Friday, December 10, 2010

Navigating our health insurance



No one likes to pay bills and particularly insurance bills. Insurance is paying for an unforeseen event at an unforeseen time and you hope the 'event' or 'disaster' never happens, but if that insured event or disaster never happens, then it feels like you've wasted so much money for something that never happened. It doesn't feel like you've gotten your money's worth if you never used it, but if something happens, you feel miserable that it happened (eg: burglary, car accident, health problems) but then relieved that you were insured. Insurance is such a lose/lose situation!

How does our health insurance compare with the U.S?
* Some American employers pay for their employees health insurance - we have to pay for our own in Oz
* American public health system is very expensive and is in shambles - our Private Hospitals are expensive, but our Public Hospitals can almost be free with government Medicare help, but in shambles just like America

Inflation on insurance claims and premiums- price revisions apply every April
It's the nasty inflation creep on prices. Every year, insurance bills go up. I didnt' anything on my car insurance (thank God) because I've been incident free for a few years now. As for my crappy health insurance...when you need the health insurance and make a claim, they will only cover a certain percentage, leaving you out of pocket unless you go to a public hospital.

Our health minister will approve any premium increases in February, with all price increases approved to apply on bills from April. You can actually save yourself a few dollars if you pay your premium in advance at the old prices. So if you get your health fund to issue your bill in February and March then you'll get the insurance at old rates for the year.

I've had a few issues with my health last year. From the snowboarding injury to the stomach problems. Turns out I'm lactose intolerant and I got the all clear about my health and that I should stay away from buffets haha ...buffets have too much variety of food and because of that, my allergy could be from anything!

Finances and my health
MBF insurance premiums: $1,200/year (and increasing every single year)
Spending on health and injuries: $3314 (!!!!! yeah, almost made me faint)
Refundable amount: $1,669 (Medicare and MBF partial reimbursements-useless!)
Net out of pocket expenses: $1645
Total out of pocket expenses for 2009/2010: $2845 (ouch, ouch, ouch)

Navigating our health claim system

I'm going to write about this because I discovered a lot of annoying things when it came to our health system. Our health system is behind the times, disorganised and inconsistent. Some places will allow you to claim on the spot, some will be connected to Medicare on the spot, some won't be any of the above so that you have to fill out form after forms, pay all your expenses out of pocket and then claim afterwards. Anyway, to help anyone who hasn't got a clue about navigating our claims system:

Ask your doctor, physio, xray, hospital or whatever medical place you're at:
1) If they can reduce your bill with the Medicare rebate on the spot so you won't have to chase Medicare afterwards to be reimbursed later.
2) If your have private health insurance, ask them if you can claim your health insurance rebate straight away so you won't have to chase your private health insurer to be reimbursed later on
3) If any of the steps above have failed, and they don't offer you a reduction on your bill straight away because they're luddites and not very connected with their technology, then you'll just have to complete paper claim forms
4) The best claim form to fill out is a Medicare two-way claim form. That means you print off the pdf, fill it out, attach all receipts/invoices and complete the health insurance information, and then Medicare does all the running around for you with your Private Health fund. If you include your EFT information, it's insanely easy because before you know it, in one to two weeks time, both Medicare and your Private Health Fund will have deposited the reimbursement amount into you account. No cheques to deposit at the bank.

I wish someone had told me all this before I went through last years tedious health system. I didn't know about asking them upfront for my bill to be reduced because of Medicare and my Private Health Insurance, I didn't know about the two-way claim form. I would photocopy my invoices/recipts and send off the original to Medicare with a single-way claim form and then complete a claim form with my Private Health Fund with the photocopies and ask them to ask Medicare for the originals. Hah! Stupido and convoluted! That's happen when I've never had any health problems and my genes are great as indicated by the lack of health issues from my own parents and relatives. Fortunately I finally figured it out a few months ago and it's been really simple.

Fortunately I haven't really had any more health issues in the past few months. Spending on health issues is the biggest waste but unfortunately it's something that's gotta be done. It may also prevent bigger medical issues in the future as a result of neglecting your health today. But if I stopped snowboarding then maybe I'd save up so much more (less trips and less injuries)...but giving that up...impossible...


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