Will private health insurance help me if I get Coronavirus?

We look at the benefits and drawbacks of having private health insurance in light of the coronavirus and ahead of the April 1 price hike.

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A lot a lot of Australian women may be wondering how private health insurance may help them if they contract Coronavirus.

While it’s still very much an evolving situation, in the event you did get Coronavirus you would most likely be treated through a Hospital emergency department within the public health system, which means you would generally be covered by Medicare.

However as the coronavirus outbreak continues to spread and places pressure on public system, it’s possible that hospitals may have to cancel some or all elective surgeries, such as non-life threatening but necessary surgeries like joint replacements, wisdom teeth or gall stone removals.

If this was to happen, elective surgery wait times will be even longer than normal.

All wait times for elective surgeries are likely to be impacted by the Coronavirus outbreak.

That said, one of the advantages of having private health insurance could be the potential access to shorter waiting times for elective surgery via the private system once we are past the worst of this outbreak.

Here are some of the typical benefits of private health insurance

  • Extras cover: One of the key benefits of private health cover for young women is extras cover. If you keep fit at the gym or play a team sport you may need to see your physio or your chiro every now and then. Or if you wear contacts or glasses then optical benefits could really help with regular costs. Extras cover can step in and help with some costs that aren’t covered by Medicare such as dental, physio and optical.
  • Shorter waiting times for elective surgery: If you keep fit and healthy it may be hard to imagine why you’d require elective surgery in the near future. However, non-urgent elective surgery can include common procedures such as the removal of wisdom teeth or a knee reconstruction due a sporting injury. If you’re not a private patient you could be waiting longer in the public system for treatment while private patients are more likely to receive treatment sooner. This is especially important to consider in today’s current climate with Coronavirus placing an immense amount of pressure on public hospital waiting times.
  • Choice of doctor and hospital: If you have private health insurance, you’ll have the peace of mind of knowing that if you do require a medical procedure you’ll generally be able to choose your own doctor and which hospital you’re treated in. For example, if you’re planning a family and have Gold hospital cover, you’ll have the reassurance of choosing an obstetrician recommended to you. The same goes for choosing which hospital to give birth in and being admitted as a private patient (meaning you are much more likely to get a private room!)
  • Discounts for under 30s: It may come as a surprise to women under 30 that they could be eligible for up to 10% off their hospital cover. This could save you up to $200 a year on a $2,000 policy. 18-29 year olds are eligible to receive a 2% discount for each year they’re aged under 30 when they first purchased hospital cover up to a maximum discount of 10%.
  • Avoid paying the Medicare Levy Surcharge: The Medicare Levy Surcharge (MLS) is designed to encourage Australians to take out private health insurance to reduce the strain on the public health system. If your taxable income is over $90,000 a year ($180,000 as a couple or family) and don’t have private hospital cover, you will generally pay at least 1% (up to 1.5%) of your taxable income in additional tax.

Here are some of the typical drawbacks of private health insurance

  • The cost: The cost of private health insurance is constantly increasing and in fact, premiums have risen on average by 61% in the past decade. If your premium payments are weighing you down, it might be time to review your policy to see if you could get better value. And if you think you’re unlikely to be admitted to hospital in the near future, speak to a health insurance consultant about whether it’s possible to increase your hospital excess (the fee you pay upon hospital admission) in an effort to reduce your monthly premiums.
  • Out of pocket costs: Out of pocket costs or ‘the gap’ can be frustrating for private health members. While having private cover can protect you from a lot of costs, it does depend on your level of cover and sometimes you can be left with out of pocket costs for treatments and procedures. Gap payments occur when your medical treatment costs more than what you get back from Medicare and your health insurer.
  • It’s confusing: With excesses, gaps, new product categories, exclusions and inclusions, private health insurance can seem daunting to understand and navigate. If you’re feeling overwhelmed by private health insurance and not sure whether you’re even covered for what you need, speak to your health insurer or a comparison site to help you better understand your options.

With private health insurance premiums increasing again on April 1, now is a great time to take stock of your lifestyle, your health needs and budget to figure out whether private health insurance is really worth it. You may decide that even though you are fit and healthy, you’d prefer to keep your cover for the peace of mind it offers you at the end of the day. Whatever you choose, it’s important that you speak to a health insurance consultant first to ensure you’re getting still value for money on your policy.

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