Is medical insurance worth it ?

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#2784074 25-Sep-2021 10:29

Depends on age and stage.

Personally I think it is pretty hard to justify comprehensive or super-type covers - the ones that pay for routine doctor consultations and prescriptions. Those are pretty expensive and you would have to be having a lot of consultations to make it stack up. And that assumes you are organised enough to keep the receipts to make a claim etc. (I'm not). Though it might make sense in some circumstances, but I'm not sure what those would be.

We do have surgical cover though with a decent excess to balance out the premiums. We're lucky enough to be reasonably fit and healthy and on reasonable incomes. While it would definitely be a grudge purchase, we can pay a $1000 or so medical bill for a scan, diagnostic or very minor medical procedure if push comes to shove. However a $10K or $20K issue would be another story.

Dynamics also change a bit when you have kids. When Littlest Miss MDF was 2, she needed a reasonably urgent but straightforward procedure. Not life threatening or anything but was looking at a 4-6 month wait on the public list but we had it done the next week privately. The peace of mind for that was pretty much worth the price on its own.

I suspect we're behind on the premiums vs claims over the lifetime of the insurance, but that's basically the nature of insurance.

Overall I think NZ's healthcare system is pretty good and will help you with the big issues - save your life heart attacks, cancer etc. But the more routine, not save but improve your (or your kids) quality of life can be a bit more hit and miss. I think it basically comes down to if you had a sudden medical bill for something, how much could you afford out of your own pocket?

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rb99

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#2784087 25-Sep-2021 10:59

Don't really want to go into too much detail, and its an in-process thing anyway.

Its moving jobs from a company that did Southern Cross to one that does some kind of diary industry scheme, think its Unimed. We hope to carry on with one or the other, not drop entirely.

Anyway, the new company seems to pay a certain fixed amount for medical insurance (for this scheme) but it might possibly be available for any scheme (such as carrying on with SC) but not sure yet. Other family members you can add but you pay for them yourself. That seems to be the same as it was for SC but we're not sure about that either as it seems to be a big secret with SC about company bulk deals and discounts and things. Therefore new company scheme might cost significantly more, but then SC might cost significantly more if we stay with them but have to pay as individuals. So there are things we need to ask about / clarify.

I can't say I like two tier medical care any more than I'd like a two tier police or fire service, but it is what it is and we probably need to look after our 50+ aged selves as we can.

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#2784095 25-Sep-2021 11:17

I dont have it due to cost but last year I ended up in hospital for 6 months with necrotising pancreatitis, 3-4 months of that was in the ICU/HDU.

I also remember an ICU doctor having a chat (after coming out of an induced coma) that there will be a time when they will have to stop treating me no matter what the success rate is, lucky for me that did not happen.

While there I was getting CT scans about a week a part,X Rays, medical drains and the only thing I could not get straight away was a gastroscopy which was very hard to get, apponitments set were getting cancelled/changed.

I got by without medical insurance but it happening in Auckland and me being in Middlemore Hospital with excellent staff on hand, helped.

If it had been any where else in NZ, it may have been a different story.

mclean

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#2784102 25-Sep-2021 11:46

As someone who has had comprehensive health insurance all my life, and now past retirement age, some thoughts:

If you run a simple PV calculation on the premiums you'll pay over your lifetime (allowing for the fact that premiums increase dramatically as you get older), and compare that with the fund you would accrue if you instead invested the premiums, the answer will shock you! Investing the premiums will put you at some risk until the fund builds up, but that's when you are much less likely to need it.

Once you reach retirement age (when you are most likely to have high medical expenses) it's practically a certainty that you won't be able to afford to the premiums. At this point you are looking at no insurance vs a very substantial investment.

Having health insurance makes medical care easier and nicer, and sometimes quicker but definitely not always. You're dealing with the same specialists and often the same facilities as the public system, particularly with some of the high-end facilities.

Nudibranch

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#2786102 29-Sep-2021 10:16

If you do get health insurance don't swap around.

Seems history plays a bit of a part. When we got our mortgage sorted with an outfit they upsold us on Sovereign HI. Encouraging me to move away from SX.

Should never have done it. Anyway, a couple years later needed to make a claim and got dicked by Sovereign pretty hard. Ended up going back to SX and being on their Ultra plan for 3 years after which they dismiss pre existing cond. I've now downgraded plans and am super glad to be back with them. They're efficient, pleasant to deal with and quick with no probs... so far. Have had to make a couple of claims recently and it's smooth as. Glad I'm back with them. and I'm staying put.

RUKI

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#2787262 30-Sep-2021 18:49

One of my clients in his 70-s got 3 major operations in a public sector recently (knee replacement, foot bones operation and skin cancer).
When you are young Insurance would lure you with $25 something premium covering all imaginable things which healthy person would not have for next 50 years.
When you are around 60, and regardless whether you are healthy or not, they would treat you as a high risk, covering minimum but charging you hundreds per months.
Tower was rising their premiums steadily by !!! 15% per year, so that your annual cover becomes something like $7000 / year without you using a penny out of that investment. So waste of money in my opinion.

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JPNZ

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#2787472 1-Oct-2021 07:59

We have SX through work, works pays the majority circa $80 p/m and I top up $25 p/m to a higher level and lower excess. Its well worth it even though I'm fit & healthy. My mother just had a knee replacement and hip replacement within the last 5 years and together cost over $50,000.

Not worth the risk imho, if something bad happens and you can't afford to get the best care possible.

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allio

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#2787516 1-Oct-2021 09:38

I work in private health and can tell you that most people who choose to "self insure" significantly underestimate what common procedures actually cost. Even the simplest orthopaedics procedures are usually $10-15k (not counting the $1500 worth of MRI scans you might have beforehand). More procedures than you'd think are $20-30k. And if something goes wrong with your spine, it can be $50-100k. That's just the surgery - not the lost income you have while you're recovering. I wouldn't consider you genuinely self-insured unless you had in excess of $100k set aside as a 50+ couple, with the ability to replenish that within a few years if you had to draw down on it.

gehenna

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#2787519 1-Oct-2021 09:40

I would have said no not really worth it pre-covid considering my experiences in the public health system have been largely positive. But post-COVID it's probably better to have the option to fast track privately if you can't afford the cost to do that without insurance.

timmmay

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#2787526 1-Oct-2021 10:01

I got my health insurance renewal this week, which told me what I paid and what they paid out. It's worked out very well for us. I check every year, even paying for the extras like physio and optometrist extensions we come out ahead. We mostly have it for the big things though.

Fred99

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#2787771 1-Oct-2021 18:33

allio:

I work in private health and can tell you that most people who choose to "self insure" significantly underestimate what common procedures actually cost. Even the simplest orthopaedics procedures are usually $10-15k (not counting the $1500 worth of MRI scans you might have beforehand). More procedures than you'd think are $20-30k. And if something goes wrong with your spine, it can be $50-100k. That's just the surgery - not the lost income you have while you're recovering. I wouldn't consider you genuinely self-insured unless you had in excess of $100k set aside as a 50+ couple, with the ability to replenish that within a few years if you had to draw down on it.

Problem with that analysis is that if you're young, not only are you far less likely to need private orthopaedic procedures (especially so - as many of those will be fully covered by ACC). When you're older and much more at risk, health insurance may not be affordable, and you're far more likely to be denied ACC cover because "wear and tear".

On average, those with private health insurance lose out - same can be said with every other form of insurance.

nash

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#2787937 2-Oct-2021 01:09

I've had this discussion numerous times with a few family members who are doctors... Their view is that we have a great health system why spend that extra when you'll get what you need on the public system eventually anyway.

I completely disagree with their statements.

Like some posters have already pointed out you get dealt with quickly and efficiently with health insurance. Additionally, who knows what a post covid world will look like.

Currently, my employer covers me and we get reduced rates for the family. Our current plan gives us $5k each annually for specialists.

Luckily, we haven't had anything serious by for the kids we've had a few respiratory and dermatology consults and they are easily $300+ per visit. From memory that's $1800 worth of value already that's covered almost our annual premium

Bottom line for me and my family is wouldn't be without it and very thankful with the employer discounts scheme.

Quinny

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#2789009 4-Oct-2021 11:29

SX since the 80s. Yet I am way ahead. In last year alone had 45k in eye surgery (9 issues in 4 ops) would be waiting years to be done on public. So the $110 a week is cheap to keep these old bones going.

Fred99

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#2789058 4-Oct-2021 12:56

Quinny:

SX since the 80s. Yet I am way ahead. In last year alone had 45k in eye surgery (9 issues in 4 ops) would be waiting years to be done on public. So the $110 a week is cheap to keep these old bones going.

What ops?

My recent experience getting care for someone with an acute eye condition at Chch public has been exceptional - "free" was a bonus.

For something like cataract surgery, then not so much. You'd need to be technically blind before you get in. But that cost $7k for two eyes.

Quinny

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#2789069 4-Oct-2021 13:13

Fred99:

What ops?

My recent experience getting care for someone with an acute eye condition at Chch public has been exceptional - "free" was a bonus.

For something like cataract surgery, then not so much. You'd need to be technically blind before you get in. But that cost $7k for two eyes.

3 vitrectomies inc an emergency one, 2x cataract surgery, retinal tear and epiretinal membrane to super-rare (1 in 5000 or more) side effects including Endophthalmitis (from first vitrectomy) and Cystoid Macular Edema (from cataract surgery which was from the vitrectomies). I did a printout of the bills SX had paid and it was over 45k before the latest round as the edema and a new epiretinal membrane are ongoing. I got a concussion in 2019 and ACC would not accept the floaters afterwards were from it. It was fixing the floaters started the above merry go round.

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