Private health insurance

Milly21

i finished my treatment April 2017,I didn’t have private health insurance during treatment.i have been debating about getting it? What is a better way to go private or public?and would I have to wait 12 months after getting private for treatment as it’s considered pre existing? Is it worth the money?

Beryl C.

Hello Milly21 - I have always had private health insurance. When my GP gave me the results of my biopsy (HER2+ and spread to lymph nodes) he explained the option of electing to go with public health. Seven years on with countless scans, three recurrences, three surgeries, and well over 90 Herceptin infusions, meetings with oncologist etc I give thanks to my GP for making sure I was fully informed about my options. In that seven years I have paid for parking. You also have the option of electing either Public or Private for different aspects of your health and treatments. Suggest you meet face to face with a private health insurance officer before making a decision and take someone with you to take notes and clarify confusions.

Afraser

It's very hard to tell. I did have private hospital cover before diagnosis and it was very handy. But yes, you may be considered as having a pre-existing condition, which may preclude cover for anything deemed related. Which is the rub. I was hospitalised for a week with a serious infection caused by a seroma, the result of my mastectomy. Nothing really to do with cancer, but I was glad I didn't have to argue the toss. I have a couple of other long term side effects, and am not (surprise!) getting younger, so I have actually increased my cover. An honest tally of your risks and positives should help you identify if it's worth doing, also what public facilities are close at hand (country options are sadly not what they should be). Best wishes.

Romla

I had private health cover prior to my diagnosis. It enabled me to choose my surgeon but he also practices in the public system - he has an excellent reputation btw.Many breast surgeons work in both systems but in the public system you cannot choose your surgeon.

I have talked to others who have used the public system and they have been delighted with their care esp the follow up care by the nurses after discharge.If I have a complaint about my private hospital it was the absence of follow up care after I was discharged - the care whilst in hospital was good however.

Private radiotherapy has a substantial gap payment not covered by insurance. My gap on 16 rounds was over $2000 , many have more treatment cycles than mine and have gaps of $5000+.You can blend private surgery and chemo with public radiotherapy which I would have done given the hindsight.

Re preexisting condition rule - I think you would need to research that very carefully with the insurance companies.

My rationale for going private was that I had had private cover for many years.I’d probably go as a private patient in a public hospital for surgery if there is a next time as gather nursing care here is excellent and definitely public for radiotherapy.

Sister

I went private for surgery and chemo because, like @romla, I had had years of private insurance.  I went public for rads and had no complaints - I would have paid a fortune for private rads and as far as I can tell, there would have been no difference in treatment or care except that maybe because my public hospital followed the latest treatment protocols, my treatment was shorter than it would have been likely in private.  As for @romla, follow up care from the private hospital where I had surgery was poor.  However, my cousin went for public for surgery and the waiting list was a few months whereas I waited 2 weeks (and it may have been sooner if I hadn't asked the surgeon to have that extra week).  The other benefit of private is that with my cover I can get a lot back on mastectomy garments and it has covered a number of weeks of oncology rehab.  

If you go down that path, make sure that you get very clear advise on waiting times having had bc (be specific and I'd go as far as to ask for it in writing) and also compare what the different levels in the tables cover.

BlackWidow

Private health insurance is just like any other - it is an insurance company and they will take your money but be slow at handing it out.
You could end up paying thousands of dollars then be let down when you need them.  Importantly, know that there are always out of pocket expenses when using private cover and these can be very high.
Waiting lists may be a factor to consider but if one is very ill (like heart, brain, broken bones etc) the public system gets you done quickly anyway.
Your age and other medical issues which are in play or may come up in time may be factors to consider.
If you have been happy with the treatments provided at your local health services then stick with them. 
Good luck with your decisions.  Anne

[Deleted User]

Ultimately health insurance gives you choice. It is expensive, but it’s worth it if you can afford it. I’ve seen a relative endure years of pain waiting for a hip replacement and another dealt with by multiple doctors in the public system. I’m happy to have a recent graduate as a GP, but prefer to have experienced surgeons of my choice. 

BlackWidow

Another consideration is the type of hospital.  If your public hospital is a teaching hospital then, whilst ''your'' surgeon is in the room, the actual work could be undertaken by a student doctor.  If you are not comfortable with this then the decision is easy.

Chelley59

Ive had all my treatment through public health cannot fault it. You have to do what you feel comfortable with though.

Sister

@Milly21 I think that you need to sit down and think about why you're considering it now.  It's expensive so you need to know what you're getting in to.  Maybe write down a list of reasons why private cover would be good for you.  Then do some research on what the different funds offer that are important to you, the costs, benefits paid, and the waiting period (don't make assumptions with this).  I was close to opting out of my private cover when I was diagnosed - I have had health cover since I started full-time work so that was 36 years at the time and most of them with the same fund (I'm with Health Partners and I have on occasion gone back and checked that it was still the right one for me and my family).  I doubt that I have come anywhere near recouping the costs over the years but this year, I have had a damn good go at it!  Given that I'm now getting to that age, it seems, when things begin to go wrong, I will try to stay with the health fund although paying the premiums is tough.  But would I join now, after treatment, if I wasn't already a member - I don't know... I would have to do some serious cost-benefit analysis given the price of premiums.

I should also say that, while it could be that I've just been lucky, I have never had any issue with claiming anything from Health Partners in more than 25 years - my family and I also use their clinics for dental and optical.