Medicare Teen Dental Plan
With Medicare not providing much help with dental care for most people, many families struggle to afford dental cover. This can be worrying for parents, as it may mean that youngsters struggle to maintain good oral health later on as they have not got into the habit. The Australian government has recognised this concern, and introduced the Medicare ...
Commonwealth Seniors Health Card
As you get older, you may worry about how you will be able to carry on funding your health care. For many seniors, your health needs may be changing at a time when your income is decreasing. If you already have private health insurance, you may worry about how to afford to maintain enough cover for your needs. If you don’t already have health insur ...
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 one ...
Private Health Fund Problems? Contact the Ombudsman!
If you’re experiencing problems with your private health fund, you may feel you have exhausted all your options. You’ve talked to representatives of the private health fund, gathered and produced necessary documents to state your case, and still feel that your questions are unanswered or that your problem is unresolved. The good news is, there’s a ...
Feeling Tired All the Time? What Your Health Insurance Covers
Are you feeling tired a lot or struggling with other worrying health issues? You’ll want to get it looked into. Many people are reluctant to consult their doctor out of fear for what it may cost. You may be aware that Medicare will cover GP consultations, but what happens beyond that? If your tiredness symptoms need further investigation, you’ll wa ...
What Medications Does Health Insurance Cover?
Australians can get cheaper medications through Medicare, courtesy of the Pharmaceutical Benefits Scheme (PBS). The PBS covers a lot of medicines, but not all. Fortunately, health insurance extras may cover non-PBS medicines. Here are some things to consider if you are not sure how medicines are covered by your health insurance. What is the Pharmac ...
Hospital Cover: Health Insurance for Inpatients vs Outpatients
If you’re not familiar with the ins and outs of hospital cover, you might assume that it doesn’t matter whether you’re in hospital as an in-patient or as an out-patient. Private hospital insurance normally covers you as an inpatient only, so anything beyond that may not be covered. Read your private health insurance policy for the full details. Wit ...
Compare Health Insurance for the Whole Family
When you’re looking to compare private health insurance for the whole family, it may often be the case that a Family policy may provide the best value for money. Within this, there will be things to think about when you’re looking to compare private health cover that will benefit everyone. How long can children remain on a family policy? For most, ...
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 ...
Private Health Insurance Comparison for Beginners
Through policies like the Private Health Insurance Rebate and Lifetime Health Cover, the Australian government has made private health insurance both an advantageous and appealing option. Doing a comparison of the various products offered by private health funds is the typical way to find a suitable policy for your needs. There are of course a coup ...
Private Health Insurance Rebate Basics
Choosing a private health insurance plan can be complex and there are many things to consider. For most people, the major consideration may be cost, which means that understanding exactly how much you’ll pay for coverage is extremely important. When looking at premiums and deciding on a policy, you need to know what money saving ideas you can put into action so you truly understand what you’ll be paying.
Luckily, there are many ways to lower private health insurance costs, and one of the simplest is the Private Health Insurance Rebate.
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Private Health Insurance Rebate Basics
In 1999, the government introduced the Private Health Insurance Rebate (also known as the Federal Government 30% Rebate). With this rebate, for every dollar you pay for your private health insurance premium, the government will give you back at least 30% as a rebate. The rebate increases as you get older. People age 65 to 69 may receive a 35% rebate and people age 70 and over may receive a 40% rebate.
The rebate is not based on income, so anyone who pays private health fund premiums for a complying health insurance policy to a registered health fund can receive the rebate. If you pay the cost of the premiums and are the policyholder, you are eligible, even if the policy doesn’t cover you. For example, if you have a policy for your children, you can receive the rebate. If your employer pays your premium on your behalf, you are still eligible for the rebate.
How to Claim the Rebate
Claiming the Federal Government 30% Rebate is simple and straightforward. No matter how you pay your premiums —monthly or yearly, in instalments or in advance— there are 3 ways to claim this rebate.
1. Premium Reduction
You can reduce the upfront cost of your premium by asking your fund to provide the rebate as a premium reduction. This is helpful for those on a tight budget who need to keep costs low and level. To claim the rebate in this way, you’ll need to register with your health fund to do so.
2. Cash Payment
You can also claim the Federal Government 30% Rebate as a cash payment from the government when you have paid the full, upfront cost. You can do this at your local Medicare office or by lodging the claim form by post. The claim form is available at Medicare offices and on the Medicare website. You will also need to attach a special receipt from your registered health fund.
3. Tax Return
You can also choose to claim your 30% Rebate on your annual income tax return if you have paid the full, upfront cost. You will receive a statement from your health fund at the end of the financial year to assist you in completing your tax return.
What It All Means
Obviously, a rebate of any kind is helpful, and a rebate of 30% or more can be a great benefit when it comes to paying for your health insurance policy. The Private Health Insurance Rebate is definitely something to bear in mind as you compare health insurance and consider how much you can spend. For example, let’s say you are looking at a policy with a premium of $300 a month. If you claim the rebate as a premium reduction, you will only pay $210 a month. That’s a substantial saving.
The Private Health Insurance Rebate is a help to Australians who want private health insurance but don’t want to spend an outrageous amount to get it. Whether you are just beginning your search for a policy or have had one for a while, make sure you understand and take advantage of this helpful and important rebate.
The Pharmaceutical Benefits Scheme: Reducing Medication Costs
Imagine this scenario: You weren’t feeling well, so you went to the doctor, were diagnosed and now you’re on the way to the pharmacy. This illness has cost you enough already in lost work time and doctor bills, and now you’ll be paying for the medicines you need. Without any help, paying for basic medicines can be a challenge for most families and an impossibility for some.
Luckily, the Australian government realized how burdensome the cost of necessary drugs can be, and instituted the Pharmaceutical Benefits Scheme (PBS) in 1948. Though it has changed somewhat over the years, the PBS is still designed to help Australians afford the medicines they need even without any private health insurance cover.
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What is the Pharmaceutical Benefits Scheme?
The PBS is a program in which the government subsidises the cost of medicine for most medical conditions. By doing so, the PBS provides reliable and affordable access to necessary medicines. It is part of the broader National Medicines Policy. The Scheme is available to all residents of Australia who hold a current Medicare card.
How Does the PBS Work?
The PBS Schedule is a list of all the medicines available to be given to patients at a government-subsidised price. When a patient goes to the pharmacy to get a drug that is on the Schedule, the subsidy is automatically applied when the drug is dispensed. The patient pays a co-payment instead of the full cost of the medication. This may save the patient a great deal of money. Many military veterans are eligible for even lower co-pays through the Repatriation Pharmaceutical Benefits Scheme. Those who pay the lower co-pays have what are known as concession cards.
In 2011, general patients paid up to $34.20 for medicines on the PBS Schedule. Concession card holders would have paid $5.60. If you choose a more expensive medicine or your doctor prescribes one for you, you may have to pay more. The PBS Schedule can be found on-line and is updated each month. The on-line version includes information on all drugs listed on the PBS, the conditions of use for the prescribing of PBS medicines and what you can expect to pay for medicines.
While the amount you have to pay for medicines is, thankfully, rather small under the PBS, it can add up over time. That’s where the Safety Net comes into play.
What is the Safety Net?
If you or your family end up needing a lot of medicines in a year, the Safety Net will help with the cost of your medicines. Once you or your family reach the Safety Net threshold, you can apply for a PBS Safety Net card. This means your PBS medicine will be less expensive or even free for the rest of the calendar year.
In 2011, the Safety Net threshold was $1,317.20 for general patients and $336 for concession card holders. If you are nearing your Safety Net threshold, talk to your pharmacist about applying for a Safety Net card. Once you have one, you will pay $5.60 in the 2011-12 financial year for your PBS medicines if you are a general patient. Those medicines will be free for concession card holders with a Safety Net card.
Helping Manage the Cost of the PBS Scheme
Since the Pharmaceutical Benefits System began, the costs of running have increased tremendously. The cost of the PBS grew nearly 13% each year over the last ten years alone, and it now costs the government approximately $6.5 billion a year to operate.
The government asks consumers, prescribers, dispensers, wholesalers and the pharmaceutical industry to do what they can to help keep costs down. As a consumer, you are asked to not refill prescriptions earlier than needed, to ask for less expensive brands of medicines, and to not get more medicine than you actually need.
Keeping health care costs down isn’t easy, but the Australian National Medicines Policy attempts to do just that in order to help Australian families. The Pharmaceutical Benefits Scheme is an important part of Australia’s health care program and an important benefit for Australian citizens. If you want to keep your family’s health care costs to a minimum, make sure you understand the PBS.
Community Rating – What It Means and What To Do If You’re Refused Insurance
In some countries, if you are older or have health issues, finding health insurance can be difficult, if not impossible. If you do find coverage, it will cost you much more than it would cost a younger, healthier person. In Australia’s private health insurance system, a single, healthy, 23-year-old man and a single, unhealthy, 59-year-old man will pay the same premium for the same coverage. This is because of community rating.
What is Community Rating?
Community rating means that all Australians have affordable access to private health insurance. Everyone pays the same baseline premium for their health insurance and health funds are not allowed to discriminate against members based on age, health status or claims history.
Community rating is very different from the usual method of determining premium payments, which is risk rating. In risk rating, the insurer bases the premium on various risk factors associated with that client. In community rating, the premium is based on risk factors applying to the community as a whole.
The goal of community rating, as set out in the Private Health Insurance Act of 2007, is to ensure that everyone who wants it has access to health insurance and to prevent private health insurers from discriminating between people on the basis of their health or any other reason.
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How Does It All Work?
In Australia, all private health insurers are regulated by the Commonwealth Government under the Private Health Insurance Act of 2007. This means that, by law, all health funds must comply with community rating, meaning you cannot be denied access, refused cover or charged extra for private health insurance, except for a few exceptions. There are some rules about waiting periods, and there is the Lifetime Health Cover rule which is designed to encourage people to start hospital cover early and keep it going long-term.
You have the right to join any private health insurance fund you choose, and you may switch from one fund to another at any time without financial penalty.
What To Do If You Are Denied Health Insurance
Although the goal of community rating is to provide coverage for all at the same price, there are times when a person is denied private health insurance coverage.
One of the most common reasons for denial is if a person has pre-existing medical conditions and doesn’t have the money to pay for the exams and treatment that may be necessary. This may seem contradictory, but if you are denied coverage, you do have other options.
- Contact the Private Health Insurance Ombudsman – this organization is there to help consumers with health insurance questions and enquiries. You may be able to appeal against the decision to refuse health insurance cover or to deny a claim.
- Learn all you can about private health insurance in Australia to fully understand your rights and what you can expect.
- Compare private health insurance policies. Find out whether you have any other choices, compare plans and prices, and make an informed decision about what to do.
Community Rating is meant to help provide quality private health care cover for Australians, no matter what their age or state of health. If you are denied coverage, try not to be discouraged; check your options and don’t be afraid to ask for guidance from a professional.
Paying for Private Health Insurance
Just thinking about health insurance gives me a headache. I have to know what I need, how much I should pay for it and how to go about finding the coverage I want. Unless money is no object to you, then cost will be a consideration when you compare health insurance options. There’s a lot to learn and consider, but with some time and effort, you can get the coverage you want and feel confident you’re paying no more than necessary.
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Understand What You Already Have
The good news is that as an Australian, you already have basic health care coverage. Medicare is the basis of the Australian public health care system and covers many health care costs like basic medical care including doctor visits, tests, surgery and more, as well as hospitalization. However, there are limits and stipulations. Medicare does not cover private patient hospital costs, glasses and contacts, most dental services, and certain other health care related expenses. You can find out more about what is and isn’t covered by Medicare from the government’s Private Health Insurance Ombudsman.
Decide What You Need
Once you’ve figured out what you’ve got, then you can start deciding what health insurance coverage you want and how much you’re prepared to pay for it. Your health insurance needs are based on a few factors. The number of people needing coverage, your age(s), general health and your personal preferences are some things to consider.
Age
Age is a consideration for a couple of reasons. First of all, you may want more health insurance coverage as you get older, to cover the health conditions that age may unfortunately bring. You may also want health insurance coverage for your whole family, including children. Another consideration is the Lifetime Health Cover, a government initiative designed to encourage people to take out hospital insurance earlier in life and to maintain their cover.
Number of people needing coverage
Obviously, the number of people you have to cover will affect your health insurance comparison and quotes. If you are a family of four, you may decide you need to provide private coverage for only the adults in the family, only the children, or all four.
General health
Your overall health is also something to consider when deciding on private health insurance. If you are healthy and rarely need medical care, you may decide you don’t need any private coverage. But if you have a medical condition that requires even occasional medical treatment, you may need some additional coverage.
Personal preference
If you are fine with having to use the doctors and medical establishments covered by Medicare, you may not want private health insurance coverage. However, if you like being able to choose who you see and where you go, you may want to take out some private health insurance.
Decide What You Can Pay
Now that you understand what coverage you have through Medicare and have figured out what additional coverage you need, it’s time to examine your options, look at the costs and decide what you can and will pay. The prices vary as much as the policies, so this is where more research may become necessary.
Although this may seem intimidating at first, there are websites that can help you to compare private health insurance. If you enter some basic information you’ll be given a list of several health insurers that offer the coverage you detailed, along with either an estimate or a quote for the monthly premium. There are many things to consider when it comes to cost. The government offers a rebate for private health insurance which means you may get back some of the money you pay on your premium.
There are many private health insurance policies out there, but don’t feel overwhelmed. And always remember, you are not completely without health insurance coverage. Medicare is sufficient for basic health care needs. If you are having financial difficulties, you may decide you simply can’t afford private health insurance
The main goal in finding private health insurance on a budget is to get the coverage you want without paying more than you can afford. This can be achieved if you take your time and do your research. Once you’ve chosen your policy with the above tips in mind, you’ll have peace of mind about your health insurance coverage and your budget.