Private Health Insurance: Do I Need It?

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With so many health insurance companies on the market, each with its own array of products and packages, how can YOU know what to choose?

There are TWO SECTORS of health care in Australia.

Dental work at Castle Hill Dental Care is predominantly under private health insurance however also accepts patients using the Child Dental Benefits Scheme (public health rebate).

PublicPrivate
Government run (Medicare)Private Health Insurance Companies
Public Hospital Medical and Pharmaceutical CoverPublic and Private Hospital Cover
General Cover (or ancillary/extras cover)
Available for citizens and most permanent residents of AustraliaAvailable for all individuals who pay for the service

This means if you’re a permanent Australian resident then you already have health insurance under Medicare. This often covers things like doctor visits, optometrists, or specialist visits in the public health care system.

So why do you need private health insurance? Good question. Let’s have a look at the types of private health insurance.

There are TWO TYPES of private health insurance.

  • Hospital Cover: This policy helps to cover the cost of in-hospital treatment and general hospital costs such as accommodation and theatre fees.
  • General Treatment Cover: (also known as “ancillary” or “extras” cover) this policy helps to cover services such as dental, orthodontics, physiotherapy, optical, and podiatry to name a few.

Most private health insurers will offer you a mix-and-match of both types of insurance in a combined policy which are either pre-packaged or selected by yourself.

No private hospital cover?

The GoodThe Bad
If you earn less than $90k a year (double that for couples and families) the only financial incentive to get hospital cover is that you will have to pay the Lifetime Health Cover (LHC) loading if you take out hospital cover after you’re 31. The public hospital system serves people who require emergency surgery well. For more complex and expensive medical conditions, you’ll end up in public regardless of whether you have private hospital cover or not, because public hospitals have the equipment. If you are admitted to a public hospital as a public patient, Medicare will foot the doctor’s bills.If you earn over $90k a year (double that for couples and families), you’ll be charged the Medicare levy surcharge of at least 1% of your income, it steps up to 1.25% and then 1.5% for higher income levels. It’s on top of the two percent Medicare Levy everyone pays. If you’re over 31, and you do eventually decide to get private hospital insurance, then you’ll pay more for it in the form of the Lifetime Health Cover loading. For elective surgery, you’ll end up on a waiting list and you won’t be able to choose your own doctor. You’ll be in public hospitals instead of private hospitals if you’re admitted to a private or public hospital as a private patient, you may end up paying a ‘gap fee’ to your doctor or sometimes even to the hospital which can run into thousands of dollars.

This means if you’re a permanent Australian resident then you already have health insurance under Medicare. This often covers things like doctor visits, optometrists, or specialist visits in the public health care system.

So why do you need private health insurance? Good question. Let’s have a look at the types of private health insurance.

Within each type of private health insurance, there are different LEVELS of cover.

  • Basic levels of cover will typically have fewer procedures and treatments covered or a lower limit for the total costs covered.
  • Comprehensive levels of cover will be more expensive to purchase but will give you a greater range of coverage for treatment and the amount you can be covered for.

Now What?

1. Research and Compare
Write a list of services you are likely to or want to use including dental, orthodontics, optical, and physiotherapy before comparing health insurers. Make sure to take note of:

  • What is included in the extras cover
  • Annual Limits and any loyalty rewards
  • Waiting periods for extras cover

2. Preferred Providers

Some health insurers place restrictions on the dentist that you can choose. It doesn’t mean that the dentist is more or less experienced but that they have an existing contract with a particular health fund.

At Castle Hill Dental Care, we choose not to be a preferred provider for any health insurance company so you can have confidence that YOU (and not a health insurance company) are our priority. Look for a fund that will let YOU choose your health professional and ensure that you can pick a dentist that’s good for YOU.

3. General vs Major Dental Cover

This information is often not abundantly clear when purchasing your health insurance however, a Standard Information Statement is required from each Health Fund and will detail the amounts (benefits) and services covered. General Dental Cover covers cleans, exams, fillings, x-rays, and some extractions whereas major dental cover includes procedures such as root canals, crowns and bridges, dentures, or veneers.

Our Service to You

At Castle Hill Dental Care, we understand that not everyone has private health insurance. As your local dentist, we believe in giving all members of our community the best chance at receiving the dental care they need. That’s why we have a range of offers available!

For private health insurance holders

  • No Gap Check-up and Clean
  • On-site HiCAPS facilities and immediate rebates
  • No preferred provider to ensure you (not companies) remain our priority

For non-private health insurance holders

  • $180 Check-up and Cleans (excluding full mouth x-rays)
  • 10% discount on total treatment costs*
  • 15% discount to Pensioners*

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