What do I get with my level of Hospital Cover?

Hospital cover will vary from state to state and from private health fund to health fund. In 2019 the Government made reforms and introduced a system that saw private health hospital cover be brought under four tiers – gold, silver, bronze and basic. This allowed Australians to easily compare private health cover like for like and work out what cover best suited their stage in life. 

In addition the Government set requirements that each tier of hospital cover has a minimum list of treatment categories that they must include. If a health fund may choose to add the word ‘plus’ to their tier of hospital cover, this means they are offering more than the minimum treatment categories. For example:  One private health fund may cover three more categories than the minimum requirement for that tier, therefore they are allowed to add the word ‘plus’ to their hospital cover tier name. 

What treatment categories do the tiers of hospital cover offer?

Gold 

With Gold Hospital being the highest level of cover,  the Government set requirements that it must include cover for all 38 categories of treatment and services. It’s designed for people who are looking for the most comprehensive cover. If you are planning on having a baby, Gold Hospital is the only tier of cover where the pregnancy treatment category is included. All private health funds have pregnancy in their Gold Hospital coverage. 

Silver

Silver hospital cover includes 29 categories and is the second highest tier of cover. There are some restrictions on this level of cover for hospitals such as rehabilitation, palliative care and psychiatric services. If you’re looking for more cover than Bronze hospital but don’t need all the treatment categories of Gold Hospital cover and price tag – Silver is a great middle of the road option.

Bronze

Bronze Hospital cover must include at least 18 treatment categories plus three restricted cover options for palliative care,  psychiatric services and rehabilitation. The upside to Bronze cover you will be covered for hospital services such as ear, nose and throat, brain and nervous system and joint reconstructions. 

Basic 

Basic Hospital is the minimum coverage tier a health fund can offer. With basic hospital cover you will only receive very minimal benefits as set out by the Government. It is best to check what you are covered for before entering hospital as you may have a large amount of out-of-pocket expenses.  

Product tiers and minimum clinical categories set out by the Government:

Source: Health.gov.au

Will I have to pay the Medicare Levy? 

You will only have to pay the Medicare Levy if you do not have private hospital cover. The surcharge is in place to encourage individuals to take out private health cover. 

The surcharge covers you and your dependents.  Your dependents include: 

  • your spouse; 
  • any of your children who are under 21 years of age; or 
  • any of your full-time student children who are under 25 years of age.

The Medicare Levy Surcharge (MLS) is determined based on a percentage ranging from 1% to 1.5% of your income. This surcharge is an additional cost imposed in conjunction with the standard 2% Medicare Levy, applicable to the majority of Australian taxpayers. To work out your yearly income for MLS and Rebate calculations, you may utilise the Private Health Insurance Rebate Calculator provided by the Australian Taxation Office (ATO) or reach out to the ATO directly for assistance.

Compare Policies 

Remember to review your private health insurance requirements depending on your stage of life. Your policy may no longer be suited to you and the treatments you require. A few things to keep in mind when choosing a level of hospital cover is who will be covered, the medical care you need, the services or categories you require and if you are willing to keep your premium costs down by paying an excess.

Be sure to compare private health policies taking into account excesses, benefit limits and co-payments that all influence the total cost of treatments.  You may find the cheapest policy is not the best policy for you and your needs.Talk to us today to compare private health cover and discover what level of hospital coverage you require – call us  on 1300 861 413 or email hello@health.compare

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A Guide to Building Healthy Habits for 2024

As we move  into 2024, setting health goals is important to ensure a successful year of well-being. Here’s some practical routines that will elevate your overall health, alongside these personal care recommendations we’ll explore the advantages of private health coverage extras that will help kick start your goals.

Prioritise Sleep for Optimal Well-being:

Sleep is the foundation of good health, like recharging your body’s battery each day. To enhance your sleep quality, disconnect from technology at least an hour before bedtime. The Sleep Foundation provides great insights into how electronics and technology affect sleep and why it’s a good idea to disconnect at least one hour before bed.

Regular Exercise to Boost Physical and Mental Well-being:

Exercising daily is a great way to boost both physical and mental well-being. Incorporating daily workouts into your routine will set you up to achieving your overall wellness goals. Variation is the key when it comes to workout routines, mix it up – you’ll not only target different muscle groups but also keep things interesting and challenging making it more likely that you’ll stick to your routine over the long term. 

Mindfulness for a Focus:  

When you feel overwhelmed or distracted in day to day life, practicing mindfulness each day can be beneficial to your overall health.  Kick off the day and spend a few minutes meditating, practice some deep breathing, or simply enjoy your morning coffee without distractions. Putting these easy steps into place each day will give you the focus to start your day. 

Foster Connections with Loved Ones:

We as humans thrive on social connection. This connection can be as simple as a phone call to a friend or loved one or a sharing of a movie.  These small actions can significantly contribute to your overall happiness. By investing in the relationships that matter most in your life, you will enrich your mental and emotional well-being.

Hydration is the key to a Healthy Body:  

Water is essential for our bodies, not only does it aid in the removal of waste from our body, it also hydrates and supports kidney function.  Water can assist in flushing toxins from our bodies and promoting a healthier you.  Did you know water also acts as a natural lubricant for our joints?  

Cultivate Gratitude:

There are many benefits from practicing gratitude each day. It not only helps us disconnect from the busyness of our daily lives, it works wonders for your mental well-being.  It’s as simple as thinking of three things you are grateful for each day – this could be people, loved ones, nature, your home or community. Commit to writing these things down and it’s more to notice good things as they happen in your life. Gratitude also may be in the form of returning a favour to a loved one or paying it forward in a simple act of kindness.

Stress Management:

Everyday life can cause pressure, demands and stress. Learning how to manage stress is vital for your mental health and your general overall wellness. Try to balance work and play, achieving work goals but at the same time making time for spending time with friends, working out or walking your dog. Another crucial part to managing stress is getting enough sleep. Start a bedtime routine which includes winding down from technology at least one hour before bedtime.

Embrace Reading:

By incorporating reading into your daily routine and immersing yourself in a good novel it allows the brain to disconnect from stress from daily life. Did you know reading enhances creativity and assists with critical thinking skills? Not only does reading increase your vocabulary, enhance your knowledge but it also helps strengthen your writing abilities. 

Adopt a Balanced Diet:

There are many benefits to a healthy, balanced diet – a diet of fruits, vegetables, whole grains and protein help you lower cholesterol and blood pressure, lose weight and lower the risk of other diseases. The food you eat supplies important nutrients your body needs to maintain your blood circulation, nerves, muscle,  brain, bone, nerves, skin and immune system.

Limit Alcohol Consumption:

By significantly reducing or cutting out alcohol altogether, you will significantly reduce many things that have an impact on your mental health. These included reducing blood pressure, weight loss, improved energy and better sleep. Alcohol also impacts the rate that the body absorbs nutrients.

More Outdoor Time:

Spending time outdoors can have an immediate impact on your health and wellbeing. Not only does it improve your mood, it relieves stress, improves your physical health and helps you connect with your locaL community. Whether it’s a leisurely stroll or a hike in the mountains – spending time in nature allows your body to unwind.

Quit Smoking for a Healthier Future:

We all know the risks associated with smoking, quitting is difficult and most people will experience side effects for around 2-4 weeks. Speak to your GP about a plan and how they can support you during your process to quit smoking. Your longer-term risks of cancer, lung disease, heart disease and stroke will be significantly reduced.

Unplug from Technology:

Make a conscious decision to disconnect from screens and social media. By doing this you will experience improved sleep, a more settled mind and strain on your eyes. Replace screen time with reading a book, walk the dog or take up a hobby.  This break from digital life will work wonders for your wellbeing.  

Listen to Music:

Music has proven health benefits, including anxiety reduction, lower blood pressure, and improved sleep quality as researched by John Hopkins. Incorporate music into your daily routine for a positive impact on your well-being.

How your Private Health Extras can help out

Check your private health insurance extras cover, there are many well-being services that could be covered with your policy, such as:

  • remedial massage
  • chiropractic 
  • physiotherapy
  • optical 
  • gym memberships

Embark on the journey to better health in 2024 by adopting some or all of these routines. As you prioritise your well-being, consider comparing private health insurance options to ensure you have the best health coverage tailored to your needs. Investing in your health is an invaluable commitment that pays dividends throughout the year.

Talk to us today to compare private health cover that’s best for you on your health journey for 2024 – call us  on 1300 861 413 or email hello@health.compare 

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Why skin checks are so important – A Comprehensive Guide on How Private Health Cover Can Assist

In our sun-drenched country, where UV radiation levels are intense, skin checks have become an indispensable aspect of healthcare. Detecting potential issues early on can be a game-changer, especially in a country with the highest global incidence of skin cancer. In this blog, we delve into why skin checks are crucial, how they contribute to overall skin health, and, importantly, how private health cover plays a pivotal role in supporting this proactive approach.

The Australian Skin Cancer Dilemma:

Australia holds the unfortunate record of having the highest rate of skin cancer worldwide. Shockingly, more than two in three Australians are diagnosed with skin cancer by the age of 70. The prevalent types include melanoma, basal cell carcinoma, and squamous cell carcinoma, all exacerbated by our country’s relentless exposure to ultraviolet (UV) radiation.

Early Detection: A Lifesaver:

The cornerstone of successfully combating skin cancer lies in early detection. Early identification significantly improves the chances of successful treatment, reducing the need for invasive interventions. Routine skin checks empower individuals to identify suspicious moles or lesions promptly, leading to timely medical intervention and, ultimately, saving lives.

Preventive Measures for Skin Health:

Beyond the critical aspect of cancer detection, routine skin checks also contribute to overall skin health. They identify non-cancerous conditions, enabling early intervention and preventing complications. By prioritising skin health, individuals can proactively safeguard themselves from various skin-related issues.

Sunscreen Application and Safety:

Consistent use of sunscreen has demonstrated effectiveness in minimizing the likelihood of skin cancer, particularly the most severe type, melanoma. Sunscreen constitutes one of the five crucial sun protection practices known as slip, slop, slap, seek, and slide. According to Cancer Council guidelines, it is advisable to opt for a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30, coupled with water-resistant properties.

This informational document offers guidance on selecting an appropriate sunscreen, ensuring proper application, addressing sunscreen safety concerns, and providing insights into the use of sunscreen on infants.

Understanding Skin Cancer:

Skin cancer results from the damage to skin cells, primarily due to overexposure to UV radiation. The most common types are basal cell carcinoma, squamous cell carcinoma, and the more dangerous melanoma. However, the positive note is that 90% of detected and treated melanomas in their early stages are curable.

The Importance of Professional Skin Checks:

While self-monitoring is crucial, professional skin checks are equally imperative. Healthcare professionals utilise tools and techniques that go beyond what the naked eye can discern. Experts recommend regular professional checks, with annual appointments being a prudent approach.

Where to Get Your Skin Checked:

Several avenues are available for professional skin checks, including your general practitioner (GP), skin cancer clinics operated by GPs, and dermatologists for higher-risk cases or a second opinion. Regular check-ups, combined with self-monitoring, create a comprehensive strategy for skin health.

At-Home Skin Checks:

Between professional appointments, it is vital to keep an eye on your skin at home. Using the ABCDE guide (Asymmetry, Border, Colour, Diameter, Evolving), individuals can monitor existing spots for any changes. Any new spot or alteration in size, shape, color, itching, or bleeding should prompt an additional professional skin check.

Protecting Your Skin:

Prevention is as crucial as detection. Wearing broad-spectrum sunscreen, covering up with protective clothing, and seeking shade when the UV index is 3 or above are essential measures to protect your skin from UV damage.

Private Health Cover for Skin Checks:

Contrary to common misconceptions, private health insurance can play a crucial role in supporting skin health. Many policies in Australia offer coverage for skin cancer screenings, including consultations with dermatologists and diagnostic procedures. This coverage helps alleviate out-of-pocket expenses for preventive skin checks.

Access to Specialist Care:

Private health cover provides access to a network of specialists, including dermatologists specialising in skin health. Timely consultations with these specialists are instrumental in ensuring thorough skin examinations and receiving expert advice on preventive measures.

Financial Assistance for Skin Cancer Treatment:

In the unfortunate event of a skin cancer diagnosis, private health cover can offer financial assistance for various treatments, surgeries, and follow-up care. This support eases the financial burden on individuals and families during a challenging time.

Medicare Limitations:

It’s essential to note that Medicare in Australia does not provide rebates for mole mapping, and the rebates for skin checks may not cover the full cost of comprehensive skin examinations. Additionally, most major private health insurers in the country do not offer rebates for skin checks or mole mapping.

Prioritising skin health through regular checks is wise, in our climate. Private health cover not only supports individuals in maintaining their skin health but also provides a safety net in case of skin cancer diagnoses. When considering private health policies, a careful evaluation of their coverage for skin checks, dermatologist consultations, and related treatments is essential. By making informed choices, you can actively contribute to your overall well-being and protect yourself from the sun’s harsh realities. Remember, your skin is your body’s first line of defense – give it the care and attention it deserves.

If you’re considering private health cover, talk to us today to compare plans that best suit your needs. Call us on 1300 861 413 or email hello@health.compare  

Your skin’s well-being is our priority!

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Colonoscopy and health cover, how does it work?

Planning a colonoscopy and concerned about whether your private health insurance will cover the procedure? In this blog, we’ll explore information around colonoscopies, the reasons why they are needed, and how private health insurance plans can be beneficial in managing the costs effectively. We’ll also provide all the information around the waiting periods associated with private health cover for colonoscopies.

Understanding Colonoscopies:

A colonoscopy is a medical procedure where a doctor examines the large intestine using a colonoscope, a flexible tube with a light and video chip. This procedure serves various purposes, including screening for conditions without symptoms, diagnosing issues related to blood loss or changes in bowel habits, investigating abnormalities from other tests, and providing therapeutic measures like removing polyps. Given its importance in preventive healthcare, it’s essential to understand how private health insurance plans can assist in covering the costs of colonoscopies.

Tips to Reduce Colonoscopy Costs:

No-Gap Schemes:

Explore private health funds that offer no-gap payments for hospital and specialist fees at specific hospital locations. This can significantly reduce out-of-pocket expenses.

Contact Your Private Health Fund:

Before making a claim, contact your health fund to get a list of doctors and specialists aligned with their gap cover agreements. This step can help you minimise gaps or potentially eliminate costs associated with various healthcare providers.

Shop Around for the Best Policy:

Prices for private health insurance plans vary from one provider to another. By researching and comparing policies, you can find the best private health coverage that suits your needs. Don’t hesitate to seek assistance from experts in the field.

Estimating Costs for Private Health Patients:

Go to the Government website Medical Cost Finder for an estimate of typical costs for private health patients. Understanding these costs will be helpful, before making an informed decision and whether your private health insurance covers the colonoscopy procedure. 

Source: Medical Cost Finder 

Public vs. Private System:

For public patients, Medicare will cover the entire cost of a colonoscopy but be aware the waiting times can be considerable. Whereas private health insurance provides an alternative with shorter waiting times and additional benefits. However, it’s also important to be aware of waiting periods associated with your private health cover. Both could be vastly different.

Private Health Insurance Coverage for Colonoscopies:

Private health insurance plans categorise coverage into tiers (Basic, Bronze, Silver, and Gold). Colonoscopies fall under the treatment category ‘gastrointestinal endoscopy,’ starting from the Bronze tier. Private health insurance typically encompasses a wide range of expenses, including fees for services by a proctologist and anesthetist, as well as the expenses associated with the use of the operating theatre and hospital stay. It also takes care of consumables, in-patient consultations, and any prescribed medications, as long as you’ve already served the necessary waiting periods.

Waiting Periods for Colonoscopy Claims:

Most private health insurance policies require a two-month waiting period, or 12 months if deemed pre-existing, for a colonoscopy treatment. Also switching private health funds while maintaining the same cover generally doesn’t require re-serving waiting periods. However, switching policies or funds before completing a waiting period may mean picking up where you left off.

Being well-informed about your private health insurance options for colonoscopies is crucial for managing costs and ensuring timely access to healthcare services. By simply understanding waiting periods, considering the tips provided here, estimating potential costs you can make an informed decision to find the best private health coverage for your needs. If you have any specific questions or need assistance, our team is here to help. Feel free to call us at 1300 861 413 or email us at hello@health.compare

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What’s the average waiting time in the public system?

Our country boasts a world-class public health system, with some of the best doctors and specialists but the extensive wait times for treatments, particularly non-emergency surgeries, can be a significant drawback for many patients. 

To navigate these delays and ensure you receive the medical attention when you need it, many individuals turn to private health insurance. If you do not have or can afford private health insurance, Australia still has a very stable public hospital and health system that can be accessed. For some treatments there will be waiting times. By understanding the average waiting times in the public system and comparing private health insurance options, you can proactively address your healthcare needs and the timing around what’s most important.

Public hospitals will prioritise surgical procedures based on urgency. Although elective surgeries, recommended by doctors for non-emergency conditions like joint replacements, cataracts, or lump removals, often lead to patients being placed on waiting lists. The duration of these waits varies depending on factors such as the required treatment, specialist availability within the public system, and proximity to the hospital. In some cases, individuals may find themselves waiting nearly a year or more for the care they need.

The impact of the COVID-19 pandemic on the healthcare system cannot be ignored. In March 2020, elective surgeries were temporarily halted, resulting in a 9.2% reduction in admissions for such surgeries compared to 2019. Despite this, the number of people waiting for surgery increased by 2.1% in the preceding year.*

These wait times for specific treatments highlighted the challenges faced by those relying solely on the public healthcare system. Septoplasty, a surgery to correct a deviated nasal septum, had the longest wait time in 2021, reaching up to 315 days. Other treatments, like total knee replacement  and cataract extractions, also had significant wait times, causing pain and potential deterioration of health for those in need.#

The average wait time on public hospital waiting lists currently stands at 43 days, but this figure masks the reality for those awaiting common treatments that can extend to almost a year. Additionally, the average wait time doesn’t account for the time between seeing a general practitioner and consulting with a specialist, which can be months in itself. ^

Taking all of this into consideration private health insurance becomes a viable solution, allowing individuals to receive prompt and cost-effective treatment in private hospitals, where waiting lists are generally shorter.

While private health insurance covers formal admissions to private hospitals, emergency care in private hospital emergency departments may not be covered until a patient is formally admitted. It is crucial to be aware of these nuances and carefully consider your insurance options to ensure comprehensive coverage.

To make an informed decision about private health insurance, it is advisable to compare various plans. You can reach out to us today at 1300 861 413 or via email at hello@health.compare to discuss and compare your private health cover options

Taking this step can empower you to proactively manage your healthcare and avoid the uncertainties of lengthy public hospital waiting lists.

Reference: 

Australian Institute of Health & Welfare

# AIHW – Elective Surgery

^ AIHW – Waiting times

Australia’s public health system is world-class, but wait times for public hospitals can be long and inconvenient. Finding private health insurance that works around the public system could help you avoid long waits for the treatments you need.

There are many benefits to Medicare but one of the major drawbacks is the long wait times for non-emergency surgery. This can often lead to prolonged periods of pain or discomfort while you wait to be treated.

This guide covers current average wait times for elective surgery and emergency care, what the longest wait times are for certain treatments, and how choosing the right private health insurance can help you avoid the back end of a long waiting list.

What are surgery waiting lists at public hospitals?

Australia’s public hospitals are busy, so all surgical procedures are prioritised in order of urgency.

If your doctor has recommended any procedure that isn’t an emergency, this is known as elective surgery and you’ll likely be placed on a waiting list.

Examples of elective surgery include joint replacements, cataracts, and removing a lump from your breast.

Wait times vary depending on the treatment your require, the availability of the specialist medical professionals, and the public hospital nearest to you. Some people will be waiting almost a year.

In March 2020, most elective surgeries were put on hold due to the COVID-19 pandemic.

That meant there were 9.2% fewer Australians being admitted for elective surgery in a public hospital than in 2019, despite the number of people waiting for surgery rising by 2.1% the year before**.

Which treatments have the longest waitlists?

Of the 25 most common surgeries in 2021 in Australia, the longest wait time was for septoplasty (surgery to fix a deviated nasal septum), with a wait time of up to 315 days.

Other treatments with significant wait times include:

  • Total knee replacement – up to 293 days
  • Myringoplasty/tympanoplasty (to repair a hole in the ear drum) – up to 259 days
  • Cataract extractions – up to 158 days

These treatments aren’t considered emergencies but they can still be painful and debilitating to live with. Your condition may also deteriorate the longer you have to wait.

This is why elective surgery waiting lists are a problem for many Australians without health insurance.

What is the average wait time on a public hospital waiting list?

Across all treatments in Australia, the average wait time on public hospital waiting lists is 43 days at the time of writing.

However, some of the most common treatments have wait times of almost a year.

The average wait time also doesn’t include time between seeing a GP and a specialist, which can often be months.

Can wait times be waived if you’re a public patient?

Sadly not. The only way your wait time can be waived as a public patient is if your condition worsens significantly and is considered an emergency.

Are there waiting lists for private patients in a public hospital?

Yes, but as your private insurance is covering you, and you are being treated by your own doctor or surgeon, you may not have to wait as long.

As public hospitals are usually busy, appropriate private insurance can allow you to be treated cost effectively at a private hospital instead.

Does private health insurance cover private emergency care?

Your insurance will only cover you when you’re formally admitted to a private hospital as an inpatient.

This means a doctor has determined that you need hospital care and you have been assigned a bed.

If you arrive at a private hospital emergency department and are not formally admitted to hospital, you are considered an outpatient.

Some health funds won’t cover you in this situation.Talk to us today to compare your private health cover on 1300 861 413 or email us at hello@health.compare

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