Private Health Insurance - All non-sleeved members - Please read!

Hi all,

This post is in regards to private health insurance.

I have seen many a post on here and other sites (FB, etc) from members regarding their insurance cover, and unfortunately not able to have surgery when their 12 months is up, as their cover has changed during the 12 month wait.

This is just a reminder for all members to regularly check with their health provider during their 12 month waiting period, to ensure their cover is up-to-date, and covers them for GASTRIC SLEEVE Surgery, and not LAPBAND.

Please make sure you clarify with your health insurer the medicare numbers for the sleeve and you have the appropriate level of cover.

I cannot comment on the exact levels of cover required for the sleeve with each fund, but a simple phone call to them will give you peace of mind.

Good luck to all those waiting to be sleeved,

Admin & Mod team.

During my 12 month wait i contacted my provider a total of four times, just to check i was covered, the people i spoke to each time couldnt of bee nicer, they took the time to comfirm my cover and one lovely even told me that after my WL i would be covered for tummy tuck and boob lift etc.

Can not aggree with this post enough during you wait make sure you keep in contact with providers and that you are covered, your providers are there to work for you, so any concerns you have it is there job to give you the answers.

smiles

Mandy

Newbie Number of posts : 20 Location : Perth Registration date : 2013-03-13

I was surprised when I was searching for PHI because of the difference in PHI costs and the one I was quoted, I had 3 people at the health insurance tell me it was the correct cover as it was 50% cheaper than most other health funds. In the end, the girl said, to be sure, I could get the item number from the surgeon and the provider number - this has calmed my fears that I have the correct level of cover and they were also able to tell me how much out of pocket I would be looking at paying. I guess I'll have to change cover later down the track as I'm sure I'll need plastic surgery for bat wings and other skin parts (but that's not til 1 year away at least).

Hi I am waiting for private health to mature. I have 6 months to go. I was told that if your not covered by private health cover
a. some doctors won't operate anyway
b. if extra stay in hospital, could blow out to stacks of dollars
c. Some docs will sleeve, but it will cost you $ extra and no safety net. and Thats too stressful for me.

So I am staying safe and waiting until November 2016 My health cover gave me the qualifying time to get back in touch with doctor and now I just have to sit tight and wait.

Many thanks
Chloebags

LittleMissCee wrote:: I have seen many a post on here and other sites (FB, etc) from members regarding their insurance cover, and unfortunately not able to have surgery when their 12 months is up, as their cover has changed during the 12 month wait.

Please make sure you clarify with your health insurer the medicare numbers for the sleeve and you have the appropriate level of cover.

You make a great point there, highlighting that cover is valid through the waiting period.

I think there is a need for those who are sleeved while covered by insurance to inform others about how much of the cost is actually covered, and how much out of pocket costs are involved. Whether that discussion should occur in this thread or one of its own is not my decision.

I was recently sleeved at my own cost, after deciding and doing it in a very short time frame.

I decided late March, saw the surgeon April 13th, and was sleeved May 3rd.

My decision process started late March 16, when I was considering insuring (and paying) for a year before April 1st when the insurance rates increased, with a view to being sleeved say, in April 17.

However I spoke to a few friends who have had it done, and discovered that at least one had about $8K to pay for the process, over and above the insurance coverage. It then became obvious to me that some doctors and hospitals actually charge more for insured patients than uninsured ones. The analogy between car repairers and insured/non-insured quotes leapt to mind.

Now I know that insurance is about risk mitigation, and there can be complications, ie leaks or infections post op, but if you look at the stats, the odds are pretty good these days, as sleeve surgery becomes more advanced, at better than 1/200. I had access to cash should the need arise for subsequent problem remediation.

Eventually I balanced out the need to get this sleeve done fairly soon with the cost of paying for it in full myself, or paying for a year of insurance and waiting out that year, with the possibility there could be a significant gap between insurance coverage and total cost anyway. I'm happy to discuss my total costs minus Medicare rebates for doctors fees when I have the surgeon's fees receipt lodged later today.

However I think we should see more discussion about the costs to patients of various insurance companies of the sleeving process, because from what I'm hearing the benefits are not universally the same,

Cheerz Wabster (Mark)

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