Planning for your changing healthcare needs

As a doctor, you will have seen how your patients’ healthcare needs change as they move through the stages of life.

Using life’s milestones as a trigger to review your own health cover can help ensure it will meet your and your family’s immediate and future healthcare needs. You don’t want to find yourself unable to claim benefits for certain services because you haven't got the right cover, or that you are paying for cover you no longer need.

Growing your family

If you want to be seen as a private patient for pregnancy and childbirth, you will need to have the right cover well before you conceive, as there is typically a 12-month waiting period. It’s also important to consider your cover for pregnancy-related conditions, such as reproductive services, as waiting periods will also apply.

Once the baby is born, there is a limited period for them to be added to your policy to automatically have the same cover as you, with no waiting periods. This is especially important if your baby needs neonatal care. At Doctors’ Health Fund, you need to add your baby to your cover within 60 days of birth, however this can differ across health funds.

Raising children

During childhood years, the cost of visits to the dentist, optometrist and speech therapist can be considerable. Checking you can claim the optimum benefits for these extras can help with this. Benefit limits for orthodontics are usually different to other dental services as they accrue over time until you reach the lifetime limit.

Children turning 21

Once they turn 21, your child is no longer automatically considered a dependant under your health insurance. Whether they can remain covered on your family policy is based on their student, relationship and income status. Every health fund has their own requirements and rules, and will get in touch each year to confirm this information.

Active lifestyles

Our recent survey showed most doctors have positive attitudes to physical health, which is good to hear. However, this can impact how often you need certain extras services such as physiotherapy, remedial massage or exercise physiology, or even call an ambulance due to an injury. Checking that your limits and benefits for these services suit your lifestyle ensures you’re covered should you need to claim.

As you grow older

As we age, our healthcare needs can become more complex. You’re more likely to find yourself needing treatment for heart and vascular conditions, a joint replacement, or for conditions such as cataracts or a hearing device. Not all policies cover these services, so make sure you regularly review your cover in line with your potential needs.

If you find yourself admitted to hospital for private inpatient treatment, the different excess options provided by your health fund can reduce the amount you pay out of pocket.

Unsuitable cover has repercussions

When your health cover is not aligned to your healthcare needs, you can find yourself unable to claim benefits for services you need due to waiting periods. This can delay care, or increase the cost.

The good news is that waiting periods served with one health fund carry over to another health fund if you switch. However, if you have never had cover for a particular service and suddenly need related treatment or care, waiting periods will apply in most cases.

Your health cover should provide access to quality and timely healthcare when you and your family need it, so don’t let it be out of sync with life’s milestones and stages.

This article was originally published in Connect magazine issue 22.

Disclaimers

Please note this is general information and may not apply to your personal circumstances.