Is medical insurance worth it ?

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rb99

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#289720 24-Sep-2021 20:20

Wondering about peoples general thoughts on the above. Health care here seems to be pretty good to me and its (kind of) free. Is it worth paying for Southern Cross or similar. We have some but might have to either loose it, or move to a different provider, or pay more to stay where we are, due to moving jobs. Generally the main benefit seems to be improved speed of treatment, but thats against, for us, them paying for only 80% for big stuff.

“The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness.” -John Kenneth Galbraith

rb99

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#2783914 24-Sep-2021 20:33

I've done pretty well out of it, and I worked out the past few years I've come out ahead. If you have a serious illness it will be a big help. Access to your choice of provider, when you need treatment, rather than waiting for the public health system is worth it IMHO. The public health system is good, but everyone there is massively busy and stretched, so you get the minimum. To me it's good value.

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#2783915 24-Sep-2021 20:33

Go with the cheapest provider assuming coverage is the same.

It's a gamble.

You get sick you win.

You stay healthy they win.

gzt

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#2783917 24-Sep-2021 20:52

Having had it and not had it, I'd say it's worth it.

There are any number of relatively minor but irritating conditions where a GP will not think about adding you to a public specialist or hospital waiting list until you've iterated through a number of time consuming diagnostic loops. Some medium conditions are like that too I suspect.

In contrast if you answer yes when the GP asks if you have insurance, quick referral to imaging and things like that, then you're off to a specialist very quickly indeed, and you're all better.

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#2783922 24-Sep-2021 21:23

It’s difficult to answer your very general question without knowing more about your circumstances - it’s a lot like asking a question about investment advice. A decent answer depends on how old you are, your family situation, your employment and financial situation and so on. It’s a ‘how long is a piece of string’ question.

In our case, we are retired and in a good financial and health position, so no longer have health insurance and are quite comfortable with that - we ‘self-insure’. However if I offered that as advice to you it would quite likely be inappropriate for your situation. You have no way of knowing whether or not the people answering you here are in the same situation as you. If they’re not, their advice is irrelevant to you.

TBH I’m not sure it’s a great question to ask here on GZ unless you would like to give a lot more detail about your personal situation.

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jim69

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#2783930 24-Sep-2021 21:41

When you say "main benefit seems to be improved speed of treatment" I don't think you fully appreciate that in our public health system that often becomes "main benefit seems to be treatment". It is a sad fact that our system is only resourced to the minimum, which means that anything that can be deferred often will be so that they can deal with someone with more urgent needs. Critical care is first class, but below that it might fail to meet your expectations. Think here of cancers, heart problems, things that aren't necessarily in failure yet but are degenerating, things where the public system can justify a deferral beyond tomorrow because you are not yet critical but they already have more people who already are than they can treat as it is. Only private medical insurance will get you out of that. I hate it, I hate that we have one system for those that can afford it and another for those that cannot, but it is the reality. I have seen both sides of this in action over the last 10 years or so with both of my parents (excellent critical care and deferral of non-critical care). I honestly feel that I wouldn't have parents alive today if they had not been able to afford S.C. insurance.

In complete contrast I have had it since I was 18 and have never made a claim, wouldn't know the first thing about doing it, but after what my parents have been through I don't regret 1c of the premiums paid. But there is that fundamental: I can afford it. I know everyone has their own circumstances but one thing I did to control the cost and increase the benefits was forgo plans that included anything I could pay for myself, eg GP visits, and I added a large excess, again I can cover that myself, such that if a Big Thing ever happens then for what seemed like "the same premium as general plans" I would get silver service in my private suite. Well, I'd probably not appreciate it at the time, but maybe my visitors would :-) This kind of mix'n'match wasn't actually offered to me, by the way, I had to drag it out of them, but in that sense S.C are like other insurance in that you can negotiate a lot of benefit / cost things to fit your own parameters regardless of what is in the brochure.

Jim

dfnt

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#2783935 24-Sep-2021 21:57

Definitely worth it

Specialist referrals are where it really helps, e.g. cardiologist etc

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mdav056

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#2783940 24-Sep-2021 22:19

It sometimes seems hard to justify -- I pay $500/month with a $1000 excess with SX. While that seems a lot, I've actually been winning for the last 25 years, and continue to do so. SX have very good specialists, and good hospitals, fast approvals. I guess you get what you pay for. Since SX is non-profit, and most (all?) of the others are for-profit, SX should be the best choice. I say, whatever your age, just do it.

gml

Divhon88

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#2783959 25-Sep-2021 01:46

I've been paying NIB $1,800 a year for 2A 2K. We never used it, thank heavens! I think it's a waste of money.

As a migrant who came from a country with no universal healthcare it was a necessity.

I can afford it and will keep it for our piece of mind.

mdav056

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#2784018 25-Sep-2021 07:39

Divhon88:

I've been paying NIB $1,800 a year for 2A 2K. We never used it, thank heavens! I think it's a waste of money.

As a migrant who came from a country with no universal healthcare it was a necessity.

I can afford it and will keep it for our piece of mind.

A rather major thing to consider is -- if disaster strikes, it may become hard to buy usable insurance subsequently as existing conditions may not be covered for a wait period, or not at all. For instance, I am now unable to change insurance companies and still get coverage. So paying for health insurance when you don't need it is an investment against future disaster -- and like all investments it may or may not pay off in the long term.

gml

GV27

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#2784023 25-Sep-2021 08:09

dfnt:

Definitely worth it

Specialist referrals are where it really helps, e.g. cardiologist etc

Definitely, but there's something people miss with health insurance in NZ: It lets you pivot from "Something is actually wrong with me and I have to convince the stretched public system to find space for me" to "I can get stuff done for a baseline and for my own peace of min and help with early intervention in the future".

You're not left waiting around until you're 50+ to get bowel cancer screening, for instance - if you have concerns or lifestyle issues and you have insurance, you can probably wrangle a referral from your GP without too much hassle.

The thing is, if something eventually does go wrong, you've got a lot more data for clinicians to work from and pinpoint the emergence of something. If you're smart about how you use your specialist cover then you can actually really make it work for you in the long run, not just in the here and now if you happen to already be crook.

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#2784025 25-Sep-2021 08:32

I don't have it and won't have it. Would have been handy when starting out on kids orthodontics, which is not covered but some oral surgery that was required at $2000 would have been.

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#2784032 25-Sep-2021 09:06

I have had a SX account since 97. I' ve had two surgeries, a number of imaging tests and a number of invasive tests.

The last one cost me the $500 excess and I asked the hospital how much it would cost if I had to pay directly and was told about $ 5000. Based on how much I've paid in the last 20+ years I might have paid just a bit more than the option of putting the money aside myself - but then what if something had happened? That's the "insurance" part of the deal.

It's all about risk management. Is it worth paying it to avoid the risk of not having it?

What's the risk of you losing your house in a fire and your computer and NAS both being burnt? Is your data valuable enough to justify paying for cloud backup?

What's the risk of you getting involved in a car accident while driving your car? How much will it cost to repair your car, someone else's car? Is your car expensive enough to justify paying for car insurance? What about someone else's car?

What's the risk of your whole bathroom being rotten because of having a broken water pipe? How much would a new bathroom cost?

It's all risk management.

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Scotdownunder

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#2784033 25-Sep-2021 09:12

My take as a fit 70+ is I took the self-insure route since retirement. I keep a good sum of money in a savings account with easy access ( out of my retirement lump sum). Some of this has recently been needed for dental care.

yes, its a gamble of what might I have to pay for private care vs what will I be paying over the years to an insurance company and what they might not cover or require part payment. I think I have come out the better as I still have most of my money but of course your situation will be different.

I also have a reasonably good experience with the public system. I have had good treatment for non-urgent medical issues after a wait but there was no urgency in those cases. Again this can be the luck of the draw as to the issues to encounter.

stocksp

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#2784034 25-Sep-2021 09:13

Ive got health insurance and would probably be dead without it. About 8 years ago I had bowel cancer, although I didn't know it. By the time I went to see the GP the cancer was necrotising and was the size of an orange. I was sent for diagnostics that day and in surgery within a week or so. The public system would have seen me waiting for weeks just to get diagnostics.

Also - a shout out to Southern Cross. I had been a member since the early 90's, but when changing jobs the year before my cancer there was a stuff up and the premiums stopped getting paid (even though I had asked for them to be carried over between employers). Clearly a stuff up and not Southern Cross's. They could have just said 'oh you're not covered, sorry we are not going to pick up the $60k of treatment'. They didn't. They let me pay the years missed premiums (once I had explained what happened), and looked after me. Bouquet for them big time!

afe66

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#2784055 25-Sep-2021 10:11

I self insure but then I am more secure than most.

Only get coverage for big things, the more things that are claimable the higher the premiums.

Analogous to do you claim on everything you can with house and contents.

One friends father didn't have insurance but when he needed an operation he just drew down against the house.

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