[Myprincesses]

I am really begiining to wonder if the $260 a month is really worth it for private health insurance. Today we put in a claim for a lecky easy seat for DD1 (has JHS) under the medical appliances clause. I get an email back declining it as it wasn't on the list of their approved medical appliances. Mind you there isn't a list anywhere is our documents or on the Internet specifying what is on the list. All it says is any medical appliance prescribeby an OT, PT, SP or medical practitioner (according to them it includes wheelchairs, walkers, toilet seats, fusion raisers, showers tools).

I have appealed the decision and escalated the claim to the claims manager along with all the supporting documents to say who prescribed it. Just waiting to hear back.

But it really got me thinking are we just wasting our money with private health insurance. Yes it was great whilst having children, but we are certainly finished and cannot have anymore so don't need obstetrics. We have recently moved and the private hospital here doesn't have a good rep and the public hospital is great. Private hospital also doesn't see kids under twelve. All private doctors treat at the public hospital. There are no private OT, and PT services for DD so will be using the public system anyway, and possibly for speech as well.

Medical appliances is limited to $1000 every three years and by the sounds of it has a very limited selection of appliances they will fund.

I have looked around and there really isn't much different with other funds.

Is it really wrth us forking out $3000 dollars a year when they won't let's claim the things we really need to. Iwould rather invest the money in a high interest saving accountant draw on it if and when we need to. We don't earn enough to be penalize.

It is justo frustrating.

[Sinister Bonnet]

We don't have PHI either. It made no financial sense for us. Once we hit the safety net, we are paying very little. We're better off putting the money saved aside and using it when needed.

[HoneyMurcott]

We have good hospital cover but no 'extras'. This saves us a very considerable amount but leaves us with the option of private hospital treatment which has come in handy for tonsils & sleep studies for the children & I'll use it for vascular surgery soon. We have a separate savings account for the 'extras' such as optical & dental. Physio is public (hurray!) & we just manage the OT & speech as required - which over the years has been way more than any health fund would have covered.

[seeingstraight]

We have private health but havnt used it once for our sons needs.

We are going to cut all extras and keep hospital cover only.

[Cat©]

We had PHI for many years and the main things we have used it for in the past is dental - the boys get to go to a private dental paed (due to the EDS) and we dont ahve to put up with the pathetic public system for dental (it is here for kids anyway!).

I worked our out and this is why I kept it -
Our PHI with GMHBA is (recent increase) $240 a month, so $2880 P.a.
Dental is $1500 a year minimum for checkup and clean for 5 boys.

When we also use it for speech and OT for one, Physio and podiatry for all, we claim back usually another $1k (we went minimally as we couldnt afford it) - this year it will be more as many of them have started speech and OT, and psych and we can afford more sessions.

So as you can see we claimed back last year over$2500, our PHI cost $2880, so for us its really costing us almost nothing but we have the extra reassurance of private hospital if we need it plus the other benefits should be use them.

This year I would say our claims will easily hit $4k at least with 5 of them accessing services - plus two need braces, plus I need dental work as well, all necessary evils!!

So perhaps work it out realistically as to what you use now and what you would use when services run out (some EI services can stop when kids start YR 1) and then go from there. I would love to kick ours but when I worked it out it wasnt really worth it unless we went back to GOV dental for the kids (ick) and I stopped taking them to therapies (gov therapies suck here, there is almost none!)

[lsolaBella]

We are thinking of dropping our extras. Also thinking of dropping obstetrics as we aren't planning on any more kids.

Don't forget you may have to pay extra Medicare levy if you drop the hospital part.

Our PHI only pays $200 pa towards speech.... Helpful when our speech costs have been $4k for the past year (not).

[Cat©]

PPhave you checked out GHMBA? ours pay $800 total PA family for OT but $500 per member for speech. Then Physio and other stuff is also extra to that. Its not a heap more but might be worth the change if the annual costs are simialr.

We have top hospy and top ancilliary and pay the $120 a f/nt with a $500 excess ($1000 per yr per family) but we have only used hosptial once and paid the $500, so wasnt worried about the excess.

[lsolaBella]

May be worth a change.

[mez70]

We used to have both Hosp and extras but now currently only have hospital,
When we had extras we were claiming more than the extras actually cost as DH and I both have glasses, DD was on weekly ST and then there was dental and Chiropractic.

We will NEVER not have hosp for many reasons but I will never EVER be reliant on the public sector for my families health as what they see as uregnt and a reasonable time frame and what I consider to be the same is miles apart. I know one of my DD's specialists who we see privately will not see "self Funded" private patients due to the nature of the specialitiy and the fact that if my DD need surgery done privately I would be looking at TEN's of thousands of dollars due to the nature of said surgery and length of hosp stay needed.

I have great public facilities which I do use but when my older DS saw a Gastro and needed some diagnostic scopes he could have been done 2 days later (but was first day of school) so we took the very next 1 which was 5 days later, in the morning etc all privately, he would have been waiting a while on public list.

I dropped our extras once DD stopped her speech and OT as we were not claiming enough , also we had similar coverage for aids and appliances whic was 1 every 3 years to the value of $1000.0 However by dropping our extras we then applied to have the Brace funded under the states aids and Equip program . This has meant her brace can be replaced when needed and in the space of 2.5 years she has had 2 Boston Braces at $1600.00 each, plus all the maintainance and adjustments etc for the total out of pocket to us of $100.00.....

I like knowing that IF DH or I need hosp we can take advantage of the private system and having worked for a major health insurer and processing the claims for Hosp stays I would NEVER self fund as I have seen how something simple can cost thousands just for the hosp portion

[handsfull]

We wouldn''t drop our private cover. Both DDs have glasses yearly, DH and I need reading glasses. We periodically need physio due to sport injuries, both DDs need speech therapy (on hiatus at the moment).

DD2 had an operation in October which I would definitely would not have had done in the public system here. Have experienced it once and that was enough to say never ever again!

Both DDs need blood tests and due to their severe needle phobia up until 6 months ago had to have them in hospital under sedation ($950 each) which private cover paid for.

Our premium is $285 a month but include top hosp and top extras. I feel we do get our money's worth not every year but at least every second one.