It’s a new year, and you’ve likely spent some time over the summer holidays considering your New Year’s resolutions, goals or plans. For many people, it’s about eating healthier, being more active, or cutting back on discretionary expenses. However, few of us use this time to review the financial protections that we have in place for our health should we become unwell.

According to Australian Government data, more than half our population – 13.6 million people – have private health insurance, but many people aren’t fully aware of what they’re covered for.

With the rising cost of living, investing in your health is one of the best ways you can future-proof your wellbeing, get treatment to recover faster and save money on surprise out-of-pocket medical expenses.

However, just having hospital insurance does not guarantee that you’re covered for all hospital visits. It’s important that you carefully review your policy early to ensure that you’re covered for heart treatments and can request Associate Professor Ford as your interventional cardiologist if you need him.

Gold, silver, bronze, and basic product tiers – which one are you on?

In 2019, the Government introduced reforms to simplify private health insurance and help people choose the cover that best suits their needs.

For the first time, private health insurers were required to classify their hospital cover policies into four tiers: Gold, Silver, Bronze and Basic. What is and isn’t covered in these tiers is based on new minimum standard clinical categories. If a policy covers a certain clinical category, for example, the heart and vascular system, then it must cover everything described as part of the category.

Many people don’t know that the heart and vascular system insurance cover is contained within the silver and gold tiers only. That means that if you’re on a basic or bronze tier and you develop heart disease, you won’t be covered under the private system and may face long waiting periods to get treatment or expensive medical bills.

We recommend starting the new year by giving your health insurance policy a health check. If you’re not on a silver tier or above, consider upgrading your policy as soon as possible, keeping in mind that the standard waiting period is 12 months for pre-existing conditions.

Heart benefits of having silver or gold hospital insurance

Investing in silver or gold-tier hospital insurance comes at a cost, and is understandably something that most people must factor into their household budget. However, when considering the outright expense of life-saving heart and vascular treatments without the appropriate hospital cover, you could be paying tens of thousands of dollars in one go.

Apart from shorter waiting times as a private patient, there are benefits to having top hospital insurance.

Choose who treats you and where

One of the benefits of hospital cover is that you can choose which specialist treats you, and where you’re treated.  For example, if you are admitted to hospital with chest pain or a possible heart attack, it’s your right to request a specific doctor. Associate Professor Ford has subspecialist expertise in coronary artery disease and complex heart interventions so would be happy to help. Your private health cover may also allow you to be cared for in a private room, and follow-up care in your doctor’s private room after you leave hospital. As a private patient, you may also be eligible to transfer to a private hospital for further treatment or follow-up care.

Extended medical device access and treatment options

Top-tier cover provides your interventional cardiologist with unrestricted access to a larger range of medical devices such as stent sizes, that can improve your health outcomes over the long term. You will also have more choices of minimally invasive procedures such as a transcatheter aortic valve implantation (TAVI) rather than open heart surgery for valve replacement.

TAVI procedures are performed under a light anaesthetic, allowing you to maintain consciousness without pain for a faster recovery. Since this procedure is minimally invasive, many patients are up and walking within a few days after having the procedure, and are often out of hospital within a few days to a week.

Contact Central Heart to find out how we can help

We are privileged to look after many patients in both the public and private systems. However, while we have a wonderful public health system, there are some inevitable limitations when it comes to treating heart conditions. It’s our mission to educate our community so that everyone has the knowledge to make informed decisions to get the best health outcomes for themselves and their loved ones.

If you have any questions or want to make an appointment with Associate Professor Ford, please contact our friendly team.