Do you need private health insurance? - podcast episode cover

Do you need private health insurance?

Nov 30, 202225 minSeason 1Ep. 15
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Episode description

In this week’s episode of It All Adds Up, Jess and Dom discuss the purpose of private health insurance and the various ‘carrots and sticks’ governments have created to force an uptake to take pressure off the public system.

It All Adds Up is the podcast where we make money easy to understand so that listeners can begin building their financial wealth. You can submit questions via email or voice memo to italladdsup@nine.com.au for us to answer each week.

See omnystudio.com/listener for privacy information.

Transcript

Dominic Powell

Hello and welcome to It All ends up the podcast where we chat about money, how to get it, how to spend it and how to invest it. I'm money editor Dom Powell .

Jessica Irvine

And I'm senior economics writer Jess Irvine. And this week, we're diving into the somewhat vexed topic of private health insurance. What is it? Who needs it and what type of coverage do you need?

Dominic Powell

Yeah, we're also going to talk about our sort of top tips to save on on health insurance. If you do decide that it's something for you and if you have room for it in your budget.

Jessica Irvine

So we did discuss in a previous episode that you currently do not have private health insurance.

Dominic Powell

Why I don't. And I feel like this is sort of like a you know, once you get to a certain stage of adulthood, it's like when you should why don't you have private health insurance? How strange of you sort of thing that.

Jessica Irvine

It's sort of a rite of passage. Congratulations, You're an adult. You have to worry about this stuff.

Dominic Powell

You have to pay like however many thousands of dollars a year of not that much, but, you know, to have private health insurance. No, I don't have private health insurance. I have just been relying on Medicare for my whole life. And as of yet, I haven't found a spot where I've actually needed it.

Jessica Irvine

We did discuss, as you do, progress throughout adulthood and you accumulate some pay rises, you will push yourself into income brackets where you get slugged with an extra surcharge if you don't have the cover. So I've got cover. I've gone through a period of sort of phasing right back what I used to have. I used to sort of think, oh, private health insurance, good, responsible people do that. I better have the top level of cover because you

know what? I want to get sick. And so, like I had top level cover, but I've been gradually just scaling it back to now. I just have a really basic policy. It only costs me about 80 bucks a month. It's it's just shy of $1,000 a year that I pay. And it's basically a straight out tax dodge for me. I just do it so I don't have to pay the extra levy. As for what benefit I would actually get from my policy, I don't know. And to be honest, I'm a little bit annoyed that I have to get

it because otherwise I will get tax slugged. But yeah, it is something for people to have to think about as you become an adult.

Dominic Powell

Yeah, and I like to say in my defense, I'm not completely negligent about my health. I have things like I have ambulance cover, like, you know, so I don't have to pay the exorbitant fee. I do have a need to get an ambulance.

Jessica Irvine

So that's interesting because I do not have ambulance cover.

Dominic Powell

I'm just not included in your you know, it's.

Jessica Irvine

Not it's not included in the time that I have. So I'm just taking it that big risk that if I do have to use an ambulance, I'm just going to have to pay the out-of-pocket cost, which can vary across states.

Dominic Powell

So who's to say whose approach is better.

Jessica Irvine

Whose to say.

Dominic Powell

Could possibly.

Jessica Irvine

We are.

Dominic Powell

But yeah, that's true.

Jessica Irvine

That's the whole point of this podcast. You're going to tell people what to do. But yeah, so just starting with some basics of like what is private health insurance? Obviously it's insurance and you pay premiums to the insurer if you want to access private health care. So that can be either in separate private hospitals or it can be the care delivered by like a private specialist which

can actually be delivered in public hospitals. And you can, you know, get private wings or private rooms in public hospitals because you don't want as many people in there. So it's basically, if you choose that, you're not going to access the sort of basic Medicare, universal health care that's available for everyone. So why do you think, as you're thinking through potentially taking out a policy, what might be the benefits of private health insurance?

Dominic Powell

Well, yeah. I mean, this is the thing and I've thought about this for a long time. I've just been like, well, I get all the health care I need on the public system. Why would I pay for more? But I think there's definitely been situations where I have had something that's gone wrong and I've gone to the hospital and said, you know, to the doctor and said, I need this to happen. And I go, Right, well, if you had

private health insurance, we'd get this done next week. But because you don't, you're going to have to go on the waiting list. And that could be anywhere up to six months to a year. So, you know, that is obviously one of the major benefits of having private health insurance. You sort of skip all the waiting lists. You don't have to, you know, wait around for the public system to have time to fit you in. You just get to go into the private system, which is much quicker because you paying for it.

Jessica Irvine

I guess we should just note for everyone to know, it's not like America where, you know, you go to hospital for emergency, say, you know, if you break your leg, please do go to the E.R. departments and you will be you will be treated. And that's an advantage of being in Australia. I mean, another reason why people might not just use that system, though, is the government has been for several decades now forcing us with carrots and sticks in policy to take out private health insurance to

take pressure off the public system. So it was the late 1990s to take you back there. John Howard was in power.

Dominic Powell

I was I was about three years old. Okay.

Jessica Irvine

I was I was born in 81. So, you know, I do remember this happening that, you know, there was public policy changes to push people into taking out private health insurance. There's the private health insurance rebate, which is sort of the carrot that there's a bit of a discount off your premiums, which depends on your income level,

but also this stick of the Medicare levy. Surcharge. So slugging people with extra tax and particularly higher income earners, if they didn't take out the policies, you know, sort of had varying degrees of success. It's a it's about just less than half of Australians have private cover. So more than half Australians still relying on the public system in its entirety. And we've we've had a lot of

problems with private health insurance. Premiums are spiralling higher, you know, because if you don't get that mass of people in the system, if younger people are opting out, that increases the premiums for whoever remains in. So we've had this what's been called a death spiral in premiums. So, you know, it's a tricky thing to navigate and it can be quite expensive these days to take out the private health insurance coverage.

Dominic Powell

And one thing this is this is me just sort of expressing my disbelief is that private health doesn't cover like GP visits. Right. If you're going to a non bulk bulk billed clinic and you pay your man and you get your Medicare rebate back, I was always under the impression that that private health covered the the the cost that the Medicare rebate didn't cover. But no, it there's nothing that's just that's just nothing. Right. Like I had no idea.

Jessica Irvine

Yeah. And I've sort of had several situations in my life where I've got out the private health insurance card and go like, I swipe this baby. This is going to be cheaper. And it's just like, oh, no, that's not part of your coverage. And it depends what you have coverage for, and that can depend on your policy. So, Dom, I want to talk you through whether you need private health insurance. But I guess more broadly, who needs private health insurance?

Dominic Powell

Well, I think it's I think from a tax point of view, especially anybody on sort of higher incomes is probably the number one like from purely saving money. So you don't have to pay the Medicare levy surcharge if you're earning over the typical threshold is 90 K, But, you know, it sort of gets more and more as you earn more and more. So if you're in that hundred K plus sort of bracket, I would say that that definitely starts to become something that you should consider.

But obviously outside of that, entirely outside of that, anyone with any sort of specific medical conditions that require private health, things like regular surgeries or any sort of chronic illness or anything like that, often private health is almost a necessity for people to have those sort of conditions. So that would be another sort of, you know, major bucket of of people who would need private health.

Jessica Irvine

Yeah, In terms of the tax dodge, if you're over 90,000, it is for singles and over $180,000 of income for families, you're going to get hit with that Medicare levy surcharge and it does scale up as well. So just taking the case of a single if the Medicare levy surcharge kicks in at a rate of 1% of your income, if you're between 90,000 and 105,000, it's 1.25% for everyone earning between 105 and 140,000, and it tops out at 1.5%

for everyone earning $140,000 and above. So if you do the numbers on that, say you're on 120 grand, you're going to get hit with the 1.25% rate. And it's not like taxes, income taxes where you only get charged the higher amount on that marginal income above the certain threshold that's on your whole income. So you would actually be paying about 1500 dollars if you're on that 120

K income. So it starts to get a pretty hefty whack you're going to get, and particularly if you can get a policy like my policy is less than $1,000. You know, if I was on 120, I'd be saving myself $500 from, you know, I've had to pay for the thousand dollar premiums, but then I've avoided the $1,500 in taxes.

Dominic Powell

See, I did the maths in terms of, you know, the, the amount that I would save theoretically in term. But, you know, if I did start a very, very basic private health cover and it was really, really negligible, I think it was like maybe a maybe $100 or maybe a couple of hundred dollars for the whole year. And in the end I was like, No, I'm not going to do it.

Jessica Irvine

Do you know what? That's legit, because maybe you might just decide instead of paying $1,000 for an insurance policy, I don't really think I'm going to use. Maybe I'll just chip in the $1,000 to federal government coffers and that can pay for some nice stuff, you know?

Dominic Powell

Exactly. I like to view it as an altruistic sort of, you know, giving back to the good of of the world. I'm paying my taxes. I just think, like especially cause that basic level of private health cover, the one that is sort of the tax dodge in a sense. It doesn't cover things like dental often and all that sort of stuff, which is the sort of stuff that I

would actually use in a year. And I was sitting there and thinking like, you know, how many times, you know, as I'm going to cover my GP visits is not going to cover my dental, it's not going to cover, you know, I don't have glasses or anything like that, so I don't need any of that sort of stuff. So I was like, Well, I'm done. I don't think I'm going to get a huge benefit out of this, but obviously each to your own.

Jessica Irvine

Yeah, and you might just want to keep checking in with that as your income goes up as you get older because it does reach a point, you know, if you are scaling into the higher 100 thousands of dollars where there is, that gap does start to really open up. And that is essentially why I have it as as the tax dodge. Yeah. So that. Side. If people are looking at taking out private health insurance policies or indeed

if you already have one. We thought we would give you five handy tips for ways to save, because I love a little listicle of ways to Save.

Dominic Powell

We love lists. Lists are great. So number one, which is we've mentioned a couple of times, is just going for the absolute basic level hospital cover. Like you can look on the websites for various private health providers and they will sort of often advertise these these basic ones. Or you can just get on the phone and just call them up and literally just say to them, Hey, I just want to I just want to avoid paying the levy. What can you give me? What's the absolute

most barebones package you can give me? And this will mean you don't get any extras like as we mentioned earlier, like dental and optical, which you call optical.

Jessica Irvine

Optical. Yeah, yeah, yeah.

Dominic Powell

Those sort of things. Those are the sort of stuff that people typically talk about when they talk about extras, like, you know, chiropractor's and all that sort of stuff. You won't get that. You'll just get the sort of the basic hospital cover. And that just means that you'll avoid the surcharge. So that's that's what you should be looking for. If your entire purpose of having health insurance is just to stop paying extra tax.

Jessica Irvine

Yeah, that's me. I've literally rung up and had that conversation with just I don't know how it makes me seem as a person, but I'm just like, I just want to avoid paying tax. Please give me your cheapest hospital policy. And the hospital policies go from basic to bronze, silver and gold in terms of what they cover you for. So if you do choose to go up the scale, I always say, you know, do have a read through

what is included. And if you're young, do you really need the hip replacements and the cataract coverage and, you know, the weight loss surgery and, you know, who knows what will happen? But that's where I got into a mess because they show you this long list of things that could possibly go wrong with you. And I go, Oh, my gosh, my health anxiety is at an all time high. I better have coverage for everything. Well, I.

Dominic Powell

Feel like that's that's how they get you right. Or it's like, you know, all this could happen to you. Yeah, you could. You could, you know, break your toe or something like that. It's like, well, think about.

Jessica Irvine

That. Exactly. And so my number two tip, if you are looking at what level of coverage is appropriate for your hospital policy, is to be aware of something called the mental health waiver, because one of the things that goes missing in some of the cheaper policies is coverage

for psychiatric admissions. So if you you know, maybe you've got some mental health issues in your family or you worried that you would develop them as you age and you need to be admitted to hospital for a psychiatric type assessment and admission, they actually change the legislation so that, you know, you can not have that in your coverage and pay for a cheaper policy. But every Australian is entitled to, once in their life, use this waiver to

upgrade their existing coverage to cover psychiatric admissions. If you get to a state where that is necessary for you now, you have to already have had. You can't just sort of have had no policy coverage. But if you've served the waiting periods on your existing coverage, you can add that on as an optional if you need to use those services and if you want to have coverage for those.

So that's something to keep in mind if you're sort of looking at that long list of things and going, Oh, I need you know, I feel like I need that everyone can have that if if you do end up in that situation.

Dominic Powell

Yeah. And if you are looking at this long list of things and sort of thinking, oh, maybe I'll have this and maybe I'll have this, maybe I do need dental, maybe I do need optical, maybe I do need a, you know, a chiropractor to come and track my back every four months or whatever. This is where you should be reviewing your extras coverage regularly. This is our third

tip every year. Look at what you did use or didn't use during the year and think about what you're going to keep and often like it's also a matter of using them before they expire too. Like often, these things will take over on the 31st of December and you it'll sort of refresh.

Jessica Irvine

And some do tick over by financial year and some by calendar year. You check your one, but there should be an almighty rush at the end of the year for you to go scurrying around. If you have extra coverage.

Dominic Powell

You get.

Jessica Irvine

To go to the dentist.

Dominic Powell

Glasses or you know, go do whatever. And that is also why it's quite hard to get an appointment with a lot of small allied health professionals towards the end of the year because everyone's doing exactly the same thing.

Jessica Irvine

It's trying to max out the the extras coverage, but just to know that, you know, the policies come as hospitals or extras cover or having them both together. You don't need the extras cover to avoid the Medicare levy surcharge. You only need an eligible hospital cover. So just to stress that the extras are completely optional for you and they do try to upsell you with all of that, really do the sums to make sure you're going to get more back in benefits than you were paying premiums

on an extras policy. So the fourth tip and this is one of my favourite strategies for saving on insurance, but that I'm a bit of a dare devil is to choose a higher excess. So your excess is the amount that you agree to pay out of pocket in the event of a claim. So with private health insurance, it's set by the government. They determine what the maximum

allowable excesses are on policies. Which is like because of my car insurance, I think my excess is set to like a thousand or $2,000, meaning that there's lots of claims that just wouldn't be worth making because my out-of-pocket cost of my excess is so large. So the government set it at $750 as the excess for private health insurance for singles and $1,500 for couples. And that has increased in recent years. So if you haven't reviewed your private health insurance for a while, there may now be

an option for you to. Increase your access to those what might be higher amounts that what you've got them sit at. And when you have the higher access you pay lower premiums on ongoing. So it is a bit of a gamble because if you have to claim you're going to be out of pocket, but if you don't claim it, you can just reap those savings. And often you can not claim for long enough that the savings that you've made would sort of add up to what the out-of-pocket cost could be. So it's a bit of

a a gamble. But, you know, if you if you're a young, healthy person and you're not being admitted to hospital for cataract surgery and all the rest of the things on your hospital policies, definitely playing with your excess is one way that you can look at. And particularly if you have someone who's looking at dropping coverage altogether,

you know, with things are getting more expensive. You know, if you're just looking for ways to make it cheaper for you to have a call to your insurer and talk about the excess.

Dominic Powell

Yeah, I mean, I think if I was to get private health, I would have my access set at the absolute maximum because I don't get admitted to hospital particularly frequently and I don't plan to be so. I mean, obviously no one plans to be right. You know, you're not sitting there to be like, Damn, I think I'm going to get into a car accident tomorrow. But, you know, like I you know, you're right. Younger, healthy people can

probably afford to have a higher excess. And just finally, sort of the perennial tip when it comes to anything like this is just shopping around, making sure that you don't just go through the single whatever your mum's on or whatever your friends are on. Make sure you you

go and look at various different things. The government website is w w w dot private health look of that are you, which is where you can go and have a look a little bit, little bit of looking, compare some of the different products that are out there.

Jessica Irvine

Yeah. I've actually used that one and found it not particularly great of the government comparison websites, but it is worth having a little look you know all those websites like canstar finder compare the market you know just put compare health insurance policies and some of them you have to give away your life details and they'll then seriously call you on your mobile phone and you have to ignore it for several weeks if you don't actually want if you're just trying to test the market and find

out what the prices are, but just ringing up and ringing up and seeing what discounts are, just asking for a discount. They're now allowed to offer younger people discounts, which they weren't allowed to do before. Sometimes you can get 6 to 8 weeks, you know, free premiums, you know, for signing up. And another little tip is also to ask if your employer, if you have sort of one salaried job, has an a corporate discount. So I think for our employer, I'm getting about an extra 5% off

just because they had some arrangements. So you just ask, are there any corporate discounts or sort of bulk discounts that you could apply and just have a little bit of a haggle?

Dominic Powell

That sounds pretty good. I didn't realise that we got a discount through public event. So yeah, there's a bit of some, some tips and ideas for you. If you're like me and you're fairly uncertain about the world of private health insurance, I still even now, even now, having talked about it for a good 20 minutes, I still think I'm not going to get private health insurance, but that obviously my situation might change.

Jessica Irvine

I'll just see how you go with your pay rises in future years.

Dominic Powell

Well, sure. I mean, maybe if I maybe I start to, you know, increase my pay and then it becomes much more sensible to get private health. But we'll see. But look, the listener question this week. We say it every week, but we always enjoy getting them. So please keep sending them through too. It all adds up at nine.com.au o'clock today.

You and this one is from Angela. She says, My husband and I are in our thirties and we've started considering moving our super into an SME F or a self-managed super fund so that we can get into the property market for investment purposes. However, she's looking at the set up and ongoing costs of managing it and is

getting a bit unsure. I want to know what we think and if it's still worth it for people like Angela and her husband who want to get into the property market but don't have enough of a deposit for a place if they can do it through the MSF. Just what do you think on this one?

Jessica Irvine

Yeah, so I have reached the level of expert adulting that I have now recently done the numbers for myself as to whether it would make sense for me to set up a self-managed super fund. And the exciting thing in that space is that there has been the proliferation of a lot of SMSF administrators and they sort of they have technological online platforms that look after your tax and auditing obligations. And so there's one called a super fund,

which will do it for about $1,000.99 a year. And if you can start to compare that once you get on a bigger balance. So, I mean, I've been fairly open that my super balance is $350,000 now. And if I pay 1% fees on that, it's about sort of three. We're getting over $3,000 in fees, although I've just switched super fund and this is my weekend column and it's absolutely slashed that to about $300. So that is exciting because I was like, I don't want to be paying 3000.

Would it just actually be cheaper to have an SMS? If so, you do that. You can also like Stake is a brokerage app and they also have an SMSF platform if you're just investing purely in shares and that's about $990, there's a few extra fees that go on anyway. So the point is that it's a mess if administration

is getting cheaper, although. When you start to talk about investing in property, that makes your tax a little bit more complicated and you can incur some extra costs from accountants and sort of keeping all that above board because there's very strict rules about what you can and cannot hold in an estimate. If and if the purpose of

it has to be to fund your retirement. So, you know, I would just say to Angela, because something that she's mentioned in the you know, thinking about an estimate off because they want to get into a property because they don't have a big enough deposit to buy their own, you know, principal residence. I sort of just go, oh, if you're setting up an estimate, if you sort of want to be at the level where you've got assets that they're high enough, that it makes it worthwhile to

have those administration costs. So, you know, if maybe this is not the direction to go in, I mean, I have a personal bias towards getting a house to live in because the great tax advantages there. So, I mean, my feedback, Angela, if I could be in the room with you is to sort of talk to you a little bit more about why you think you don't have the deposit to get into property ownership of your principal residence, because there's a lot of schemes to get people in

with low deposits. House prices are coming down. So that's where I would be putting my attention before, during and a semester off. But, you know, you can you can look at it, but just also be aware there are ultra low super fund fees out there as well by some of this industry. Super funds have got really low fees and I've just switched to one where I think I'm going to be paying about 2.1% from 1% to about 2.1%. So stay tuned.

Dominic Powell

Just to sort of tie that off. Angela, I would sort of be in agreeance with Jessica that, you know, there are schemes, there are schemes that literally allow you to save your super for a house deposit, you know, like you can. There are many, many, many ways which I think would be probably better to look into a better use of time and money than possibly setting up an SMSF in your thirties. So that's, that's sort of that's how I would, would approach it.

Jessica Irvine

Yeah, they're a bit trendy at the moment, you know some assets and everyone wants control. And part of that is because the super industry's fleeced us for fees for so long that we're all now like, wouldn't it just be cheaper to do it ourselves? But that's not the direction I've ended up in. But of course, everyone's personal circumstances are different and there may be things we don't know about Angela's set up anyway, but that's just some thoughts there.

Dominic Powell

Indeed. And just lastly, your budget tip of the week. What is it?

Jessica Irvine

Yes. So this is a a summer holidays themed tip. This is for people who are going away on holidays and maybe going away on group holidays with family, Friends with family is often you can sort of end up incurring a lot of expenses. You know, you go out for lunch, you go out for dinner, you're buying things, and it's hard to remember who's paid for what. And if there tends to be a serial offender in the group who sort of just puts it on the group

tab and never ends up buying the particular round. There are apps and my favourite one to use is called Kitty Split, so I've used that on the girls weekends when we go away and just if you have an expense, you lodge it into the group. It's just a website actually. It's not an app that we used, it's just a browser. You lodge all the money that you've spent and you can apportion it to who participated in that particular event.

And then at the end it spits out, you know, you owe this person this amount and you can, you know, reconcile it all. And so it's just a little way to sort of avoid if you're the person who ends up sort of picking up the tab because you're a generous hearted person, this might be one to suggest for the group.

Dominic Powell

Yes, it's funny because we do that in my friendship group. We do that for any weekends away that we do. But instead of using an app like this, which would make a lot of sense and be really easy, we have one person who knows how to use Excel and we all give our expenses to that person. And that person makes a very complex spreadsheet which works out exactly who everyone is owed and how much they paid for things.

Jessica Irvine

Is that is.

Dominic Powell

That a goal? Okay.

Jessica Irvine

And can I meet this person? Because I think we would get along.

Dominic Powell

Yeah, I'm. I'm sure you would. He's an Excel wizard. And this is just the way that we we've done expenses for like, I think like the last like four years for any like group trip or anything. And it's, it's notoriously inefficient, it's a terrible way and I, I still don't trust the guy. I don't know how to excel work. So I think something like this would be much better. Yeah.

Jessica Irvine

Kitty split was the No. There are other ones too, so you just google some alternatives. But yeah. Happy holidays everyone.

Dominic Powell

Thanks again for listening this week. We will be back next week with another episode. See you.

Jessica Irvine

Next week. This episode of It All Adds Up was produced by Chee Wong. The information discussed is general in nature and does not take into account your personal financial situation, goals or objectives. You should always do your own research or get professional advice before making any major financial decisions. If you'd like today's episode, hit follow in your podcast app. Leave a review and recommend it to all your friends. You can submit your listener questions in text or audio

format at. It all adds up at nine dot com. You.

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