Medical Insurance Options- Thoughts and Feelings?

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Jaxson

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#146766 28-May-2014 15:56

Hi,

A friend of mine just signed signed up with Bupa in Australia. It's a fair amount but it covers dental after 2 months and pre existing conditions after 1 year.

I had a quick look but they're not set up like that in NZ, so I wondered what other people are using here?

I found NIB but they've got some plain weird bits, like really low caps despite advertising that they cover expensive stuff like braces and crowns etc.

Ideally I'm after Dental cover to some degree, as I've been shocked with the costs of visits lately.

My work offers a subsidised plan through Southern Cross but they don't appear to be in any rush to take my money, and I'm still waiting to see if the work tie in actually amounts to anything substantial really.

Thoughts from others are appreciated. (Not so much on the wider 'do you really need it' discussion, but more on what people who did chose to purchase actually decided upon, and how it's worked out in practise etc.)

Thanks.

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Geek @ Coastguard NZ
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#1055210 28-May-2014 16:01

We just had SC in the office talking to us about their plans, dental dosent come into it much with them apart from their top end plan IIRC - with our work subsidy its not a bad price, but only if you think you'll really use it.
I'm just on the RegularCare which is more than enough for me, the money I "save" from doctors visits etc, will go towards any dental work ;)

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Lias

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#1055288 28-May-2014 17:52

Been with SouthernCross for years, fairly happy and they are a non profit too.

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Geektastic

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#1055347 28-May-2014 19:03

Jaxson: Hi, A friend of mine just signed signed up with Bupa in Australia. It's a fair amount but it covers dental after 2 months and pre existing conditions after 1 year.

I had a quick look but they're not set up like that in NZ, so I wondered what other people are using here?

I found NIB but they've got some plain weird bits, like really low caps despite advertising that they cover expensive stuff like braces and crowns etc.

Ideally I'm after Dental cover to some degree, as I've been shocked with the costs of visits lately.

My work offers a subsidised plan through Southern Cross but they don't appear to be in any rush to take my money, and I'm still waiting to see if the work tie in actually amounts to anything substantial really.

Thoughts from others are appreciated. (Not so much on the wider 'do you really need it' discussion, but more on what people who did chose to purchase actually decided upon, and how it's worked out in practise etc.) Thanks.

I can't get cover worth paying for now since I had open heart surgery. I can't get life insurance either, so am probably technically in breach of my mortgage conditions too...!

We did have cover from Tower through SWMBO's employer some years ago that covered pre-existing conditions etc but once she left that employer the premiums escalated to about $600/month for two of us so we waved it bye bye!

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#1055358 28-May-2014 19:19

Dental treatment is very expensive.
Therefore insurance that covers dental work has always been prohibitively expensive.
Anyone wanting dental insurance probably already needs dental work - so it costs the insurers even more - so insurance costs even more.

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billgates

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#1055454 28-May-2014 21:01

Accuro gets my vote. Service, premiums and payout value is great.

Do whatever you want to do man.

blakamin

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#1055473 28-May-2014 21:15

I used to have Southern Cross through work in NZ... They covered my whole family and pre-existing, which was awesome when I needed an op years ago. They paid up no worries.

Geektastic

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#1055531 28-May-2014 22:29

Sideface: Dental treatment is very expensive.
Therefore insurance that covers dental work has always been prohibitively expensive.
Anyone wanting dental insurance probably already needs dental work - so it costs the insurers even more - so insurance costs even more.

I've never understood why dentistry is not regarded as a normal part of any health service. If I can get my heart fixed, why not my teeth?

I can see that cosmetic dentistry could be a paid option but normal maintenance type stuff not so much.

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#1055551 28-May-2014 23:22

Geektastic:
Sideface: Dental treatment is very expensive.
Therefore insurance that covers dental work has always been prohibitively expensive.
Anyone wanting dental insurance probably already needs dental work - so it costs the insurers even more - so insurance costs even more.

I've never understood why dentistry is not regarded as a normal part of any health service. If I can get my heart fixed, why not my teeth?

I can see that cosmetic dentistry could be a paid option but normal maintenance type stuff not so much.

probability. you're much more likely to claim on dental every year, than to claim for heart surgery.

insurance is all about risk. they are typically for-profit companies, so they need more premiums coming in than they need claims going out.

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itxtme

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#1055588 29-May-2014 01:22

I think he was suggesting it should be covered by th DHB. It wont ever - far too expensive!

JayADee

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#1055608 29-May-2014 07:27

Income insurance is more important than house insurance...

jnimmo

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#1055612 29-May-2014 07:34

SX has been mucking a few of our customers around recently.. They have decided one type of treatment isn't worth paying for despite having done it for years and it being publicly funded in many countries overseas. I'm confident they will come around, but a pain for those that it is currently affecting.

gjm

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#1055614 29-May-2014 07:42

I am with SX and was able to get my wisdom teeth out under the surgical policy (which cost about 5k all up). Had the dentist just done it I would have had to fork out about 1k myself. Getting surgeon to do it while under GA was a no brainer. SX paid everything promptly and was zero hassle.

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Jaxson

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#1055727 29-May-2014 10:34

Geektastic:

I've never understood why dentistry is not regarded as a normal part of any health service. If I can get my heart fixed, why not my teeth?

I can see that cosmetic dentistry could be a paid option but normal maintenance type stuff not so much.

I fully agree, and it's a decision at government level that has determined this. Not all countries leave dental as isolated as we do here.
www.nhs.uk link...

All political and emotional discussions aside, I honestly don't know how a lot of NZ families are coping dental wise. I'm looking at around $100 for a checkup and in the $250 - $350 bracket for a single tooth filling.

Thanks for all the suggestions thus far, I'll look into some of those.
Still waiting for Southern Cross 'sales' to come back to me with some info, any info actually...

wasabi2k

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#1055741 29-May-2014 10:50

gjm: I am with SX and was able to get my wisdom teeth out under the surgical policy (which cost about 5k all up). Had the dentist just done it I would have had to fork out about 1k myself. Getting surgeon to do it while under GA was a no brainer. SX paid everything promptly and was zero hassle.

Yeah they cover Oral Surgeons under WellBeing etc - that is separate from Dental - which is a separate module (and cost).

As someone who is probably getting braces this year - braces (and most orthodontic stuff) is explicitly excluded from almost all policies.

Fred99

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#1056424 30-May-2014 11:05

I have very mixed feelings about SX. Firstly, while the organisation itself is nominally "non-profit", the ownership structure is through trusts with interested parties receiving remuneration through provision of services. So it's not right to think of it as some kind of "charity". It serves to keep salaries at very high levels - whether that's "fair" or "reasonable" and how that relates to maintaining "affordability" of a public heath system is another discussion point perhaps.
We had SX regularcare family cover as part of my remuneration package for 15 years or so. That was of course at no cost to me (I couldn't trade the deal - declining the SX offer for a salary top-up). In 14 out of those 15 years, I doubt we claimed more than $150 PA (Dr visits, occasional prescriptions). Over that period I changed employers, and the scheme was able to be transferred over - which was good.
One year however, my wife finally needed an operation for a pre-diagnosed (before joining the scheme) condition. This was covered through the employee SX program (after 3 years membership), but I expect would not have been covered for a private individual seeking cover.
There is a schedule of (maximum) payment allowances in the SX (and other) health insurance policies. This is curious - no doubt overall it helps keep costs down, but for example, if you took out an extended mechanical warranty on a car, then it's not set out that they allow eg $2500 for a new camshaft, $250 for each piston etc. Yet the average person has a much better understanding of costs to fix a car, than how close the extensive SX schedule relates to real costs. Even a GP working in the "industry" really has no idea what the actual costs are for specialised treatments, medical devices etc.
As it turned out the nominal "80%" cover didn't even come close. The medical device (prosthesis) cost was 3x higher than the SX schedule, each and every cost (in an SX hospital) exceeded the schedule maximum, surgeon, anesthetist, room charges, sundries etc etc. The final reimbursement covered only about 45% of the procedure. It still cost us about the price of a small new-ish car. The op was a great success, so no complaints there.
However, had we not had the insurance, then the operation would have been carried out in the public system, and although there would have been some wait list, being young, employed, with family, it would have been prioritised - so that the wait may not have been very long at all. The accommodation in the public hospitals lack some of the luxury of private hospital, but I'd argue that if and once you're well enough to enjoy those luxuries post-op, then unless you're connected up to drips etc and/or need continuous monitoring, and someone is available to provide home-care, you probably shouldn't be in hospital anyway, but discharged as soon as possible.
The cost example I gave above is probably an exception rather than the norm. But as you get older (with luck you will - it beats the alternative, so I'm told), then you get the triple whammy of massively increased insurance costs, possibly bumped down the wait list in the public system, while of course you probability of needing treatment starts increasing exponentially. Long term, I suspect the best option may be to put aside cash for a rainy day, and start doing that when you're young.

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