Healthcare Haggle … and February 2023 – End of Month Update

Slack Investor’s Dental Shenanigans

Laying in the dentist’s chair recently, I was confronted with the bad news that I was up for a dental implant and this would probably set me back about $8000 – Lucky I was lying down!

After the initial shock, Slack Investor resolved to start treating his interaction with healthcare in the same way that he would treat any other professional service. I have decided to be an informed consumer and take control of the financial side of my healthcare. Lets get some quotes!

An internet trawl and a few phone calls later, I had a quote for around $4000 – dependent on an inspection and a dental scan. After the initial consultation, I asked for a written quotation. The quote was emailed to me and, subject to some caveats about extra costs if any bone grafts were necessary, came in at $4050 – Bewdy, lets go with this. In a classic piece of “anchoring bias”, if someone mentions $8K … and you end up with a price of $4K, this new price feels like an absolute bargain.

In retrospect, I was satisfied with the whole experience and enjoyed the empowering feeling of having some knowledge of the range in costs for a particular treatment. Because I am lucky to be amongst the privileged 55.2% of Australians (June 2022) who have private health insurance extras cover (45.2% of Australians have private hospital cover only), I also claimed a rebate of $1400 through my insurance provider.

Private Health Insurance

The funding of the Australian Healthcare system has evolved into a complex beast – with Medicare being at its foundation since 1984 – but there is also a private system. The arguments for and against taking out private health insurance are well covered by the consumer advocates CHOICE.

Medicare and the public hospital system provide free or low-cost access for all Australians to most of these health care services. Private health insurance gives you choice outside the public system.

The Australian Health System

As well as the Medicare Levy, 2% of your taxable income for most people, there is also the Medical Levy Surcharge which is an additional charge to encourage high earners to get private health insurance. Again, this is a bit complex, but if you are single with a taxable income (plus fringe benefits, super, etc) of greater than $90K, you are better off with private health insurance hospital cover.

The consumer body CHOICE has a calculator to answer if it financially makes sense to get private health insurance – but this is not just a financial issue, it depends on your circumstances and philosophy.

It is also important to know that there are a few areas that private medical insurance does not cover.

• GP visits
• Consultations with specialists in their rooms
• Out-of-hospital diagnostic imaging and tests.

These services are under the umbrella of Medicare and their list of approved services and government subsidies available, the Medicare Benefits Schedule (MBS). If Medicare doesn’t cover the full cost of your treatment you will have to pay the difference, known as ‘the gap’ or “out of pocket expenses”.

Engaging with Medical Specialists

Again, I recognize my fortune in having private extras insurance cover and being in a large city (Melbourne) where there is choice in medical specialists.

Rather than getting a “big surprise” bill, I have resolved to be pro-active and informed when dealing with specialists.

It’s your right to get an estimate of costs from your doctor or hospital before you agree to have treatment. This helps you understand what you might have to pay.

Department of Health and Aged Care

If I think that I am in need of specialist’s attention, before I arrive at my GP asking for a referral, I get into research mode OR, if I haven’t had the chance to do any research, I will ask my GP for an open referral.

The reason for this is that my private health insurance provider has arrangements with some specialists to charge either a “No Gap” or a “Known Gap” arrangement. My insurance provider HCF have, on their member pages, a place where you can search for their preferred specialists in your area. They also have a good guide on questions to ask your doctor/specialist at your first consultation.

Medicare contributes a set amount for each treatment or procedure, as laid out in the Australian Government’s Medicare Benefits Schedule (MBS). For in-hospital treatment, Medicare pays 75% of the MBS fee; your insurer pays the other 25% (provided you’re covered for the service).

Department of Health and Aged Care

For in-hospital services, the Medical Cost Finder is an Australian Government site for estimating your out of pocket expenses for an operation. For example, the results below are for a Knee Replacement in a private hospital that indicate a typical $1600 out of pocket cost.

For “out of hospital” consultations with specialists in their rooms, where no private insurance claims can be made, get on the phone and ask the receptionist at a few places for typical “out of pocket” costs before you make an appointment. When you decide on a specialist and feel comfortable with him/her, ask for a written quote with any gap fees for any further work.

For a deeper dive, CHOICE have a number of tips on how to avoid out-of-pocket healthcare costs.

February 2023 – End of Month Update

Slack Investor remains IN for Australian index shares, the US Index S&P 500 and the FTSE 100.  It was a mixed month for the Slack Investor followed markets. The FTSE 100 is powering on, but both the ASX 200 an S&P 500 drifting south (FTSE100 +1.4%;  ASX 200 -2.9%; S&P500 -2.6%).

All Index pages and charts  have been updated to reflect the monthly changes – (ASX Index, UK Index, US Index).

In full financial empowerment mode, Slack Investor set aside an hour and 10 minutes of his valuable time this month to get a better deal on some of his fixed costs. Good Results.

Task	Internet Research Time	Phone Time	Result
Home Loan	15 min	5 min	0.65% reduction in Interest rate – now 4.95%
Car Insurance (comprehensive)	40 min	10 min	Reduced annual payment from $1204 to $1031 ($173 saving p.a.)