Insurance discounts are an ally to those that may be searching for health insurance, as well as those that are currently in a policy. Perhaps you aren’t taking full advantage of your policy and other related options. Follow along for a quick rundown of some possible health insurance discounts that may be available to you.
When it comes to your health insurance, something you should be aware of is the Medicare Levy Surcharge. This is essentially an extra fee levied upon higher-income individuals who choose to use the public Medicare system rather than take out private health insurance. This surcharge was implemented to reduce the number of people relying on the public health care system, and it covers not only yourself but your spouse and dependents as well.
The decision of whether or not to purchase private health insurance is an important one in Australia as in many other countries. While private health insurance is not a necessity, there may be several benefits to private health cover, both on a practical and financial level.
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.
Luckily, there are many ways to lower private health insurance costs, and one of the simplest is the Private Health Insurance Rebate.
Regardless of whether you are purchasing a comprehensive policy in addition to your Medicare coverage, or just want hospital cover or ancillary cover, the bottom line is that purchasing private health insurance is going to cost you money. However, there are government programs that may help you reduce the overall cost of your private health insurance.
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.
The government’s Lifetime Health Cover initiative rewards you for taking out hospital insurance earlier in life, and adds a financial loading charge should you procrastinate.
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.
Switching health insurance has its own particular issues. There might be differences in the coverage offered by the old and new health insurance policies, and you may be faced with waiting periods, so proceed with caution.
There are of course a couple of basic terms and concepts that you may need to understand while making your health insurance comparison.
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.
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.
If you’re not familiar with hospital cover, you might assume that it doesn’t matter whether you’re in hospital as an in-patient or as an out-patient.
Australians can get cheaper medications through Medicare, courtesy of the Pharmaceutical Benefits Scheme (PBS). The PBS covers a lot of medicines, but not all.
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.

Image by David Jackmanson
The PBS covers a big chunk of prescription costs to make them more affordable. This means that Australian residents, and visitors from countries with Reciprocal Health Care Agreements with Australia, pay less for prescriptions that are on the PBS list. You just need to show a valid Medicare card when you pick up medicines.
PBS medicines are included as a Medicare benefit. From January 1st 2012, you’ll pay $35.40 for most PBS medicines (or $5.80 with a concession card). The rate will almost certainly change in the future, so be sure to check.
Medicines for most health conditions are covered. Some of the medicines covered include those for:
Only medications on the Australian Register of Therapeutic Goods can be listed on the PBS, though. Not sure if a certain medicine is covered? Browse the online list of current PBS medicines. The list is altered on a regular basis to reflect changes.
If you are spending a lot on prescriptions, the PBS Safety Net can help. The current threshold is $1363.30 (or $348 with a concession card). If you reach this, you may apply for the PBS Safety Net card to cut your costs. Your payments when you have the card will reduce to $5.80 for the rest of the calendar year. If you have a concession card, they will be free for that period.
Sometimes you may be given non-PBS medicines. These are full price. They do not count towards the PBS Safety Net. While the PBS list is fairly extensive, it does not cover everything that may be prescribed to you. Sometimes you may get a prescription costing more than the cheapest brand.
However, private health insurance may cover non-PBS medicines as an optional extra. This will often be up to a certain amount, and typically carries a two-month waiting period for new cover. Be sure to compare health cover for pharmaceutical benefits to make the right choice. The annual limit can vary, so compare private health funds to see your options.
A lot of medicines are covered by the PBS, so you may find you get everything you need for less. If you or your family are getting a lot of non-PBS medicines, health insurance extras may start to look like a good idea. Spend some time on health insurance comparison to compare health cover for pharmacy benefits.
When you compare health cover, what do you look for when you have special health conditions? What different things should you be aware of with respect to chronic pain conditions and health insurance comparison? Follow along for some tips on what elements you may want to zero in on for your health insurance plan.

Image by Steven Depolo
It may be helpful to begin with the essential needs of your health insurance plan. In other words, forget for the moment about any special needs in relationship to your chronic pain condition. Before we move on, look at your current private health cover, if applicable. What do you have now, and is it adequate for your general health care needs? If coverage amounts, network, prescription medication, or some other factors are particularly important to you, note that down and be sure to sompare those criteria in prospective policies. By seeing what you do and don’t like with any current policy, you can imagine your ideal policy more easily.
So, identify what basics you want and need in your health insurance plan. Do you have a certain policy limit you’d like to increase, such as for hospital care? Do you want to seek out a higher excess in return for a lower premium? Take some time to identify all your other health insurance needs before dealing with your chronic pain related requirements.
Now we move on to the important special feature of your health insurance – your pain, and what is provided to help you deal with it. What parts of a private health plan are typically relevant to your chronic pain condition? While there are no universal guidelines, you can identify what is important for your condition. For instance, consider the following:
While Medicare will often cover many of your health needs, it may be advantageous to compare private health cover for your pain condition. Having access to personalised health care on your plan could be well worth the investment, in addition to other advantages such as tax incentives.
Take some time to consider your needs in detail. Look at both your basic healthcare requirements and then those that are relative to your condition. Once you do this, you can compare health insurance options in full. Looking through the whole policies may help you make a final decision on your health insurance.
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.

Image by Erich Ferdinand
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.
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.
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.
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.
While there may be downsides to switching almost any type of insurance, switching health insurance has its own particular issues. There might be differences in the coverage offered by the old and new health insurance policies, and you may be faced with waiting periods, so proceed with caution.

Image by jfcherry
Indeed, this is the “big one” – many people worry about whether they will be able to get coverage for pre-existing conditions. The simple answer is that you cannot be denied health insurance, but there may be a waiting period before your new policy covers pre-existing conditions.
Your new policy will specify the waiting periods for different types of pre-existing conditions to be covered. It will also explain how pre-existing conditions are defined. For instance, your new policy may define it as having recently received medical advice or treatment for a problem. Or you could meet the “prudent person” definition, relating to a situation in which symptoms were present that would be expected to cause a prudent person to seek treatment.
These kinds of definitions are important to be clear about – make sure you know how your private health insurance policy works. Claims for the cost of health care may be denied if you have underestimated the waiting periods on your policy.
Take a long look at your coverage and needs before switching private health insurance. These points will be important to consider before you start your health insurance quotes comparison.
Sure, the premiums and excesses are relatively straightforward, and the basics of a private health insurance policy are easy. However, you may want to check whether your preferred doctors/specialists are covered by your potential new policy. Certain special needs such as coverage for contacts or glasses, oxygen supplies, or mobility aids may not be covered as standard. Your current medications represent yet another point that you’ll need to consider; losing coverage that you’re accustomed to using may undermine your budget.
Use these factors to compare medical insurance policies and consider your options. You wouldn’t want to switch companies in haste and end up regretting it later.
Is the date approaching when the switch will need to take place? Don’t wait to the last moment to do your medical insurance comparison, unless you don’t mind being left without private health insurance coverage for an interim period while you rush to make new arrangements.
You should also make sure that you have the necessary information ready to go, if you need to switch medical professionals to be treated within your new medical insurer’s network. Data you’ll need at the doctor’s office include:
With your essential information in hand, you can be ready to switch health care as well as insurance. Your physician can usually send your medical records directly to your new healthcare provider.
Be aware ofthe potential drawbacks of switching health insurance. For some health problems, such as pre-existing conditions, you may be left without coverage for a set waiting period. If you have a number of special health needs, you may wish to consult with an insurance professional. Alternatively, you could ask individual insurers’ customer service representatives to clarify the coverage available for your requirements, as well as any ambiguous or otherwise confusing policy points. Perhaps that could give you some peace of mind if you are wondering where you stand in regard to private health insurance cover.
When it comes to your health insurance, something you should be aware of is the Medicare Levy Surcharge. This is essentially an extra fee levied upon higher-income individuals who choose to use the public Medicare system rather than take out private health insurance. This surcharge was implemented to reduce the number of people relying on the public health care system, and it covers not only yourself but your spouse and dependents as well.

Image by MC4 Army
According to the PrivateHealth.gov.au website, the following individuals are subject to the Medicare Levy Surcharge (these criteria may change in future, so check direct on the government website):
When it comes to the actual Medicare Levy Surcharge itself, the normal amount is 1% of the taxable income on top of the 1.5% levy that most people already pay. So, if you are single and make $100,000 this year, you would normally have to pay an additional $1,000 in Medicare surcharges if you don’t have private health insurance.
Luckily, there are some ways around this. According to the same site (listed above), you are exempt from the Medicare Levy Surcharge if:
So, if you are making less than the above income requirements, then it’s generally safe to assume that you are exempt. However, if you’re on a higher income and seeking to avoid the Medicare Levy Surcharge, there are other ways of obtaining an exemption.
For instance, if you simply take out hospital insurance that covers a specific amount of general hospital expenses and medical treatments, you would be exempt from the Medicare Levy Surcharge. This is, of course, assuming you are purchasing said hospital insurance through a registered health fund only.
Furthermore, when you opt for private insurance over Medicare, you could receive as much as 30% back from the federal government in the form of a private health insurance rebate. These rebates are not based on income levels.
There are special incentives for seniors who purchase their own private health insurance: for those aged 65-69, the rebate is 35%, and for those 70 and older it is 40%. At this point, the gap between paying for the Medicare Levy Surcharge and private health insurance shrinks, making it a viable option for people to choose private coverage over Medicare altogether.
So, even though you may make more than the maximum threshold for the Medicare Levy Surcharge, you can now see that there are a few ways to ensure that you are exempt from having to pay it.