I am reviewing my parents health insurance and am thinking that their Wellness One package is excessive for their needs.
It is costing them $7000 per year.
Dad is mid 80s and frail and my logic is that if he were to get sick or have a fall or whatever then he would go to the public hospital - there are no private facilities on the West Coast anyway.
Mum is late 70s and I am less sure about what she needs and whether I keep her with insurance.

Can anyone here guide me as to what sort of health insurance you have and what you think is necessary as you age?

Thanks

We have wellbeing 2 as family and my father at 75 just switched from ultra care to wellbeing 1. He views it as more of a catastrophic cover rather than for routine things or even chronic at this stage if his life. He still works full time as an architect and is in robust health.

If having coverage wouldn't change how your parents would be treated (either in speed, location, choice of Drs), then it makes sense that a lesser, or perhaps no, plan would be a reasonable option.

Thanks Jenna, mum and dad are on Well-being 2 as well but I think it is way more than their needs. I’m going to cancel dads completely I think but need to think carefully about mum. She is 79 and I just don’t know what makes sense. It would be awful to cancel to find that she needs a hip replacement or something else with a waiting list.

When we retired at age 67 we shifted from Ultracare because it became just too expensive for us. Some time later we decided that we could pay for simple procedures ourselves and put the amount we would have had to pay to Southern Cross into our KiwiSaver account giving us a good return. We are in good health at age 77 and expect that the public health system will look after us but that we also can pay for something like a knee replacement if the waiting list is too long.



Edited 1 time(s). Last edit at 09/18/2019 11:11PM by Chris.

Thanks Chris for your input, that does make sense.
I hadn't realised that mum and dad were paying such large sums into this and while dad had some private surgery years ago, they haven't needed the private system for the past 6 years or so.
Its always that fear of the unknown. I would hate to cancel it and then mum need some expensive surgery but she seems in good health and anything urgent will go through public anyway.

When I turned 65 I reduced my Southern Cross health insurance to "Kiwicare", which covers 80% of most procedures, it doesn't cover GP fees or prescriptions. It costs me about $225 per month. The main reason I have kept it up is in case I need something like a cataracts operation or hip replacement that is subject to a long waiting list in the public system.

It might be a useful exercise to find out which procedures have a long waiting list (I think colonoscopy is one) and have a think about whether your mother is likely to need any of those.

All public procedures have a long waiting list, and appears to differ from Health Board to Health Board. We have Southern X, not sure which level as George's premium is covered by his employer and my premium is deducted from his wage.

With regards going Private - I have found over the years that even private can mean longer waits. I saw my GP about a concern at the beginning of June and was referred to a specialist, using Southern X. About a week later the Specialist's staff rang me to say there was a backlog and to please be patient and they would get back to me. So a big girls waits, and waits and waits... When we got to mid August I thought this can't be right, so rang again - and was told that they had noted on my file that there was no urgency. Which I had never ever said. I was advised that the last 2 weeks of September the entire practice would close for leave for all the staff and Doctors. After I sternly reminded them that I could not wait until October just to see the Specialist, they finally squeezed me in this week. The Dr has suggested that surgery is required - but once again they were going to be on leave and he couldn't operate until October, and I would be rung with a date this week. So I followed up yesterday only to be told that a surgery date would not be allocated until they were back as they had to discuss the length of theatre time etc.

This isn't the first instance I have had with hitting brick walls with insurance cover. Southern X isn't the problem and have approved everything, it is the private specialist practices that are the problem.

Its very confusing as it appears that Canterbury DHB has less of a waiting list than other boards and I think they come under that.
I would hate mum to be sitting waiting for surgery but then again the $3500 per year p/p seems a lot.

helen Wrote:
-------------------------------------------------------
> Its very confusing as it appears that Canterbury
> DHB has less of a waiting list than other boards
> and I think they come under that.
> I would hate mum to be sitting waiting for surgery
> but then again the $3500 per year p/p seems a lot.


Yes Helen, the West Coast is being looked after by Christchurch which has shorter waiting times.

Give Southern Cross a call and get a quote for Wellbeing 1. It covers surgery, cancer and specialists (but only specialists within 6 months of surgery) -- that would cover most serious procedures, and the premium may come down a lot. Wellbeing Starter excludes orthopedics, gyn and urology, which would be common needs for an elderly person.

Also, check out what the premium would drop to if you added a deductible. Even $250 will make a huge difference, and is only applicable once per calendar year, so your mum could have $400,000 worth of procedures and specialist consultations, and only have to pay the first $250 (or $500 or $1000 - the right level will depend on her means). Last time I checked, adding a deductible made a significant difference to the premium.

I had health insurance years ago as part of my employment package so we only had to pay for MOH. After I left that job,we continued to pay, but as years went on and the premiums got higher and higher, we ditched it about 10 years ago - whether it was the right thing to have done remains to be seen, but so far so good.

A couple of comments Helen - I believe that whatever you decide should be for both parents, not just one. It's a tricky one, I know, as no-one knows what lies ahead health-wise or in life in general.

I note that with Southern Cross (and probably others) you can opt for a higher excess in order to reduce premiums - maybe that is worth considering.

... and I see there is a cancer assist option for both Wellness One & Two whereby they pay a nominated lump sum in the event that you are diagnosed with certain cancers - maybe also worth looking into.

My family is in the Southern DHB area - both my mother and my brother (neither of whom had health insurance) have had shoulder surgery as a result of separate accidents, so ACC came into play. In both cases, the surgery was performed by a public hospital surgeon in a private hospital and neither had to wait very long. I'm not sure if ACC uses the private system routinely but that is certainly my family experience.

So that's the other thing to consider - the same surgeons work in both systems, and in the event of an accident, you are covered by ACC and are prioritised anyway, regardless of whether or not you have health insurance.

A few things to think about - good luck in your decision-making.

Regards,

Barbara Anne

Thanks so much everyone, you have really helped with my thinking.
Barbara Anne, my only reason for thinking of continuing for mum not Dad is that Dad is now very frail and has said he would refuse any medical intervention with anything aside from keeping him comfortable.
Mum is younger and more able and would be able to cope with a hip replacement etc... should she need one.
Hmm.

I have well being 2 because I figure I will need specialists and operations more than the GP.
My GP actually phoned me to say they didnt want me as a patient because I didnt use the doctors!

If I was older however, just going on my parents, they have regular checkups that I assume they pay for - doing the calculations - what does that add up to each year? Maybe well being 1 would be a better policy.

I know you can lower the monthly costs by adding an EXCESS to the policy.

Vanessa

It can very much be a lottery as to which DHB you come under. I feel it should not be like that but we know that funding seems to have slipped behind and do we need so many hospital boards? I can't answer that, it's political. We don't have enough medical personnel across the whole spectrum
I agree with Jenna about discussing deductables with Southern Cross. When we could no longer afford the enormous hike in premiums, after reducing it down to the bare minimum of cover, the deductable system wasn't available. I believe that was introduced after an enormous number of people cancelled their insurance around the same time as us. Even worse, there was no other competition at the time. We decided that if it was necessary then we would just pay. Not easily, but we would find a way to do so.
It isn't so much of a problem of what you know you may encounter but when you are bouncing around the netball and tennis courts etc you don't ever imagine that a "healthy lifestyle" could still cause problems in years to come.

Irene, I know how you must feel, I am sorry and hope you have your surgery very soon.

Although this isn't applicable to Helen's parents, Marnie makes a good point when she says "It isn't so much of a problem of what you know you may encounter but when you are bouncing around the netball and tennis courts etc you don't ever imagine that a "healthy lifestyle" could still cause problems in years to come." We've noticed with our family and friends that around the half century in age all sorts of things start popping out of the woodwork, generally not much related to lifestyle. Just in our circle, two brain tumours, a burst abdominal aortic aneurysm, acute myeloid leukemia, prostate cancer, glaucoma, two cases of motor neurone disease, breast cancer, ovarian cancer, liver cancer, pancreatic cancer, bowel cancer, late-onset psoriasis, early-onset Alzheimer's, etc.......

Hi Helen,
Please be assured that your Dad could qualify for FREE palliative care should the need arise.
Hospice care is available to all who have a terminal illness.......not just people with cancer.
I hope you and your readers never need it for your loved ones, but from someone who has worked in a Hospice for over 28 years, it is appreciated by so many people.

Raewyn G

My father chose to cancel my mother's policy when he moved to wellbeing 1 a few months ago. My mother is in the later stages of motor neurone disease and will receive absolutely no benefit from the policy - she lives in the hospital ward of a rest home - and he does have to watch his spending even though he still works. Situations are not always the same.

That's some awful luck in your circle, J1. I hope the ugly diagnoses slow down significantly.

Thanks Jenna. My heart goes out to you and your family too.

Update on this just in case anyone else needs to consider it at some stage.
We have cancelled Dad's insurance as he wouldn't agree to surgery of any kind any more.
Mum we have increased her excess for surgery to $4000 which means her premium is $1800 per year.
It is really only surgical cover that we would want for her and there is nothing that is being considered at present.

That sounds like a great resolution, Helen. The coverage is there for major surgery and the premiums are affordable.

I choose health insurance based on my and my family's needs. We have a family package because it is much more profitable. Before we took out this insurance, we were paying about $13,000 a year for a list of medical services that we never used. It was our mistake that we were not serious about choosing a medical plan. Fortunately, a year ago, we learned about the services of ibgportland.com. They strive to deliver medical options that meet the needs of individuals while also keeping the budget at the forefront.



Edited 1 time(s). Last edit at 01/21/2023 03:02PM by MakenzieBeck.

Barbara Anne Wrote:
-------------------------------------------------------
> I had health insurance years ago as part of my
> employment package so we only had to pay for MOH.
> After I left that job,we continued to pay, but as
> years went on and the premiums got higher and
> higher, we ditched it about 10 years ago -
> whether it was the right thing to have done
> remains to be seen, but so far so good.
>
> A couple of comments Helen - I believe that
> whatever you decide should be for both parents,
> not just one. It's a tricky one, I know, as
> no-one knows what lies ahead health-wise or in
> life in general.
>
> I note that with Southern Cross (and probably
> others) you can opt for a higher excess in order
> to reduce premiums - maybe that is worth
> considering.
>
> ... and I see there is a cancer assist option for
> both Wellness One & Two whereby they pay a
> nominated lump sum in the event that you are
> diagnosed with certain cancers - maybe also worth
> looking into.
>
> My family is in the Southern DHB area - both my
> mother and my brother (neither of whom had health
> insurance) have had shoulder surgery as a result
> of separate accidents, so ACC came into play. In
> both cases, the surgery was performed by a public
> hospital surgeon in a private hospital and neither
> had to wait very long. I'm not sure if ACC uses
> the private system routinely but that is certainly
> my family experience.
>
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>
> A few things to think about - good luck in your
> decision-making.
>
> Regards,
>
> Barbara Anne

it's really worth thinking about



Edited 3 time(s). Last edit at 08/08/2023 03:12AM by AndyLindberg.