By St.LukesHealth CEO Paul Lupo

In Australia, we have come to expect that we can access health treatment straight away.
However, sometimes accessing healthcare means having to wait for treatment, especially for those Australians without private health insurance.

Each year on April 1, health funds across Australia release their new premium rates for the coming 12 months and naturally consumers question whether they are receiving value for money through their private health insurance.

And it is a hard decision to make. The true cost of maintaining your health is not simple to calculate as you cannot foresee the need for, and the potential cost of treatment. For example, a simple hip replacement could cost you $30,000.

In comparison, if you have comprehensive car insurance and you decide to change to third-party insurance you know your potential loss is limited to the cost of replacing your car.

According to Private Healthcare Australia’s Annual High Claims 2018 Report, private health insurers paid more than 17,000 claims with benefits exceeding $10,000 for people aged under 30.

The highest claim for a private health insurance member under 30 was for a 16-year-old male with gastrointestinal bleeding with a cost of $221,195.

Despite the high potential costs of healthcare, many young Australians do not see the value in private health insurance and live by the belief that “it won’t happen to me”.

While wage growth has stagnated and household debt is at an all-time high, the rise of buy-now, pay-later services is touted as an alternative solution to those requiring urgent healthcare.

Buy-now, pay-later schemes are increasingly being promoted by some health providers, particularly optometrists, dentist and fertility clinics, meaning that high-value purchases – or access to treatment – can be made instantly.

Private health insurance provides peace of mind that when something does go wrong, you will be covered and have access to care in a timely manner.

There is a growing concern that young Australians without private health insurance risk becoming trapped in a cycle of debt to cover treatment, whether it be through credit cards, personal loans or buy-now, pay-later programs.

Health insurers offer general treatment cover, which provides members with benefit for dental and optical services. In a growing number of cases, insurers provide “gap-free” options meaning the member is left with no out-of-pocket cost.

In 2018, St.LukesHealth paid more than $9 million on preventative dental services on its Super Extras general treatment product, with 95 per cent of members having no out-of-pocket costs associated with their care.

Consumers are entitled to ask their dentist, optometrist, health insurer or hospital about any extra money they may have to pay for treatment. This is called informed financial consent and will ensure that you do not receive any financial surprises.

If you have private health insurance and are considering the value of your product when you receive your rates notice, I challenge you to think hard about the value and security your cover provides.

If you are not receiving value and don’t feel your level of cover is working for you, speak to your health insurer and ensure you are getting a product that is suitable for your lifestyle and financial needs.

Without it, could you afford to finance a significant health event or afford to be incapacitated for an extended period while waiting for treatment in the public system?

Health really is our most important asset and it is worth insuring.