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 insurance, Lifetime Health Cover loading fees may make you feel that you cannot afford to compare health insurance. Even if you can afford to continue being a health fund member, you may worry about meeting the out-of-pocket costs that are not covered by this. This may seem like a scary prospect, but there is hope.

Thankfully, there are various concession cards that can help you out. One of these is the Commonwealth Seniors Health Card (CSHC). This can lower your costs for PBS medicines. It can also help with the costs of other health services.

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Commonwealth Seniors Health Card Eligibility

Could you be eligible for the CSHC? You must satisfy the following eligibility criteria.

• You are an Australian resident
• You are not serving a waiting period as a new Australian resident
• You are of Age Pension age, but are not eligible for the Age Pension
• You are not receiving Social Security or DVA benefits
• You must provide Centrelink with the Tax File Number for you and your partner (or be exempted from doing this)
• You must meet the adjusted taxable income criteria. This is currently $50,000 (singles) and $80,000 (couples). For dependent children, the threshold goes up by $639.60 per child. Not sure what counts as taxable income? Check with Centrelink to confirm. Super payments for over 60s are usually tax-free, but this is not always the case.

How It Works

The CSHC entitles you to discounts on PBS medicines. You may also benefit from being eligible for the Medicare Safety Net, which would reduce your out-of-hospital costs on medical services assuming that you meet the threshold. Another major benefit is bulk-billing rates for doctor appointments. GPs are encouraged to adopt bulk-billing, but they are not obliged to do so.

The CSHC does not cover your dependents. If you want them to be able to benefit too, there is an alternative concession card. The Low Income Health Care Card offers the same benefits as the CSHC but also covers dependents.

Getting the Card

You can register your claim online via an Intent to Claim. In effect, this informs Centrelink of your intention to apply for a concession card. You will need to make your claim within 14 days of your Intent to Claim. You can also claim by paper form, by telephone or in person at a Centrelink centre.

Need help with your health care costs as you get older? This is a big concern for many seniors. Don’t forget to compare health cover – it may not cost as much as you think. Beyond this, concession cards can make things a bit easier. For example, the CSHC can help with buying PBS medicines and can also reduce medical costs. This can be a big help for many seniors but not everyone will be eligible.

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.

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 third party who can help you when you deal with your private health fund — the Private Health Insurance Ombudsman.

Who Is the Private Health Insurance Ombudsman?

The Private Health Insurance Ombudsman is the name for an Australian Government agency that deals with consumer concerns about their private health funds. However, the Ombudsman acts independently of the Government.

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What Does the Ombudsman Do?

The stated purpose of the Private Health Insurance Ombudsman is to “protect the interests of people who are covered by private health insurance.”

The Private Health Insurance Ombudsman office handles consumer inquiries and complaints regarding all aspects of private health insurance, but the Ombudsman also works with the government and the private health insurance industry, offering advice to them, and publishing independent reports about the performance of the health insurance industry.

Publications that inform consumers about private health insurance funds, making complex aspects of the industry clearer to the general public, and helping the public to understand their responsibility as members of private health funds, are available from the Ombudsman.

How Can the Ombudsman Help Me?

When you encounter problems with your private health fund that cannot be resolved by contacting the health fund directly, the Ombudsman can take your complaint and assist you in reaching a resolution.

If your complaint stems from a misunderstanding of your benefits, the Ombudsman’s staff will help you to understand how your benefits work and what you can do to use them effectively in the future. However, if your complaint is not due to a misunderstanding, the Ombudsman will initiate contact with your health fund or third parties with whom you have experienced difficulty using your health fund, and obtain more information and suggestions for resolving the problem.

In cases of complaints that are complex,  the Ombudsman will seek additional information about the problem from the health fund or other organization, and in some cases, recommend a certain course of action to resolve the problem.

How Do I Make a Complaint to the Ombudsman?

You can make a complaint to the Ombudsman by contacting them through the following channels:

Mail: Suite 2, Level 22, 580 George St, Sydney NSW 2000
Complaints Hotline: 1800 640 695 (free from anywhere in Australia, though mobile phone charges may apply)
Telephone: (02) 8235 8777
Fax:   (02) 8235 8778
Email: info@phio.org.au

While your complaint is being investigated, Ombudsman staff will keep you regularly informed about the status of your complaint, usually by telephoning you.

Keeping Healthy for Life

Even if you have excellent health insurance, getting sick may still be expensive. What’s more, chronic health problems such as heart disease, diabetes and high blood pressure may take years off your life and money out of your pocket. Doing a few simple things to keep yourself healthy won’t just help you to live longer, and with a higher quality of life — it may save you money in the long run.

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Eat Right and Get Regular Exercise

By now, we all know that eating plenty of fruits and vegetables, low fat proteins and fibre is the best way to maintain our health and our weight. But that doesn’t stop us from relying at times on a diet of takeout foods, unhealthy junk foods, and sugary soft drinks and snacks.

Changing the way we eat — and  the impact of our diets on our health — is easier said than done, but making small changes, slowly, can help you to get on the right track to better eating and better health. Just trading out full-fat dairy products for low-fat or no-fat options, replacing fried meats for baked, broiled or grilled dishes, saving soft drinks for special occasions and watching the salt and sugar you add to foods are small, manageable changes that can set you on the path to better health without totally overhauling your diet.

Adding some regular exercise to your routine will also help. Getting regular exercise, even if it’s just 20 to 30 minutes, three or four times a week, may help you lower your body fat, cholesterol, blood pressure and risk for diabetes. What’s more, it will help build bone and muscle that can keep you strong.

The right diet and exercise won’t just improve your well-being and reduce your weight – it may also help you save money on prescription medications, medical care and health insurance excesses or co-payments. A poor diet and lack of exercise may catch up with you one day in financial, as well as health, terms.

Get Regular Checkups

We often think we’re too busy or strapped for cash to have regular checkups, but in truth, going without is something neither your budget nor your health can afford. Waiting until you’re in seriously poor health to see a doctor is like waiting until it starts raining before you close the windows — by then, some of the damage is already done.

The importance of seeing your physician regularly for a checkup can’t be overstated; seeing a physician at least once a year may help you to catch some health conditions early, and may help to prevent others altogether. Medicare and most health insurance plans allow for yearly checkups that can help you to keep healthy without spending a lot of money.

Take Care of Your Teeth

Having a mouth full of pearly whites won’t guarantee good health for life, but simply taking better care of your oral health can help you to avoid some health problems. Poor flossing habits have been linked to everything from oral cancers to heart disease, and failing to brush regularly can result in painful and expensive dental clinic visits. Even if your private health fund doesn’t include cover for dental care, you can do a lot to contribute to your health by brushing and flossing every day.

Making an effort to keep yourself healthy is not just the key to a longer life — it’s the key to avoiding expensive medical conditions.  And if you have only public or basic level private health insurance cover, it’s the best way to avoid letting a small health problem snowball into a huge one that you can ill afford.

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.

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How long can children remain on a family policy?

For most, Family cover will be the most cost effective type of private health insurance policy and while you’ve still got dependent children living at home, they can be kept on your private health insurance policy at no extra cost. According to the Private Health Insurance Ombudsman, a dependent child is “unmarried … under the age of 18 years,” but check with your health fund to confirm their specific criteria for what is classed as a dependent child.

Your health fund may also extend this up to the age of 25 for full-time students, provided that certain criteria are met. This will often mean that your child must be studying at a recognised educational institution or in a recognised apprenticeship or traineeship, is not married, and is not working full-time or earning over a set amount. Again, check with your health fund to find out their eligibility criteria for a student dependent.

If your child fits neither of these options, you may want to look into Extended Family Cover, which may cost more than standard Family cover.

Be selective

It’s natural to want to protect your family finances against as many potential scenarios as possible, but you may not need all of the policy extras that are available to you. By narrowing your selection down to just the optional extras that are relevant to you and your family, you may help to make your private health insurance cheaper while still making sure that you’ve got the right cover for your family.

If there are any extras that you feel may be needed further down the line but not right now, don’t forget to factor in waiting periods, especially for pre-existing conditions. Many private health funds impose waiting periods of up to 12 months for pre-existing conditions (with some exceptions, e.g. for psychiatric care), so if you only look to arrange the cover after you realise that there’s a health problem in your family, you may not be fully covered until the waiting period has been served.

Some of the optional extras that may benefit your family include:

• Dental. General dental cover covers things like dental check-ups, x-rays, fillings and extractions.
• Optical. Medicare will usually cover eye tests from approved practitioners, but to cover things like glasses and contact lenses, you’ll need optical cover.
• Orthodontic. If your children need things like braces to straighten their teeth or align their jaw, orthodontic cover may help to pay for these.
• Physiotherapy. If someone in your family has a neurological, developmental or respiratory condition which requires physiotherapy treatment, you may find this cover useful.
• Podiatry. Once your children are able to walk, they may need care for their feet. Adults may also have treatment requirements for foot health at any stage in life. Podiatry cover can help to pay for treatment costs.

Making sure that your new baby is covered

To make sure that your newborn is covered straight away, make sure that you have the relevant cover at least several months before the birth. If you don’t already have appropriate cover e.g. Family Cover or Single Parent Cover, you’ll need to switch to it before the birth.

When you’re looking to compare private health insurance for the whole family, think about the level of optional cover that your family may need. Benefits such as dental, orthodontics and optical can be important where children are concerned, but you may want to exclude cover that doesn’t seem relevant to your family. As your family grows, you’ll probably need to make some changes to your policy, but you may save money by not taking on extras that you don’t yet need, as long as you take waiting periods into account. If you’re about to start your family soon, don’t forget to make sure that you have the right cover in place before the birth, or your newborn may not be covered straight away.