Private health cover and young children

While parents are likely to hold private health insurance for the baby stage of their family life, some times there is a temptation to reduce or drop private cover once the family is complete and the budget squeezed. According to Medibank Private, parents are most likely to use private health insurance when their young children need ear, nose and throat treatment as elective surgery. 

Medibank data shows that the ten types of hospitalisation most frequently claimed for children aged less than six years included*:

1. Middle ear drainage (usually referred to as grommets insertion - a procedure to alleviate fluid build up in the middle ear that can interfere with hearing or cause ear infections). It is estimated that about 60,000 children undergo this procedure in Australia each year.
2. Removal of tonsils.
3. Umbilical or scalp vein catheterisation or cannulation of a vein (neonate procedure).
4. Circumcision of a male aged between 6 months and 10 years of age.
5. Neonatal intensive care.
6. Femoral/inguinal hernia or infantile hydrocele.
7. Removal of adenoids.
8. Circumcision of a male aged under 6 months.
9. Oesophagoscopy (inspection of the gastro-intestinal system).
10. Wound or soft tissue debridement (the removal of foreign material from around a wound to optimise wound healing).

The public hospital waiting time for an ear, nose or throat condition can be up to 114 days in some states, and the waiting time for urgent conditions as high as 19 days. 

For non-hospital services, the most common reason parents accessed their private health cover was to pay for their child’s*:

1. Chiropractic consultations
2. Speech therapy consultations
3. Dental examinations
4. Dental - topical application of a remineralizing treatment
5. Dental – removal of plaque and/or stain
6. Dental – adhesive restorations
7. Dental – removal of calculus/tartar
8. Physiotherapy consultations
9. Dental x-rays

** Based on data from Medibank Private claims for children aged 0-6 years during the period from July 2003 to June 2005.

The information provided in this article is intended as a guide only. Always consult your doctor if you or your child is suffering any medical complaint. Any websites referred to by Australian Family contain information moderated by government and medical institutions or organisations.

This article was first published in Australian Family Magazine, May 2006. Updated July 2009.