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Why should I keep private health insurance?

6 minute read
A man in a consultation with his doctor

If you’re fighting fit, have no family history of serious illness and are unlikely to be heading to hospital anytime soon, you might be asking yourself, “Do I need private health insurance?”

The truth is it’s impossible to know what’s around the corner, which is why one of the biggest benefits of your cover is knowing you and your family will be protected against the unexpected. And peace of mind is just one of the many benefits you’d lose if you decided not to continue your policy.

To help you make an informed decision, we’ve outlined seven reasons why your nib health insurance is worth it.

Why you need private health insurance:

1. Chances are you’ll use it

Last financial year, we funded over 270,000 hospital admissions and almost 3.4 million Extras visits for our members, amounting to almost $4 million paid in claims per day. The average benefit paid on behalf of our members for a hospital episode was $3,200, which isn’t exactly loose change.

2. Can you afford to wait?

Without the right cover, wait times in the public system can be weeks, and even months. And if you choose to go to a private hospital without the right cover, your treatment won’t come cheap.

Did you know the median wait time for a knee replacement in the public system is 195 days1? With the right level of nib hospital cover, you choose when and where you get your surgery – meaning you can get back to work - and play - quicker.

A woman holding her injured ankle

3. Receive the private hospital treatment you want

With the average hospital stay lasting almost 5 nights, nib aims to make your recovery just that little bit easier. From the privacy of your own room to having a say in which specialist you see, our hospital cover gives you more certainty and choice.

Private hospital cover helps our members avoid public hospital waiting lists, pays benefits toward the cost of private treatment and also allows customers to (subject to availability):

  • Choose the specialists who treat you
  • Attend the nib Agreement Private Hospital or day facility of your choice
  • Decide when you’ll be treated with your doctor
  • Stay in a private room

4. Protect yourself in case of emergency

Are you one of the 25% of Australians who think Medicare will cover the cost of your ambulance in an emergency? Unless you live in Queensland or Tasmania, the costs associated with ambulance services – whether it’s an emergency situation or not, and regardless of who made the triple zero call – will be incurred by the patient.

The average ambulance claim for nib members in FY17 was $8,4212, and the most we paid for a member’s ambulance claim over the same period was $10,475. If you’re with nib, there’s no need to be caught out by the cost of an expensive ride; every nib hospital cover includes unlimited emergency ambulance3.

Find out how much you can expect to pay without the right cover.

5. Keep calm if accidents happen

It’s not just ambulance fees you have to keep in mind. While public hospital healthcare (including emergency treatment) is free to all Australian citizens and most permanent residents, if you need further treatment after your initial admission, that’s when the costs (and waiting times) can quickly add up.

On the majority of our hospital covers, nib offers extra protection against the unexpected with the Accidental Injury Benefit.

If you’re an nib member on an eligible hospital cover and you seek treatment within 24 hours of an accident at a hospital emergency department, you’ll receive benefits in-line with our top hospital cover for the following 90 days.4

active older woman is using her private health insurance for rehabilitation

6. Potential savings on tax and loadings

- Medicare Levy Surcharge

If you're earning over $90,000 as a single or over $180,000 as a couple, family or single-parent family, you could be affected by the Medicare Levy Surcharge if you don't hold private hospital cover for the full financial year. If this sounds like you, you could be up for $900 or more in extra tax if you don’t have the right level of Hospital cover.

- Lifetime Health Cover loading

If you don’t have private hospital cover by 1 July following your 31st birthday, you might have to pay a Lifetime Health Cover (LHC) loading in addition to your standard premium. The LHC is a Government initiative put in place to encourage people to take out private hospital cover earlier on in life.

For every year you delay taking out health cover after turning 31, you’ll be charged a 2% loading on top of your premium when you take out a policy. The LHC loading is applied to your health cover when you join, and you’ll need to pay this loading for 10 consecutive years before it ceases to apply.

- The Australian Government Rebate

To make private health insurance more affordable, the Federal Government provides many Australians with a rebate, known as the Australian Government Rebate (AGR). If you earn an income of $140,000 or less as a single, or $280,000 or less as a family, you are eligible for the rebate. Find out which rebate tier you fall into and what percentage of your premium the Australian Government will cover.

7. Helping to keep you healthy

Through Medicare, you can be treated in a public hospital as a public patient for no charge and receive subsidised prescription medicines and GP appointments. However, Medicare doesn’t cover the costs of your Extras appointments. If you need dental treatment, a new pair of specs or rehab with a physio, you’ll be left to foot the bill.

At nib, we encourage members to talk to our expert team about selecting a policy that best suits their needs and budget. If you're not sure your current cover meets your needs, but don't know where to start, contact us – we’re here to help.

Looking to get private health insurance? With nib, you can get a quote in just a few minutes.

1 Median public hospital wait times sourced from Australian Institute of Health and Welfare data, Public Hospital wait time for public patients (days) 2016 - 2017. Actual wait times will vary by hospital and severity of the condition.

2Average ambulance charge incurred by nib members between July 2016 and June 2017 (excluding TAS and QLD residents).

3There are no annual limits for emergency ambulance with nib, but it is excluded for residents of Queensland and Tasmania because they have ambulance services provided by their State Ambulance Schemes.

4Excludes consult at an Emergency Department. Accidental Injury Benefit criteria must be met for approval.

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