Health insurance

Top 10 Things To Know Before Buying A Health Insurance Policy

by Lily White
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Most Australians pay 2% yearly on their income taxes to help the country pay for Medicare costs. It is required, so it is simply part of your taxes that you must accept. You don’t have to accept the extra fees the government will charge you if you earn over a certain yearly income and do not have private medical insurance. Currently, those limits are as follows:

  • $90,000 – Single earners.
  • $180,000 – Familie earners.
  • $1,500 – Per child after the first one.

If you earn more than the limits listed and have no private medical insurance, your taxes will also reflect another Medicare tax that could be up to another 1.5% of your yearly earnings. Most of the time, you will find that having your own medical insurance policy is cheaper.

But do you know anything about health insurance and how it works? You may comprehend the basic concepts of the policy they are offering you. Still, before making any decision, you need to understand the top 10 things before buying a health insurance policy.

Age Is A Huge Factor In Medical Insurance

Most insurance carriers do not want to insure older people within the population because they are at a much higher risk. You require more medical attention when you age, which means more medical visits. To the insurance company, this means more money they have to pay out of their profits.

You can see how this may become a problem. Get a health insurance policy before you turn 40 because your insurance will go up around 6% in that age group. When you hit your 50s, you can expect an increase of 10% or more. If you do not have health insurance before then, the carriers may not accept your application if you have never been a policyholder.

What Health Insurance Plan Should You Go For

When checking into a health insurance plan, you want to ensure that you are not one of the many people paying for something they do not need or paying too much for what you require. Before you figure that all out, you need to know about the three different types of policies so you can decide if you need them in the first place.

  • Ambulance Coverage – This one is self-explanatory. It will cover the costs of being transported by ambulance to the hospital in emergency situations. This one is important if you do not have people around you that can give you rides when needed. Or if you have some pre-existing medical conditions that could cause you significant issues.
  • Hospital Coverage – This type of medical insurance will help cover the costs you acquire while in the hospital. The amount it covers will be entirely up to the level of coverage that you have chosen to pay for.
  • Extras Coverage – This is the section of health insurance policies that pay for medical visits outside the hospital, such as dental and eye care. You can combine this with the hospital coverage to get a better deal, but remember that the more extras you add to your policy, the more you will pay in premiums.

The main policy you will want to opt for is hospital coverage. If you have teeth or eye problems, you may want to add them to the extra part of the policy. The ambulance coverage may not be a part of the policy that you need, but if you can get it added on for a reasonable price, you may want to consider putting it on the contract. You never truly know when something terrible is going to happen.

Waiting Periods Can Be A Problem

If you have pre-existing problems, are pregnant, or have never had a policy before, the insurance carrier may add a waiting period to your policy. This means you would not be able to file a claim against them for that condition. This is another reason you should get health insurance earlier in life before having any issues or deciding to have a baby.

This waiting period can be a game-changer for you because if it does not cover an appointment in a month, you need to ask yourself if it is worth the effort. If you are over the annual earning limits, you will have to get a policy regardless, but you will want to check to see if the insurance agent adds a waiting period to your policy.

Policy Premiums Can Vary Drastically

When looking around for a policy, you need to compare several insurance carriers and see what they offer you. As well as how much they want every month to cover the cost of the premiums. When figuring out how much private health insurance costs, you will want to go to an online comparison site. They do all the hard work for you, offering a variety of policies from the little information they ask you to put in.

From there, all you will have to do is go through all the offers and find the one that best fits your needs. Do not just judge the policy by the price because of the golden rule when buying insurance: “The cheapest insurance policy may not always be the best policy.” Check all the specifics of the offer and then compare the pricing.

Cashless Hospital Visit Benefits Are Important

If an emergency arises and you need to be rushed to the emergency room, you do not want to have to deal with all the tedious paperwork and payment requirements that the hospital will want. You can go to the hospital if your insurance has a cashless visit option and be taken care of without any delays or issues.

This happens because the insurance company will pay the hospital the exact amount of the cost you have incurred. They do this because you have been a paying customer of theirs, and you opted to have cashless hospital visits added to your policy. If you read the policy and it is not mentioned, ask your insurance agent what you must do to get it included.

Maternity Expenses Are On the Rise

Even if you are not planning on having children any time soon, you will want to ensure that the policy you are considering has this type of coverage. The cost of pregnancy, and a birth, currently averages around $9,000 for a normal pregnancy. One that ends in a C-section will run you up to $14,000 or more if emergency situations arise.

Most of you will not have that much money lying around to pay cash for pregnancy services, so getting a policy that covers its costs is crucial. Remember that you need to get the policy before you are pregnant. Otherwise, the carrier may put a waiting period on the account. A waiting period that goes past the length of the pregnancy so they will not have to cover any of the expenses from it.

Medical Coverage Should Include Pre And Post Needs

You will want to check to ensure that your insurance covers everything you need after visiting the hospital. You already know that they will pay for the visit, but if you are released to go home but need a nurse to help you get well, you will want to have coverage for it. Or, if you need medicine to alleviate your pain before surgery, you will want to know that the insurance will cover it all for you.

Pre-care and post-care are the two parts of a visit that most people do not account for. Unfortunately, it is a grey area for most insurance agents. This means you have to ensure that it is written down in the contract. What exactly do they cover, and what is not included.

Preventative Health Care Can Be An Issue

Some insurance companies will have exclusions built into their policies for preventative care. This means they will not cover your yearly check-up to ensure everything is working correctly. This is one thing that you must look for in the insurance policy offers. If they do not allow these visits, you will want to go on to another insurer or find out what you have to do for them to kill the clause.

This is important because preventative care can help medical professionals catch any cancer that is starting to spread, heart issues that are beginning, diabetes that may need to be controlled, and so on. The point is that it is always better to be proactive than reactive, so if you can make a visit to the doctor to help prevent life-threatening illnesses, you need to do it.

The Co-Payment Clause Must Be Analyzed

Many insurance companies will require that you pay a set amount up front to the hospital when you go in for your care. This may be as little as $20 a visit or as high as 50% or more of the bill. It all depends upon the policy that you have. When reading the offer, take special care to check for the co-payment information so you do not get surprised the first time you visit the hospital.

Claims Process Needs To Be Simple

The claims process should be simple for you. When you go to the hospital, you should hand over your information to the check-in desk, and they should be able to do the rest. You will have to make your co-payment before you are seen, but you should not ever have to worry about the process.

It is essential to know this process before you actually have to do it. Otherwise, you may be sitting in the hospital with a bleeding ulcer but unable to be seen until the paperwork has been filed and authorized. That is, if you are coherent enough to do so.

Final Thoughts On What To Know Before Buying Health Insurance

This may seem like a ton of things to remember and check for, but if you read through the offer or policy thoroughly, you will know the specifics of the contract you will need to have now and in the future when you use the insurance card.

Remember that not all insurance companies are equal, and none of them will offer you the same coverage for the exact premium costs. You need to compare, find the best plan for you, and then check how much it will cost to obtain.


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