If you are one of our overseas beneficiaries, have you thought about getting health insurance?
Even if you feel well now, it is important to make sure you are covered to avoid expensive hospital bills later.
Whilst we are still amidst the Covid-19 Pandemic, making sure you have the right cover, is more important than ever.
What is Health Insurance and why do I need it?
Health insurance is a special type of insurance taken out, usually by a person, to help pay for the costs of medical care.
The amount you pay and the level of cover you choose for the insurance decides on how much the health insurance company pays and how much you have to pay if you need treatment.
Some countries do not have any state funded medical care like the NHS. This means that you have to foot the bill for any medical costs you have. Even if the country where you live has “free” medical services, not everything may be covered so you may need insurance to pay for “extras” like medication or physiotherapy.
To get health insurance, you need to make regular payments (called “premiums”) to a health insurance company.
As with all health insurance policies, pre-existing conditions may be excluded unless you pay a top up fee to have them included. This may include your thalidomide damage. Having said this, insurance is still worth having to cover any other medical problem you may develop.
Listed below is how you can find out more about health insurance in 3 different countries. If you would like some more advice and support, please contact a member of the Health & Wellbeing team who can help, on 01480 474074.
Anytime you need to see a doctor or have any type of medical care in the USA, you need to pay for it. This includes anything from seeing your local family doctor or getting surgery in a hospital. This can mean you spend thousands of dollars on your health unless you have health insurance.
The USA government website suggests the following for those with disabilities who are looking for health insurance:
- Medicaid provides free or low-cost medical benefits to people with disabilities.
Find out more about Medicaid in different states
- Medicare provides medical health insurance to people under 65 with certain disabilities and any age with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant). Learn about eligibility, how to apply and coverage.
- Affordable Care Act Marketplace offers options to people who have a disability, don’t qualify for disability benefits, and need health coverage.
Learn about the Marketplace in different areas, how to enrol, and use your coverage.
It’s also important to remember that you if you travel out of state, your medical insurance may not cover you so do check with your insurance company before you travel.
One US beneficiary who has recently taken out health insurance said;
The system has two major parts: the public health system, and the private health system. When you need health care, you could access it through one of two systems, or a mix of both.
- The public system is made up of number of components, including public hospitals, and community-based services such as GP surgeries.
- The private system includes health service providers that are owned privately, such as private hospitals, specialist medical and allied health, and pharmacies.
What is Medicare?
Medicare is the government’s scheme to give the public access to health care and is paid for by contributions made through your taxes. It is available to Australian and New Zealand citizens, permanent residents in Australia, and people from countries with reciprocal agreements. Medicare covers the following:
- Treatment in a public hospital.
- 75% of the fee on a government list for doctors’ services in hospital if you’re a private patient. This is called the “MBS list” which is a list of services subsidised by the government.
- All or some of the cost of going to a GP or specialist. This is referred to as “bulk billing”.
- Reduced cost on some prescription medications, if they are on a government list called the Pharmaceutical Benefits Scheme (PBS).
What’s not covered?
Some services aren’t covered by Medicare, such as dental services, physiotherapy, opticians and chiropractors. It may be worth getting health insurance to cover these options.
Do I need private health insurance in Australia?
Medicare will cover most basic medical expenses - but it doesn’t cover everything. If you just rely on Medicare, you may have long waiting lists for surgery and there will be limitations on which doctors you can see and where you will be treated.
Private health cover can mean you have a greater choice of specialists and hospitals. This is important as having thalidomide damage may mean you want to be seen by someone who is an expert in their field.
As mentioned above, you will also need it to cover things like physiotherapy, which aren’t covered by Medicare.
What is Medicare?
People who live in Canada can access free healthcare by applying for Medicare. Medicare is a public health insurance, paid for by your taxes, and will cover about 70% of medical services in Canada.
It’s important to say that Medicare can vary hugely within Canada. The country is made up of 10 provinces and 3 territories, and each provincial/territorial government is responsible for dispensing its own healthcare services. Therefore the standard of care – and the extent of medical cover – can vary by region and so what is “free” in one area may not be in another.
You need a health insurance card from the province or territory where you live to get health care in Canada. You must show this card each time you get medical services.
What’s not covered?
It's important to remember some things aren’t paid for or covered by Medicare. These include prescription drugs, dental care, optometry and other medical expenses. Physiotherapy is also not covered.
Do I need private health insurance in Canada?
It is recommended that you buy some health insurance to cover these extra expenses. Most people (60-70%) will have some extra health insurance to cover these costs, especially because prescription drugs aren’t covered.
You may also need private health insurance if you travel from province to province because what is covered in one area, may not be covered by the next.
If the county you live in isn’t listed here and you would like to find out more, please contact a member of the Health & Wellbeing team and we can help. Call on 01480 474074 or email.