Health insurance - common questions

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Q. What is health insurance for?
A. When you are faced with a serious health problem, instead of receiving treatment through the public system, its waiting lists, and associated delays and access problems, a person with health insurance can have private treatment paid for.

Q. Do I need health insurance?
A. Your health is your biggest asset. People seem to have no trouble remembering to insure their home or car, but often forget to take care of the most important thing - their health. We don't know what kind of health problems will affect us, or when they’ll emerge. Think about what would happen if you faced a serious health problem. If you’d want to be able to get the treatment you need, at a time and place of your choice, then health insurance is the way to go.

Q. Can I wait until I'm older to get health insurance?
A. It's actually really important to get cover early while you're still healthy - before you develop any medical conditions. If you suffer a sickness or an injury before getting covered, that condition can be permanently excluded from your health plan. The earlier you start your health insurance the greater the chance that you’ll have a policy with as few exclusions as possible.

Q. What type of health insurance should I get?
A. First of all, make sure your plan covers 100% of your major medical expenses. Some plans offer cover for day to day medical costs - costs like GP visits and prescription charges. We recommend that people get cover for major medical expenses and pay for things like GP and dentist visits themselves. The reason is simple – health insurance that pays for these small costs is hugely expensive and simply doesn't offer value for money. A good rule when looking at insurance is to only get it for things that you can't afford to pay for yourself.

Q. What is an excess?
A. An excess is the portion of any claim that you choose to pay. If your medical bill is $3000 and your excess is $300 the insurance company will pay $2700 and you pay $300. Most plans offer a range of  excess options to choose from (and the bigger you choose, the lower your premium will be).

Q. Some health insurance plans offer a "Specialists & Tests" benefit. What is this?
A. Sometimes your GP will recommend that you see a specialist or take a test. As long as these relate to a medical problem that requires admission to hospital (and occur within a certain period of time either side of that admission), the costs of visiting specialists and taking medical tests will usually be covered by a major medical plan. Some plans also give an option so that visits to specialists and recommended tests are always covered - whether or not they relate to a medical problem that requires admission to hospital. This is often referred to as the "Specialists & Tests" benefit.

Q. Can I get cover for pre-existing conditions?
A. Pre-existing conditions are health conditions that exist at the time you apply for insurance. Getting cover for these can be difficult, and it’s important to discuss any issues you’re aware of with your adviser (as this can have a big impact on the health insurance plan that’s right for you). Most insurers treat these in one of three ways: by permanently excluding that condition from your cover, by charging a higher premium to cover that condition, or by offering cover for that condition after your policy has been running for a set time (often 3 years).


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