Does Health Insurance Cover Treatment for Alcohol Addiction?

Alcohol use seems to be high in Australia, according to the Australian Bureau of Statistics which has conducted surveys on this issue. According to the observed trends, alcohol consumption is expected to increase in the years to come.

Alcohol is a depressant drug that can cause a host of physical problems. It can bring about disability and death. Too much can lead to physical illness as well as violent behaviour and accidents. Frequent alcohol drinking can result in addiction too. This could then lead to serious mental health problems later on.

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There are solutions for people facing alcohol addiction. For one thing, relevant medical and psychological help can be readily accessed through health insurance.

Private Health Insurance and Alcohol Abuse Treatment

Being treated as a private patient in a private health facility such as a rehab centre is one of the benefits you may find in a private health insurance policy. Those with private health funds may access treatments according to their policy inclusions:

• Accommodation at an alcohol treatment facility may be covered in full under hospital cover. Coverage may be for a short one-day stay or for an extended period, as determined by the doctor overseeing your treatment.
• Hospital cover may pay a percentage of the doctor’s fees for alcohol addiction treatment.
• Access to 24/7 ambulance services may be made available through ambulance cover.
• Fees for out-of-hospital consultations may be partly paid by general treatment cover.

Private health funds are not created equal. Some will provide coverage for alcohol treatment, while some will not. Carrying out a comprehensive private health insurance comparison is crucial. You want to make sure this particular health issue will be addressed if it is likely to affect you.

Fortunately, doing a thorough insurance comparison no longer requires tedious legwork. There are reputable health insurance comparison sites which makes this task easier. They can accurately gather and present quotes from various insurers. It can all be done with just a few clicks of your mouse and some basic information entered on-screen.

Make sure to review all the exclusions and restrictions before buying a health insurance policy. Read the product disclosure statement to ensure you fully understand all the terms of the policy you will be buying.

Help from Medicare for Alcoholics

Alcoholics can now count on Medicare health support thanks to the Australian government’s new program called Better Access to Healthcare. One can now seek assistance for alcohol treatment from a psychologist who is registered with Medicare.

These conditions have to be met:

• You must get a recommendation from your primary healthcare provider before seeing a psychologist. It can be from your general practitioner or your psychiatrist, or from your paediatrician if you’re a minor.
• Your primary healthcare provider can refer you to a particular psychologist. However, you can always choose to work with another. If you take the latter option, make sure that the one you’ll be enlisting has a Medicare Provider Number.
• A maximum of ten individual sessions and ten group therapy sessions per year can be received through Medicare.

It is important to remember that not all Medicare-listed psychologists follow the suggested schedule fees. Expect to pay for the difference between the schedule fee and the practitioner’s rate if this is the case with your psychologist. If a bulk billing system is used, then you won’t have to worry about paying out of pocket for professional fees at all. Familiarise yourself with these essential details. This will help you prepare financially before starting your treatment for alcohol addiction.

Health Cover for a Disability

Health insurance provides security for times when one is unable to work and support one’s basic needs. Health insurance packages vary, though. This is why it is very important to always perform a health insurance comparison prior to obtaining a policy.

Disability Benefits under Private Health Insurance

No disability coverage is as varied as the ones extended by private health insurance providers. It is crucial to read through every insurance product disclosure statement when in the medical insurance comparison phase.

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Insurers have different names for different types of disability covers. These are the most common ones:

• Trauma Cover – This insurance gives coverage for those who have been injured. It also applies for illness such as stroke or cancer. The cover may provide assistance for previous and ongoing medical costs not covered by health insurance. The costs for needed lifestyle and housing changes which make the patient’s life more manageable may be included too.
• Income Protection Cover – This insurance provides for a person who is unable to work because of injury or illness. Income replacement may be provided for a set period of time. It can also continue for the rest of the afflicted person’s life depending on the terms of the policy.
• Total and Permanent Disability Cover – This insurance provides steady financial assistance when the policy holder is deemed fully and permanently disabled. Every insurer has its own criteria for determining this medical state. Commonly, total and permanent disability means being unable to work in the former job. It also pertains to being completely unable to work again in any kind of occupation.

Doing a private health insurance comparison does not only entail checking the rates offered by insurers. One should also examine these important points:

• Coverage level – Debilitating injury or illness has a huge impact on one’s life. Think about how much income you and your family will need if you’ll be unable to work. This will help you decide how much disability cover to get. Other kinds of life insurance should be taken into account. For instance, if you have a superannuation fund going and it includes total and permanent disability cover, then there is no point in obtaining similar insurance.
• Waiting periods – Waiting periods basically prevent immediate claims after policy purchase. This tends to increase the costs for all members of the health fund. Providers have varying waiting periods but they normally range from 60 to 90 days.
• Life insurance – If you already have life insurance cover, this may include some coverage for disability such as trauma cover or income protection.

Disability Benefits from the Government

Welfare payments as well as services for the disabled can be obtained from the following. This is based on the National Disability Insurance Scheme and National Injury Insurance Scheme.

Centrelink

Centrelink is in-charge of distributing welfare payments such as:

• Carer Allowance. This may be extended to people who take care of injured, disabled, ill, or aged members of the family who require additional round-the-clock care.
• Carer Payment. This may be provided to people who are unable to work because they provide full-time care to a disabled, ill, or aged member of the family.
• Mobility Allowance. This may be extended to injured, ill, or disabled persons so that they can attend in approved activities. The allowance is meant to cover transportation costs because they can not use public transport without the assistance of a carer.
• Sickness Allowance. This may be extended short-term to wage earners who are unable to go to work because of a medical condition.
• Disability Support Pension. This may be provided to Australians who have a severe physical, mental, or intellectual impairment, and who receive government employment and wage support.

CRS Australia

CRS Australia assists the disabled or injured acquire and keep suitable and gainful jobs. This agency works closely with employers to ensure workplace safety. The focus is of course on the disabled.

Australian Hearing

Australian Hearing provides support to hearing-impaired Australians. Assistance is in the form of medical services. They also help the hearing-impaired access cheaper products that are crucial to improving their quality of life.

Is Drug Rehab Covered By Health Insurance?

The Australian government estimates that one in five Australians will suffer some form of mental illness at one point in their lives. It has also been found that teenagers and people aged over 50 are the most vulnerable. Mental illness manifests in various ways. One of these manifestations is drug abuse and addiction. Fortunately, you can access relevant medical support and treatment with the help of your health insurance.

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What private health insurers will cover

Those with private health insurance may be treated as a private patient in a private hospital or drug rehabilitation facility. But that isn’t all.

• Accommodation at a residential facility may be fully paid for under hospital cover. The coverage may be for a one-day stay, or for an extended period of time if recommended by the doctor.
• A certain percentage of medical practitioner’s fees may be paid for through hospital cover.
• Holding general treatment cover may significantly lower out-of-hospital consultation fees.
• Ambulance cover ensures the patient can be quickly transported to a medical facility should a mental health or other health emergency occur.

Keep in mind that not all health funds may offer coverage for drug rehabilitation. Performing a thorough private health insurance comparison prior to signing up for a policy is important if you have specific needs you want covered.

The motivation of most people who compare health funds is to find cheap health insurance. But what’s the use of paying a cheap premium for your health coverage if you end up paying out of pocket for many of your health care needs? Don’t just scrutinize the rates when you compare health insurance funds. Review the various restrictions and exclusions of each offered product too. This increases your chances of finding a private health insurance that will provide adequate coverage for your mental health needs.

What you’re entitled to under Medicare

The Australian government provides support to mental illness sufferers through its Better Access to Healthcare program. A patient can enlist a registered psychologist to commence rehabilitation from drug addiction under the updated Medicare scheme.

These are the conditions that can help ensure maximum use of one’s Medicare benefits:

• Prior to seeing a psychologist, a recommendation must be made by your GP, your psychiatrist, or your paediatrician if you’re a child or young adult.
• A doctor can refer you to a particular psychologist. However you may be able to choose your own psychologist for the rehabilitation.
• The psychologist must have a Medicare Provider Number. This ensures you can access your public health insurance benefits.
• You are entitled to a maximum of 10 individual sessions per year with the enlisted psychologist. A total of 10 group therapy sessions per year is also available under the Medicare scheme.

Not all psychologists with Medicare Provider Numbers follow the recommended schedule fees. If such is the case with your practitioner, expect to pay the difference between the Medicare fee and the actual rate being charged by the practitioner. If the psychologist uses bulk-billing, then you may not need to pay out of pocket at all. It is crucial to acquaint yourself with these types of detail prior to starting your drug rehabilitation.

Will Private Health Insurance Cover Everything?

When you do a simple health insurance comparison between public (Medicare) and private health insurance, it’s easy to see how the latter can supplement the former in terms of coverage. Private health insurance encompasses the benefits provided by the Medicare system, but can offer more as well. Of course, there’s no such thing as an insurance that “covers everything”.

As you may know, any type of policy will always have its exclusions and restrictions. Nevertheless the types of coverage available in private health insurance are wide enough to include what you would reasonably expect.

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Common coverage

These are the four areas of coverage that private health insurance can provide. Private health funds may offer them as separate policies, or combine them into packaged products that include all four. You’ll find that hospital and general treatment policies come in different levels of coverage. Top or comprehensive levels have the least number of exclusions and restrictions, while basic policies have all the common exclusions. Naturally, higher benefits and wider cover tend to result in higher premiums. Keep this in mind when you compare health insurance from the various companies and accredited health funds.

Hospital cover – A top level policy in this area would normally include all services that Medicare also covers. 75% of the costs of services listed in the Medicare Benefits Schedule (MBS) will be covered by the public health insurance system. The remaining 25%, which may include doctors’ professional fees or hospital accommodation, can be covered by your private health policy. You also have the choice to be treated as a private patient regardless of whether you’re in a private or public hospital. Unlike in Medicare, you can also choose your own doctor.

General treatment – There are certain treatments that are outside of Medicare’s scope or limited in benefit. Examples of such are dental, psychiatric, and optical treatments. It is in this area that private health insurance may be advantageous as this would be the only option to get coverage for such treatments. Other services for which you can get coverage through this type of policy are physiotherapy, chiropractic services, podiatric treatment, and prosthetics. General treatment cover is also sometimes called extras or ancillary cover.

Pharmaceuticals – Whether you have private health insurance or not, you only have to pay for the partial cost of certain prescription medicines listed in the Pharmaceuticals Benefits Scheme (PBS). The discount you receive depends on the type of medicine you purchase. Not all types of pharmaceuticals however are listed on the PBS. Thus you may arrange coverage for such medicine with your health fund and have it included in your policy. Usually a co-payment feature is used where pharmaceuticals are concerned.

Ambulance cover – This is another area which isn’t covered in Medicare. State governments such as those of Tasmania and Queensland have free ambulance services. The same is available in New South Wales and Australian Capital Territory but applies only to pensioners and those with low income. Generally, however, emergency and ambulance services are something that has to be either paid out of pocket or included in a private health insurance policy.

Broader health cover

Treatment doesn’t always have to be done in a hospital. Some services are available in healthcare clinics, while others can be done in the patient’s home. Then there are chronic conditions that need to be constantly treated and managed. These areas are not usually found in common private health coverage.

Fortunately, in April 2007, health funds began to devise health insurance products that would address such situations. Hospital substitute treatments are those done or continued outside of a hospital, and may include intravenous therapy or wound care, for example. Chronic disease management programs such as those for diabetes or cardiac conditions may also be covered by such policies. How these new coverage features are made available for contributing members is at the private health fund’s discretion.

5 Simple Things that May Lower Your Health Insurance Costs

The federal government manages the country’s health insurance system, but you still have to accept that there will tend to be annual rate increases. Making a private health insurance comparison is a good approach to see if you can find a cost-effective policy that suits your needs. To make a fair comparison, however, you need to be familiar with certain aspects that have a direct effect on premiums and other costs. Presented here are five things that may lower your health insurance costs:

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1. Excess and co-payment

These two are common mechanisms that may help you to lower your private health insurance premiums. An excess is a particular amount you agree to pay out of your own pocket for hospital expenses before the actual insurance benefit kicks in. This is why this is also sometimes called a front-end deductible. A co-payment is similar in that it is also an amount you agree to pay on your own. But this is usually a partial cost of a particular hospital service, like accommodation for example. Excesses and co-pays feature in hospital insurance policies and the usual pattern is that premiums become lower as excess or co-payment amounts become higher.

2. Method of payment and rate protection

As you compare private health insurance products from various service providers, you might come across some lower prices offered based on how you pay your premium. Some insurers for example may offer lower premiums if you decide to pay through a salary deduction scheme, an automatic debit from a bank account, or even just a simple advance payment of several months’ premium.

If you can manage it, paying for a whole year in advance may make you eligible for health insurance rate protection. If health insurance rates increase within a year, those who still aren’t fully paid may be burdened with the resulting balance or have their coverage periods reduced. With rate protection you don’t have to worry about such events, at least within the year of coverage you’ve already paid for in advance.

3. Private Health Insurance Rebate

Even as you compare health cover from various health funds, the federal government has already instituted a way for you to reclaim part of your insurance costs. Started in January 1999, the Private Health Insurance Rebate means that you can get back 30 cents of every dollar you spend on private health insurance. 30% is the set percentage for those under 65 years of age. Those who are 65 to 69 years old can get back 35%, and those who are 70 and above are entitled to 40%. There are several ways you can receive this rebate. You can claim direct payment from a Medicare office, request your insurer to subtract it from your premium, or get it when you accomplish your tax return.

4. Lifetime Health Cover

This is another relevant federal regulation, that prompts rather than rewards. According to the Lifetime Health Cover rule, you will have to pay an additional 2% on your premium for every year that you didn’t have hospital cover above the age of 30. So someone who just got private health insurance at 34, for example, is going to pay 8% more than someone who bought the same type of policy at age 30. The message here is clear – get hospital cover early if you want to reduce health insurance costs in the long run. Take note that the date it kicks in is the 1^st of July after you turn 31.

5. Exclusions and restrictions

These refer to particular treatments or conditions that are either completely outside your policy’s coverage (excluded) or can only receive limited benefits (restricted). Policies may come with default exclusions and/or restrictions, but it’s also possible to actually negotiate or agree to such provisions in order to reduce your premium. Take note that this can be a risky approach compared to simply opting for more excess or co-payments, as you’ll actually be removing coverage and not just simply reducing the payable benefits.