Health insurance - is it worth it?

What do you think?

DH and I are planning to TTC early next year, so we thought maybe we should see about getting health insurance, so that should anything be wrong with our little one, we could get it covered right away. (One of my friends just had a baby with cleft palate, so it got me thinking...)

I've just met with the Southern Cross rep that covers my workplace, and he's quoted us $25-$64 per fortnight (not sure why the range? ) to cover DH and myself for specialist care and surgery.

So at a conservative 4.5% after-tax return (if i put the money in the bank instead), that equates to $663-$1700 per year, just in case one of us needs to see a specialist. How much do specialists and operations cost?

Also, this policy EXCLUDES accidents (covered by ACC), infertility or assisted reproduction (we don't know if this will be an issue yet), pregnancy and childbirth, and congenital conditions... which is pretty much everything that is *likely* to affect DH and I in the next few years.

So, to me, I find it a little hard to justify. Especially as they won't cover congenital conditions, which was the risk we were trying to cover anyway (FYI, congenital means something you were born with - I only recently learnt this, so thought I'd share in case you didn't know... or maybe I'm a slow learner and everyone but me already knew!).

BUT, I know lots of people have health insurance, so in some cases it must be worthwhile? How have you justified it (or justified not having it)? Seems to me that maybe I'd be better paying to see the specialist should the need arise (as long as it didn't cost more than $1700 per year!), and then if I need a big expensive operation, can a private specialist put me on a public waiting list?

Sorry for the novel, I'm just rather perplexed by all this! I grew up pretty much dirt poor, so health insurance is something I've never had any experience with.

I am with Southern Cross and have been for a long time now. Sth Cross told us not to include Zaara as we would be paying full price for her even tho child health care in NZ is free. So not wort it. So only hubby and I are under the policy.

We have regular care and that covers every day Doc fee upto 80% per visit. We can also go and see various specialist and they would pay $200-250 Depending on which specialist. w are also covered more most surgery upto a certain value (thousands)...

So far we only ever needed to go to normal doc...but I feel secure knowing that I have this as a security blanket.

My company pays a portion of my health insurance so I only pay $4.71 from my pocket each week.

I also dont hessitate to go to the emergency docs and pay $65 to see them because I know at least 80% will be back. So its good! I would never let go of it!

My wife Teresa needs an op for a degenerative something. If we went privately (which we have considered - because she can be in terrible pain sometimes) it would cost approx $10,000. That is excluding any doc or specialist visits which cost as well. And it also exludes any further ops - which sounds like a possiblity.

We don't have Medical/Health insurance. I don't know about you but I dont know many families that could afford that kind of cost. And because we have found out the problem before we have insurance - any insurance that we subsequently take will not cover this problem.

The alternative for Teresa is to wait 2 years on the public waiting list. Not good when Teresa is in pain and slowly getting worse.

I would say that health insurance is worth it, however you might like to look around. That policy that you have quoted doesnt sound very useful. I can't really be more helpful than this - Yes health insurance is worth it.

Also remember like Roksana pointed out... in NZ child health care is free - or at least the doc appointments are - (up to 5 years?).

Try to use an insurance broker that is well known. Talk to more people.

Edited by Chovynz

DH & I are with Southern Cross through his work who subsidise a small portion of the policy cost, and DD is on our policy too as not *all* GP's offer free care for children under 5. DD will soon be receiving a HUC (High User Card) though, which helps a little, and we can then claim the rest - fortunately prescriptions for her for most things are often free of charge. Unfortunately however, at least for me, we can't claim for much at all seeing as I have a LOT of exclusions - which is the part I get most frustrated with.

I have southern cross insurance and for me and the boys (DH has all medical care free through the army) and its $212 a quarter. This is for specialist and surgery (wellbeing plan), and I have opted for nil excess so that is why its a bit pricey. I have the boys covered because here in Palmy it can take forever to see a specialist at the hospital and when they have something wrongs its not nice for you or the child.

i am with southern cross(luckily my Mum pays for me and for Ethan) ...anyway i think its very important to get coverage personally (for me)

so far Ethan has had to go to the specialist (320) for his allergy and we get 80% back..we would never have been able to find that money .. my Dad just had a hip operation which he was able to get very quickly privately and get 80% back as well.there's no way my parents could have found 12,000 to pay for it..

so in my opinion its important and Ethan had to be on our policy before he was 1 month old...dunno why...and as for health care being free..hmmmm...our docs cost us 5$ for him and 10$ at after hours..and i have found the public system crap:( and when docs cost 55 for me it was worth it (29 now) and the only things not covered for me where pregnancy(already free) and smear tests and contraception(in terms of claiming back)

Hmm now that's an interesting thought. Matt has private health insurance, which i'm not covered by until we get married - but will bubs be covered cuz it's half his baby.. I might have to get him to call them and find out.

Thanks for all the feedback. Its certainly helpful to get different perspectives on things.
To clarify - Southern Cross is my workplace insurer, and that was a subsidised rate. That was the total for DH and I, not each, and that was the range he quoted for the "Wellbeing 2" plan. I'm a bit annoyed as he said $25 to me, but after he left I noticed he'd written down $25-$64. I have emailed him to find out what the story is. I imagine its based on perceived risk, which hopefully I should be at the low end of.
ChovyNZ, unfortunately I'm not the sort who has a spare $10k lying around either, but we do have a revolving credit facility on our mortgage that we don't use (we keep the balance at 0). That is our emergency fund, and we could draw that down to -50K if we really needed it. (Of course, then we would have an even bigger mortgage to pay off, but it could be used to prevent us having to suffer pain for a long time).
Hmm. It is a lot to think about. He said they'd probably cover my pre-existing health condition after 3 years, so long as it continues to behave in that time (it has for the last 6 years, but I expect if its going to flare up it will do so when I'm pregnant )
DH is away at the moment, so will discuss with him when he's back. In the meantime, keep the opinions coming

Thats the plan I am on Rhick, I just worked out mine and its $18 a week for me and the boys. IMO it is so worth it, i've been with southern cross since we moved to NZ in 1984 so I get a long serving members discount. Andrew has had grommets twice ($3000 each time) and Josh has seen the eye specialist, and i'm in the process of sorting out an operation for me which will be about $20000 (and add on top of that the specialist appointments and the hopsital stay of over 1 week). I pay $800 a year and it is nothing compared to the price of waiting in pain and on the public list.

It think the price differences would be for the excess.

I've always had health insurance. Until I was 21 I was covered under my parents Sovereign scheme (which cost me approx $35 p/mth once I left home). I had my tonsils out when I was 20 and the process took about 5 weeks from referral from GP to the day of surgery. The specialist said public waiting list was about 9 months at the time. Now DH and I have Wellbeing 2 plan with SOuthern Cross. We pay $12 p/mth but this is subsidised through my work. My work does provide a free plan but it was a basic scheme (doctors visits & subsidised surgery) and we decided to stick with the plan we already had. Without work subsidy it cost us $15 per fortnight so still a good price. I needed grommets last year but as it was existing I wasn't covered so I paid for the specialist visits (approx $80 ea) until my specialist got me on the public list which took about 3 months. To pay privately was about $2500 which I couldn't justify paying as I was ok to wait 3 months for public. I cannot imagine what it would be like for a child having to wait that long with ear problems though. SO basically, we wouldn't be without it