn't realise Australia is just the USA 20 years behind, one is on drugs. Capatilism working as intended. Nothing to see here....
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I’m well aware it’s general revenue. I just see every dollar private health gets is another dollar in their war chest to lobby governments and weaken Medicare.
Yeah did know that.... Still prefer to pay more in tax generally on this one.
Doesn't exist. Even GP visits are 80 bucks now unless you can find a needle in a haystack
The push to get everyone onto private involved defunding the public free services so everyone would start feeling like they had no choice. It's planned. Shouldn't be this way. Hard to unwind 10+ years of actively trying to make the public service look shit so people go private.
100% mate. I'm a biomedical engineer and the budget constraints in the public system are a joke considering the amount of tax we pay plus the Medicare levy. That's why I don't pay it, but I agree with you it's all set up to be this way. Guess they'd rather fund more overseas wars
Private health insurance doesn't cover you for the GP.
I think Australia is quite gifted. Look at the disaster in USA.
If there is no private option it’ll turn you into Canada and err… it’s not going well there.
Same boat, and it's actually so nice to see others that think a bit further than our own families. I rarely need to go to the doctor so I'd much rather see my money go to the commons to help others than some insurer's pocket.
I’m with you. If we all withdrew our cash from private health insurance and funded the public system we’d see a far better more equitable service that which would challenged the private system in to irrelevance and ultimately oblivion .. Instead people pay thousands to a private company to act as a conduit between you and healthcare, it’s illogical.
Same here. Household income is about 200K p/a. I believe that every individual and family that enters into private health cover weakens the public health system as a whole, and that's the absolute opposite of what we should be doing. I know that this isn't strictly logical given the way things are structured in our tax system etc but I just don't feel like we should be buying into the idea that the quality of healthcare you receive should be tied to your ability to pay. It's grotesque. Further still, I worked for a US company for 4 years that provided top-tier private health cover for my family by default as part of my package. It was during this time that we had our first child and there were a few bumps in the road for us health-wise in the years that followed. I had the opportunity to experience either using or not using my private health cover, and in most cases we were better off not using it. The only thing I ever got out of that stupid gash out of my salary was a few massages per year and free TV in the hospital room. I find the entire concept diabolical to be honest. One in, all in. We all deserve the same standard of care when we need it. Anyone selling the idea of user-pays healthcare in this country should be given a stern talking to - it's not the way forward.
What we need to collectively do is lobby the federal government to take over financial responsibility for all healthcare not just Medicare and aged care. Hospitals are the states problem and it's a giant dumpster fire.
Yeah after Robodebt and spiralling NDIS costs, we definitely want the federal government to take over hospitals. /s
Be careful.what you wish for. The NHS is an example of a similar system to what you describe, and it is also a lumbering dumpster fire lurching to a demise
That's intentional government policy though, the solution is to just not have that policy. i. e. Not intentionally undermine the public healthcare sector, maybe even try to improve it. "We've intentionally ruined it, and now it's bad, see it doesnt work." Private health care in Aus is also a dumpster fire. Sure its more accessible if you have money, but they charge incorrectly, fail to follow through with documents/referrals, refuse care, are rude to patients, the same as the public system, minus the charging incorrectly.
It's the governments ABC policy.....health edition.
Just a stern talking to? There’s a perfectly good stockade in Ballarat that hasn’t been used for a good 150 years for this kind of behaviour!
The only reason I have it is due to being quite a sickly person in general and having many of my issues not covered by Medicare. As much as I hate the idea of private healthcare I also enjoy being alive and functional lmao! It’s so frustrating being forced to endorse a system when you can see the damage everywhere around you.
What is your Medicare surcharge with that salary? I'm new to Australia and was told to take out private healthcare to avoid additional Medicare tax.
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same here. I'd rather not support multinationals that profit off the suffering and lack of care for our loved ones
Same, but I will stick with that ideology. I’d rather my money went back into the system. Private health cover is shit.
Same here, man. I would much rather my money goes to Medicare for a service I wholeheartedly believe in, than some garbage private company that goes out of their way to deny people medical care. It's honestly shocking to me that the government disagrees with me and will punish me in multiple ways for doing so.
Yup, I want to support what is a very valuable public resource. I’d rather be out of pocket than prop up some junk corporate insurance
Yeah I am too. I hate that the government subsidises and effectively props up a private sector, when they could literally put the same amount of money directly into the public system that benefits everyone. There must be some serious corruption going on here. But after landing a new job on $97k I had to bite the bullet. The tax system penalises you too hard for not having it. I'm 39 and had to cop the LHC of 8% as well.
The fact that our Government incentivises PHI is a disgrace and allows the insurers to provide essentially junk for your premiums. In a free market, I'm paying for your service/product because of the value it provides to me, there should be no interference from Government to drive uptake of your product. The whole MLS PHI waiver should be scrapped, and the threshold for increased MLS should incrementally impact only the top most earners in the country. Atm they're trying to incentivise [half the country to take out PHI with the threshold sitting at $90k](https://www.salaryexplorer.com/average-salary-wage-comparison-australia-c13#disabled) which is a substantial amount of money to push into the insurers pockets.
This for me to. I’m on $135k… I hate privatisation of services I believe should be available to all. I work in government schools for a reason.
I feel the same but still have private insurance (as a couple) more for my wife's health reasons. I had an emergency op last year and was admitted into public A&E. The nurse gave us an option to charge it all to our private insurance - I believe this keeps more money in the public fund?
Same here. I have seen the US, I don’t want us to be like the US. Save our Medicare
I actually like paying Medicare levy. I can afford it and those of us who can should contrubite. I don't mind private options existing in additional to public systems, but I don't like that you can get away with paying for the public system just because you add some private additions. The ambulance will take rich and poor to the same public emergency room.
Same here. I grew up in the US and private insurance was the primary reason my parents had no economic mobility. we were always beholden to their employer and we were always fighting with our insurance to cover shit they were supposed to cover. I grew up always knowing that, because I was born with a (fairly common) health condition, I'd always need to make sure I prioritised getting good health insurance over anything else (studies, travel, different career paths, etc). I'll never forgive private insurance for the needless suffering they inflicted on my family and continue to inflict on many others. I'll happily pay more for Medicare if it means I'm not contributed to such a vile industry. When you see a cancer, you need to excise it quickly and take aggressive action to prevent its spread.
My thoughts exactly. It may get to a point where my partner and I can't afford not to have it, and that'll be the only (or at least, primary) reason we get it.
Same. Hate that it exists Probably won't bite the bullet any time soon
My thoughts exactly. It may get to a point where my partner and I can't afford not to have it, and that'll be the only (or at least, primary) reason we get it.
Same friend. Happy to pay extra into the public pot.
This and anything that I can't get done in time under public health, I will happily fly to Thailand and pay myself to do it if I need to, ie: Dental. That said, I do have insurance for Death and Disability through Super.
Medicare is strongest when we all pay into it. I'm happy to pay the levy because I am young and healthy and financially secure, but I have not always been and will not always be. A strong public health system helps everyone.
You don’t stop paying into it when you get private health insurance, everybody pays in to it, it’s just the private health insurance is additional.
I think everyone pays the levy, but the surcharge is forgiven/not payable when you have eligible hospital cover xx
You avoid the surcharge though. When your surcharge gets to 6 or 7 thousand per year ON TOP of the $10k you’ve already given them in your levy, it seems stupid not to get it.
Some can afford not to support a corrupt system.
Whether you can “afford” it or not, most reasonable people would avoid wasting their own money when given the opportunity. $7k is a lot of money to waste on some bullshit surcharge no matter how much you earn, especially considering you already pay a massive levy by that point which probably way outweighs how much you cost Medicare
What? The maximum Medicare Levy Surcharge is 1.5%. For a Single person to pay $7k in MLS, they would have to be earning $467k per year....
In which case, I would still pay $7k.
Have you done a comparison between levy vs hospital cover? Hospital cover generally wins in the amount you pay per annum.
Ever so slightly
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A private hospital will send you to a public hospital if things go wrong in surgery. Private health has fewer resources, is more expensive, and lets people pay their way to the front of the line when other people have worse conditions and should be prioritised.
Since surgeons work both; the more people who goto private hospitals, the more the surgeons are pulled away from the public hospitals. The longer everyone has to wait for the queue jumpers. The Medicare levy partially goes to the future fund which funds the NDIS Atleast… The less money that goes to the insurance companies the weaker they become, it’s the only way to starve the beast.
crowd mysterious wakeful reminiscent full plucky cooing march divide fuel *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
With the Medicare safety net private can actually cost Medicare much more than public. This is certainly the case in my field of radiation therapy where a private patient probably costs Medicare 5 times or more than in public. The argument is that private is getting treatments closer to the patient without the government needing to build and operate the centre. But radiotherapy is a bit unique because it's not covered by private health insurance because it's outpatient
🙋🏼♀️ I don’t go to the doctor / specialists enough to justify the monthly fee and out of pocket fees. I’m also pregnant and it made more sense for me to pay out of pocket for private fertility treatment than to get PI as there wasn’t much difference out of pocket. Im also not regimented enough to take advantage of PI though my health would probably be better off ie I am well overdue for the dentist and optometrist. Im also just not educated enough on the other benefits to be totally honest so I go without.
Are you going public for your birth as well? Or paying for private?
Public. I’ve had positive experiences having surgery in both the public and private systems but am opting to go public because quite frankly would rather put the money towards a longer period of mat leave than a private birth experience.
I had a brilliant birth in the public system - including staying for five nights (I didn't want to but there was an abundance of caution due to him being 2.4kg) and our own private room w a double bed. Those seemed to be the two things people waxed lyrical about in private. My actual birth experience was exactly what I wanted and they followed my birth plan to a tee, can't recommend enough
I have replied elsewhere in this thread but my wife had two fairly difficult pregnancies, both with caesareans, one private and one public. The public one was much better and we saved 3000 + the cost of insurance itself.
Flat out reality is that private birth is only effective for births where nothing goes wrong. If pretty much ANYTHING goes wrong, they're rushing you to the nearest public hospital who will actually deal with the problem.
This isn’t correct. Plenty of private hospitals have emergency rooms and care for new borns.
Outright misinformation
Same here (and also five nights), couldn’t praise the staff and hospital highly enough.
Tbh, private insurance actually became useful after kids. They are added for free, so now there are 4 of us on the same policy, for the same money. After dentists, eye check-ups, OTs etc, we finally used most of the money. Before kids it wasn't worth it.
Agree. We’re also a family of four. 1 child wears glasses. They both obviously go to the dentist. Other child has needed two procedures, for some reason the GP put us on the public waitlist for one, it was an 18 month wait just to see the specialist. I got a new referral to a private specialist and we were seen in 3 weeks and had the procedure done not long after. It meant my child was out of their pain quicker and we freed up the space for someone else on the public waitlist.
I recently went to the dentist after far too long and was faced with the potential of a root canal. I thought, gee, that is a lot of cash but over the past 5 or 6 years of my wife and I not having to pay phi it is not a lot.
we deliberately don't buy insurance and pay the surcharge. I am a huge fan of the public system and the teaching hospitals in particular.
Have you had to use a public hospital in the last 5 years for any serious illness?
Not op, but yes for myself and several family members. Never more than a couple of weeks wait for surgery, top notch chemo and palliative care when mum was on her way out, one of my surgeries was next day even. Dads elective non urgent was the longest wait at 6 weeks. Have you?
My brother has all the bowel cancer symptoms, he’s been marked as a category 1 (highest) via public system. He’s been waiting since early September for his colonoscopy and has another month wait to go…..
OH my. I hope he's okay. That's scary and just shouldn't happen. All the best to him and family.
Me too!! :/ We both signed up for PHI during this time :/ i see it as insurance for no wait times.
I don't see the value. When I looked into it, it'll cost me more out of pocket for something with negligible benefits.
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Let's say you have home and contents insurance. Your TV gets damaged. Aside the excess, the TV gets replaced. The insurance company doesn't say, we only contribute 16% toward that TV, and you pay the rest. Oh, and by the way, you have to pay for the petrol and lunch of the delivery driver.
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Yes. Which you agree to when you purchase the insurance. Which you can also reduce to zero, or almost zero. Health insurance doesn't present you with a known figure when you sign up to it. Sometimes it is nothing, but more often you will only find out the gap figure when you go to make a claim.
I’m totally against private health insurance, and agree with your previous comments, but this comment just isn’t true. For extras, all health insurance documents I’ve looked at while doing my own research shows either the fixed amount the insurer will contribute to each service, or the percentage they will cover. Given that private providers can charge whatever they want, it’s up to you to find out what the fees are and work out if/what gap there may be. For hospital, there’s limits like every other insurance. Anybody expecting to get more out their insurance than the premium they pay doesn’t understand insurance. For one, if this were the case the insurance industry would exist. Secondly, insurance isn’t about extinguishing risk, it’s about spreading the costs of those risks over time into a (mostly) predictable monthly or annual premium. In saying all this, private health insurance is a total rort and the double helix relationship with Medicare is pathetic and I think we can all agree on that.
Weirdly enough, you can expect to come out ahead with health insurance depending on your circumstances. Most insurance (like car insurance) is risk rated, so for example young men pay more because their likelihood of crashing is statistically higher. But PHI is community rated - insurers have to charge the same price for the same policy to everyone (excluding a partial adjustment for age). This is why they never ask if you’re a smoker - they can’t change the price for risk factors like that. There’s plenty of cases where your risk outweighs the cost even at just a demographic level - older people, women in their early 30s...
Go to the dentist more bro.
Yes, and most of the cheapest options with dental don't really give much benefit. I get 2 checkups/cleans a year, they cost $70 each and I have never had a single issue with my teeth (touch wood). To get 2 free dental checkups with PHI, it'll cost more than $140.
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Dentistry (i.e. extras) not relevant for Medicare surcharge
Insurance for things like routine dental, glasses, physio, is factored into the cost. You're just paying for it indirectly, it's like a subscription service. You'll very likely be worse off financially over the long term.
Because it offers you nothing and is basically a scam unless you have chronic health issues. I know the Medicare care levy doesnt all go to the public system but I still rather support it.
I have chronic conditions and it’s still borderline useless and confusing af to navigate. Had no diagnosis for endometriosis- too bad, period pain counts as pre-existing so surgery will be delayed. Your coverage covers everything except the expensive stuff so you’re actually out of pocket $13,000, not including your monthly payments on top. Treatment was far poorer than I’ve ever experienced in public. Very hard for me to justify private health insurance.
My partner has endometriosis, and honestly her private health cover has been a blessing for us, and for the specialist/surgeon she has gotten, and hospital coverage for the many surgeries. Before that was public, and was a horrid experience trying to get anything done. For myself though, I am glad I have stayed off private health
The thing about health issues is you don’t know when they will appear.
You don’t play sports and get regular physio massage? You don’t have teeth? It’s very much worth it as a healthy and physically active bloke imo.
This is extras you're talking about though, nothing to do with the Medicare levy surcharge which you pay if you don’t have hospital cover. Two distinctly different things when it comes to tax.
Nothing was covered, i was out of pocket for dental and when i broke my thumb and had to see a hand surgeon. They basically stated because i chose to see them then it was on me to pay them. I cancelled on the spot.
Yep had it last year, came down with shingles really bad got in my had to see an opthamologist multiple times told can’t claim an outpatient visit what’s the point if it doesn’t cover seeing a private specialist.
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There isn’t much saving until you get to ~$180k salary or so. You can be straight up worse off at the bottom end.
I’m ideologically opposed to having to pay for private healthcare but I also have a chronic illness and without private health I would be on waiting lists 5-7 years long in most places. I attended a private ED the other night, paid $250 and was seen within 20 mins, given a bed and medicated within 45 mins. My friend is an ED nurse at the public tertiary hospital and said with my presentation, I would have been in the waiting room for hours and then likely in a corridor for a day or two. Ideology and reality are sadly miles apart currently and the gap continues to grow.
I am so opposed to the scam of private health insurance. The fact junk policies exist enrage me, it’s literally a penalty imposed by the govt to knowingly line the pockets of private companies with ZERO return. However, the more I earned, I felt forced so am now the holder of said junk policy. A hypocrite, I know. I do write to my local MP often enough about this that he doesn’t respond anymore… Edit: to continue my rant, the fact couples have a significant tax advantage is equally infuriating. Someone who earns say $150k and is single is worse off than someone who earns the same amount but happens to have a partner even if they don’t actually financially support them in any substantial way.
What tax advantage do couples have? Are you talking about how 2x $75k incomes are taxed less than 1x $150k, or is there some way I can use my partner to reduce my tax?
Levy surcharge for singles starts after 90k. Levy surcharge for couples starts after 180k
Well over that. Haven’t had it for 20 years once I figured out it was a con. Funnily enough I will never have it because the lifetime loading that is supposed to convince me to get it means I will never get it now. Screw paying an extra 40% premium for the next 10 years.
PLEASE get ambulance cover, even if you don’t want more comprehensive private cover. Too many people assume Medicare will cover emergency ambulance if they ever need it. Policies vary by State, but in general only Qld and Tas residents have free ambulance for non-concession card holders. For everyone else it costs ~$1000 per trip (can be much more, sometimes less) - compared to just ~$50 per year for ambulance cover.
I don't believe in private, so yeah here.
I loathe that parasitic industry. It’s a disgusting tax, get fined by the government for not buying a private service? WTF? I’m losing money and it might get ‘wasted in government bureaucracy ’ but I’d rather 1c go to actual people’s needs via taxes than the private scum get my money for nothing on a junk policy I won’t use.
Remember it’s 180k in a couple
https://www.doineedhealthinsurance.com.au/
Here. Cause it's a complete rip unless I'm missing something? Pay 99999 per month for premium, then need glasses and they kindly chip in 100 bucks once a decade. Cool story. Rather save my 99999 and spend the 100. Pops had private health his entire life and swore by it - still died in the same palliative care system, still had to go to the public hospitals to get specialist care. I've got 2 kids, both were birthed in public hospitals and had very risky traumatic births leading to emergency ceasars, nicu for weeks the whole deal, haven't paid a cent, had a private room the entire time, wife and kids are healthy and happy years later. Idk.. . Other than dental, or getting physio or massages, personally I just don't see the point or the value?
The value is in not having to pay the Medicare levy surcharge if you earn above a certain amount. That's why OP asked about people earning above 90k (or 180k for a couple, plus allowances for kids).
It’s purely the chance to skip the waiting list. Eg , need a new knee or hip? 2-3 years on the public waiting list- a couple of weeks on private. Want a vasectomy or your wife’s tubes tied? I was told I’d be in menopause before I’d reach the top of the public waiting list. Got them done the next week on the date i picked with private. Kids need grommets in their ears? 2 years public or 2 months private. It’s not right or ok, but that’s why we have it.
Vasectomies are around $400 and can usually get them within a month (it's not exactly an urgent medical problem anyway)
Mine was entirely bulk billed to Medicare. $0, done within 1 week.
People seem to think that waiting lists are a line. They are not. They are triaged very regularly. If you are waiting 2 years for treatment then you are not as bad as someone else.
Be me, aged 43 and I Needed a hip replacement. Was going to take 5 years in the public system so I signed up for gold private cover, waited the year waiting period, had the surgery and then cancelled my cover after the surgeon gave me the all clear. Cost me $2800 all in. I’ll need another hip surgery on my other one in a couple of years and I’ll do the same thing again.
On top of that, most hospitals wouldn't bother seeing you as private patient unless you have a PHI
It's still hit and miss. I have an appointment scheduled with a urologist at a private hospital, earliest I could get in with him when I got the referral in October is late January 2024.
That’s pretty understandable; non urgent health care professionals basically don’t work all of December and early January. It’s a pretty shitty time of the year to try and get surgery done.
I pay around $200 a fortnight to cover myself, my husband and our daughter. We've only received around $700 worth of benefits this year but it means we don't have to pay the Medicare Levy Surcharge which is around $4,600 for us so we're close to breaking even. The other benefit is being seen fast for some elective surgeries. I've had a few surgeries in the private system and was able to be seen and operated on within a few months and it only cost me $500. At the time, the public system wait was over a year. On the other hand, I had my kid in the public system as the private out of pocket was ridiculous for obstetrics. It can be very hit and miss and does depend on individual circumstances. Even a basic policy can save tax if you're earning over the thresholds.
So the dental part is why I got rid of my health insurance. Went for a minor surgery (<2k) told that I can only claim 10% because it's not the 'insurance prefered' dentist. No health insurance company tells me what specialist I can see!
Because the limit is $93k
And 186k between you & your partner combined. E.g you can earn 150k and they earn 20k and not be stung.
We earn a tick under 180k as a couple so haven't needed to get private health. I don't think we will get it when our income does go over 180k. As others have said, the cost of private health is not worth the benefits received. As a side note, why are the thresholds not rising with inflation? If I recall it was a 80k threshold in 2010 and now 90k in 2023. Seems it should be much higher if it followed inflation?
I'd only get it if the math works out cheaper than Medicare levy surcharge
1. Private health insurance is becoming unsustainable. It used to offer some value, but as the years went on, the premiums kept going up, the value kept going down. 2. I am ideologically opposed to private health insurance, and the rebate system was only brought in by a conservative government to try and destroy Medicare. 3. When I had a serious accident and spent a week in the trauma ward, the only advantage I got from private health care was a toiletries bag and a voucher book for the cafe, which I couldn't use because I was fasting most of the time. I still had to share a room.
I'm a socialist and I'd rather pay more to help fund Medicare than give my money to an insurance company.
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> You'd be better off saving your tax bill and donating to a health focused charity Except PHI is priced to be JUST under what the MLS is anyway (how convenient), so the charity won't be seeing much...
Big reason for me is that when I've historically had PHI and something has gone wrong (had to have all wisdom teeth removed by a maxillofacial surgeon under general anaesthetic, as one example), the PHI level I could afford at the time meant the insurer paid significantly less than the premiums I'd been paying to that point, and I was still very out of pocket. PHI are no better now than they were then, and now we have even more heavily inflated premiums for very little benefit. When I compare the cost vs benefit for what I'd actually *want* PHI for, I'm better off just saving that money myself and holding onto it for when I need, rather than lining the pockets of another corporation bent on making money as their highest priority. Between the cost of premiums for what I would actually want covered from PHI, and the ridiculous lifetime loading because I haven't had it for a few years, I am at least 2-3k better off annually, even considering the MLS, than I would be otherwise. Even considering the most basic hospital cover to not bother with the MLS, I'd still be paying the PHI more.... and I honestly don't think they deserve any of my income. Would much rather pay the MLS and help the public system.
280K+ HHI. Deeply ideologically opposed to private health insurance and the slow creep of American neoliberalism in our healthcare system. My high school history teacher once asked, “how can you support a government that can’t support the health of its own people?” And it’s stuck with me ever since. Will take the surcharge levy every time vs buy into a system designed to destroy our public healthcare.
90k pff sorry but you need 250k+ to even speak here
A lot of comments regarding the support of free public healthcare system. Beside the Emergency Departments, does the Australian free healthcare system still exist? SW Qld all Drs have stopped bulk billing and the public wait times for my daughters minor procedure is 12-18 months.
Yes and after several years of my family going through it I’m a huge advocate. Dozen surgeries all less than a couple of weeks wait. Amazing chemo treatment and related surgery then in home palliative care for the old lady. Next day surgery for me when I needed it. Data says Average wait time for elective surgery is only 40 days. Urgent is way faster. 12-18 months would be a ridiculously out of the norm wait time unless it’s a deviated septum from cocaine use or a total hip replacement that’s non urgent… even then it’s like 150 day average. Look up the institute of health and welfare for data. Bulk billing is another issue in that the government hasn’t raised the rate in a decade and the GPs aren’t getting enough to live on.
I refuse to give oxygen to that rapacious bloodthirsty industry. Just look at the US to see where that road leads.
if you dont do dumb stuff and look after yourself you wont need it well at least that was my thinking until 26 when my check knee light turned on
Ahh cause it’s a scam.
Had it, didn't get the value out of it, instead put that money aside in an emergency fund.
And then paid it back to the government at tax time?
It worked out cheaper for me to pay the medicare surcharge.
I got it as soon as it became cheaper than the surcharge.
On $120k... never had private health insurance and don't intend on getting it. Would rather pay the additional levy than contribute towards corpo's and their shareholders, especially for something we have for free that is world class.
Two reasons, I can’t justify the $5-700 a month and I refuse to participate in the increasingly US centric model of health care being all about profits.
I would prefer my money go to the government than a private health insurer. That’s how much I hate private health insurance.
I didn’t have health insurance until about 5 years ago and I am so thankful to have it now. I was diagnosed with an in-situ melanoma (not staged) and within 6 days it was removed. At the same time, I knew someone with stage 1 skin cancer who was put on a waitlist, they had to wait almost 2 months for treatment. For me, the mental torment of having to wait that long would have been debilitating. Everyone is different - I chose to pay for peace of mind.
I don't currently and at the rate we use services currently it's not worth it. There's no way known that the extras present any value for my family currently. I find myself better off allocating 5% of take home to healthcare costs and saving it if I don't use it.
Even if I did start earning $90K, I can’t justify paying health insurance. I regularly keep up to date with my dentist appointments which cost me $200 every 6months. My optometrist is bulk billed. And I see my gastroenterologist once every year through the public system.
I don't have it because it was too confusing working out if it was cheaper or not. Plus, most funds that I compared that were cheaper than the amount I would pay in tax had pretty low rebates for a lot of things. If I had gotten it when I was a healthy 20 year old as hospital only cover it probably would have made more sense.
Ideologically opposed and I went without it for many years but medical costs were rising and I'm getting older. Sorry for letting you lot down on this one
If you hold out for a long as you can then that still kept money out of Bupa's pocket, so thats worth it. If you're actually in need of private health treatment it makes more sense to have the insurance, versus the swaths of people pushed into PHI because of the MLS waiver who don't even need private health treatment.
Have the cheapest to avoid Medicare levy which costs more than holding crap private health that covers nothing. It’s a total rort but the difference is about $700 a year so despite hating it in design…I’m on the bandwagon. The thing is, even if you have good private health insurance and pay day $3500 a year for it….if ever you actually need to go to hospital, you then pay a heap out of pocket anyways. Whereas if you go via Medicare - there’s no gap/no cost. So that 3500 is basically almost just a ticket to further costs if you actually utilise it. Maybe when im older I might reconsider…im in my late 30s so I accept the risk for now.
An observation. Health expenditure can be very “lumpy” or concentrated. I’ve had friends who were against it for the good reasons outlined in these posts but then found themselves with very high bills for elective surgery or even if they wanted a choice of surgeon. One of them ended up going on private insurance and suffering for a whole year (waiting period) with a condition as the public list was just too long. I don’t like the private health direction but the reality is that a one-off $20,000 hospital bill will wipe out any imaginary savings over a large portion of your lifetime from not going private. That plus now of course you’re penalised of household income is above the threshold so it makes no sense.
We don’t, to expensive. 6500 per year is a rip off. MLS is cheaper.
Cheaper to pay levy
Why would I get public healthcare, when I'm fit and healthy and live in Australia which has one of the best public healthcare systems anywhere in the world.
I support a free and public health care.
Yes, private health hurts society.
I didn’t have health insurance..household income is $250k+.. had it for years and years and never used it.. one month went to the hospital 3 times for myself and kids.. I could have used it then bout would have had to pay the $500 excess or $0 if I went public.. decided then and there it was worthless.. back then it was $4500 a year and going up rapidly every year.. I would rather give my money to the government then insurance company executives and shareholders at the end of the day
$210k household, pay Medicare, I have been told private would be cheaper but last thing I want is Aus going the way of USA, we already gave up power, telco, roads, etc Private=profit
Absolutely no justification in paying the premiums for the service provided.
I could be earning a million and I wouldn't have it. It shouldn't exist in Australia.
I am stupid
What’s private health insurance?
Yes earning 95k without health insurance. Why? I don't have children.
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I never thought about it before now tbh. I have no idea what the difference between private and public(?) is. Costs? Benefits? No clue. Probably should look into it I guess.
This is why this discussion is here
My partner's low income brings our combined household under the threshhold. But similar to what others have expressed, I want to do my part to smother an American-style system in the cradle.
i have it but i hate it i never use it, its completely useless, i have basic cover just to avoid thousnads in tax. im idelogically opposed to it but the government is also corrupt since that money wouldnt nec go into health anyway. if they ever force people into gold plans to avoid the tax ill ditch it all togeather
Up until you're 40-50, take all the money you'd spend on healthcare and invest it. And get yourself some extra Insurances for TPD etc. Then use that fund to fund the private health if you're showing signs of NEEDING VOLUNTARY procedures.
Into 7 figures, no private health looked into it once and to get decent coverage I’d have spent 90k so far on private, I’ve spent half that amount on braces (for the kids) and elective surgeries in the past 15 years, anything emergency the public system has done immediately including heart work on my son and removing a bad kidney in my wife. For trips to emergency with myself or kids I’ll generally front the $300 for a private hospital because I can which reduces frivolous cases in the public ER, ER, X-Ray and a MRI cost me just under $1000 for a fractured rib still way in front though.
My wife has it because she’s got a series of medium level health issues (endometriosis, sleep conditions and a couple of other things) but I simply don’t get the benefit out of it. I’m quite healthy, the only thing that gives me grief are my teeth, but I can still cover that out of pocket better than what Insurance can.
I had it back when I was earning 80k, had to have a biopsy on my eye, was told eye surgery would not be covered. Paid $4k out of pocket. Cancelled it the same day.
I'm way above that with no PHI.. despite my accountant reminding me every year! It's partly because I'm lazy and partly because many quotes I've seen end up being higher than the Medicare levy surcharge anyway. I should get it soon though....
As with all other commenters, our household income is $220k, we won't take out PHI because we don't believe in funding insurers over our public health system. I believe the PHI/MLS waiver should be removed.
Me. I just can’t justify it.
My reasoning is simple, public healthcare is almost as good.
I don't need or want to sign up to another *thing* and pay money (knowing I'll get it back and more). I'd rather just... not.
Just to play devil’s advocate, you should be asking reasons for and against otherwise you’re simply seeking validation for your own reason/agenda.
Admirable that a lotta people want to support Medicare with the surcharge in place of private health care, but consider that if you or a family member unexpectedly require surgery/specialists/emergency help, you might be bumping less fortunate people from long public waiting lists (depending on urgency) or contributing to the current horrific waiting times in public hospitals by not accessing care that was available to you and not others. That and if you’re a private patient in a public hospital then the hospital receives more for your admission, allowing them to fund other endeavours. No one expects to be ill or require care, but a lot of us don’t prepare at all for it, and we should. Wish we could have better public funding, but we have a mixed public private system and it’s not going anywhere. As a public health care worker, insurance was the way to go for me (below the surcharge limit) and even then I put it off for a while. Otherwise not much in the private system for me — don’t like it ideologically, prefer the culture and work ethic and care that was always provided to me in public system when I was younger, am healthy, and too lazy to access many services regardless
Bunch of underinsured folks in this thread thinking they’ve figured out how to game a corrupt system or some other ideological theory. Private health insurance is worth every dollar. People don’t have issues grasping this with their cars and assets, but for whatever reason feel differently when it’s their own physical body/health.
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Imagine giving money to an organisation for nothing. Its principle.
When I last looked into it, the cheapest eligible health insurance policy cost more than the tax reduction I would receive for holding it. So there isn't a net financial advantage to purchasing private health insurance.