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kazbo
Newbie


Female
Number of posts : 95
Location : Canberra
Registration date : 2012-03-25

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptySun 25 Aug 2013, 3:32 am

Dejablu72 wrote:
kazbo wrote:
I think HCF (well, for me at least) is the best because I get the WLS coverage (okay, still have a gap payment) but the 'extras' make it worthwhile because they tend to pay more per annum for physio, osteo, remedial massage, etc (all things that I use)...

I'm just bummed that my out of pocket expenses for ultrasounds and scans aren't covered (to my knowledge anyway)...In 6 weeks I was out of pocket around $600 for different scans that I had!
Hi Kazbo,

My surgeon sends me for a chest x-ray, ECG and bloods prior to the surgery but his practice manager informed me that I get sent to places that will bulk bill these so no out of pocket costs there. Is this what you're referring to?

Cheers,
Deja

I'm new and need help with private health cover... 697586

PS. Yes I get the extra's for things that I use alot too eg: chiro, massage, dental etc
yes...although I had different drs sending me for different tests...here in Canberra there are some/many places that only bulk bill for health care card holders/pensioners....which sucks!!
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Dejablu72
Newbie
Dejablu72

Female
Number of posts : 8
Age : 47
Location : Australia
Registration date : 2013-08-22

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptySun 25 Aug 2013, 2:51 am

kazbo wrote:
I think HCF (well, for me at least) is the best because I get the WLS coverage (okay, still have a gap payment) but the 'extras' make it worthwhile because they tend to pay more per annum for physio, osteo, remedial massage, etc (all things that I use)...

I'm just bummed that my out of pocket expenses for ultrasounds and scans aren't covered (to my knowledge anyway)...In 6 weeks I was out of pocket around $600 for different scans that I had!
Hi Kazbo,

My surgeon sends me for a chest x-ray, ECG and bloods prior to the surgery but his practice manager informed me that I get sent to places that will bulk bill these so no out of pocket costs there. Is this what you're referring to?

Cheers,
Deja

I'm new and need help with private health cover... 697586

PS. Yes I get the extra's for things that I use alot too eg: chiro, massage, dental etc
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kazbo
Newbie


Female
Number of posts : 95
Location : Canberra
Registration date : 2012-03-25

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptySun 25 Aug 2013, 2:18 am

I think HCF (well, for me at least) is the best because I get the WLS coverage (okay, still have a gap payment) but the 'extras' make it worthwhile because they tend to pay more per annum for physio, osteo, remedial massage, etc (all things that I use)...

I'm just bummed that my out of pocket expenses for ultrasounds and scans aren't covered (to my knowledge anyway)...In 6 weeks I was out of pocket around $600 for different scans that I had!
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wilkiebarkid
Part of the furniture
wilkiebarkid

Female
Number of posts : 464
Age : 32
Location : Melbourne
Registration date : 2013-06-02

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyFri 23 Aug 2013, 10:30 am

Thanks Deja, I definitely need to make this appt with my surgeon to get this ball rolling. We have the same level of cover, and I (like you) specifically chose it for its WLS entitlement.

Thank you for the advice Kazbo. :)
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Dejablu72
Newbie
Dejablu72

Female
Number of posts : 8
Age : 47
Location : Australia
Registration date : 2013-08-22

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyFri 23 Aug 2013, 10:09 am

I'm new and need help with private health cover... 355206 

Hi wilkiebarkid and kazbo,

Wilkie....my appt with the surgeon went really well. 
He weighed me, measured by height, worked out my BMI (40.2), provided lengthy explanations of all available procedures and basically approved me for the surgery. 
Something he explained to me that I thought was interesting and have read in doing my research, is that dieting/weightloss methods frequently do not work for human beings struggling to maintain a lifestyle that is conducive to a healthy weight, once we are overweight. 
He stated that the sleeve is the best option for me as it has a better success rate which is attributed to the fact that when that particular portion of the stomach is removed, so too is a significant amount of the hormones that trigger hunger signals to the brain. 
I just want it all to hurry up as at this stage I wont be sleeved until August/Sep 2014. 


Kazbo....I telephoned my PHI again yesterday to confirm that I have enough cover for the sleeve surgery as it means longer in hospital (when I originally joined I only asked about banding). HCF (my fund) confirmed that my Cover which is Hospital Advanced Savings with Multicover ($450 excess per yearly admission), will definitely cover either Banding or sleeving. I currently pay $65 per fortnight. I will however still have an Out of Pocket amount for approximately $5900.00 as these are the costs associated with Surgeon, Anaesthetist, and the stapling/sleeving, plus 1 x dietician and 3 x Psychologist and 1 x Exercise Consultant appts. These costs are paid direclty to my Surgeons Practice with me being able to obtain Medicare refunds ona  small amount....I think the Surgeon and Anaesthetist. 

I went through iSelect and they stated that based upon my reasons for obtaining PHI (eg: WLS), HCF was the best with the best Gap cover :)

Cheers all,

Deja :)

I'm new and need help with private health cover... 120705
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kazbo
Newbie


Female
Number of posts : 95
Location : Canberra
Registration date : 2012-03-25

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyFri 23 Aug 2013, 3:58 am

When I had my band done, I only had HCF Advanced Hospital cover (around $27 per fortnight) and I had to pay the gap payment and an excess of $450 for my overnight stay in hospital. They covered the theatre and hospital costs.

I recently upgraded to include 'extras' and I upped to the highest hospital cover they had, but the result is still the same, I will still have to pay a gap payment.

You do need to read the fine print VERY carefully for PHI as some will not cover weightloss surgery, some will partial cover, some will provide 'full coverage' (which does usually mean a gap payment of some description). I believe that there are one or two PHIs that have no gap but they are VERY expensive.

When I adjusted my PHI, I did a lot of comparisons on iSelect and the ones that were cheaper had either no or partial WLS coverage.

It could be worth speaking to a couple of PHIs you are considering to see if they cover the item numbers before you sign up. Your clinic can provide the new item numbers to you will need to have coverage for (31575 for the sleeve, not sure if you need other item numbers)
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wilkiebarkid
Part of the furniture
wilkiebarkid

Female
Number of posts : 464
Age : 32
Location : Melbourne
Registration date : 2013-06-02

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyFri 23 Aug 2013, 2:53 am

Oh, you're way ahead of me.. I have picked my surgeon but have procrastinated making an appointment.

How did your appointment go?

Im hoping the waiting does go super quick.

At this stage I will be sleeved in June 2014.. still sounds a long way away..
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Dejablu72
Newbie
Dejablu72

Female
Number of posts : 8
Age : 47
Location : Australia
Registration date : 2013-08-22

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyThu 22 Aug 2013, 10:20 am

I joined HCF also on 9 August 2013 so I am only at the start of my wait :(

However, I have already seen my bariatric surgeon, spoken to his Practice Manager who was wonderful and up for a chat about the surgery at any time.

I am trying to keep myself busy with work and study but am so impatient! lol
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Megzy04
Newbie
Megzy04

Female
Number of posts : 57
Age : 35
Location : WA
Registration date : 2013-03-22

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyWed 19 Jun 2013, 4:25 pm

I know everyone says it but honestly the time really flies by! I used to get sick of hearing it but am now under 3 months to go so the wait will go in a flash. I've been able to do a lot of research and checking out this forum in that time so I believe I'm as prepared as I can be for the surgery.
Try not to dwell in the wait too long and it will be here before you know it! 😃
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MAXI2mini
Newbie
MAXI2mini

Female
Number of posts : 21
Location : Western Australia
Registration date : 2013-05-31

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyWed 05 Jun 2013, 12:53 pm

I joined with HCF too, did most of it over the phone and paid a months premium by credit card.....was covered from that day. So, you're not the only one with a wait ahead of you. We'll be waiting together
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wilkiebarkid
Part of the furniture
wilkiebarkid

Female
Number of posts : 464
Age : 32
Location : Melbourne
Registration date : 2013-06-02

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyWed 05 Jun 2013, 10:38 am

I've just joined up with HCF, and today got told my commencement date is in july.. so I guess that means a 13 month wait? seems so mean when I'm hanging out so badly now to get this sleeve done!
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mrsroyce
Newbie
mrsroyce

Female
Number of posts : 24
Age : 29
Location : Western Australia
Registration date : 2013-05-30

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyThu 30 May 2013, 2:38 pm

Ive started my 12 mnth wait today! We can be buddies whilst we wait!!
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Angel_Est1982
Part of the furniture
Angel_Est1982

Female
Number of posts : 204
Age : 36
Location : Australia
Registration date : 2013-05-21

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyThu 30 May 2013, 12:33 am

Hi Suzie Q,

I'm with HBF on the most basic cover (Around $27 per f/t). The gap that I paid to the Surgeon was $2900 and the Anesthetist was $1400. Other than that, I paid $142 to the hospital for the 2 nights for a private room.

Unfortunately, like others have said, I think you will have to wait 12 months with any provider you go with.

Good luck with your research :)
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Suzie Q
Newbie


Female
Number of posts : 4
Age : 45
Location : Nsw
Registration date : 2013-05-28

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyWed 29 May 2013, 10:55 pm

Thanks for all of the advice, I do some investigating and start making appts. Thanks for the advice
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sassyjane
Part of the furniture


Female
Number of posts : 557
Age : 64
Location : Albany
Registration date : 2012-11-04

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyWed 29 May 2013, 3:11 pm

Hi, I had to join hbf and then wait the year,but I got all my appointments rolling so was ready to go at the 12 month end. I was sleeved by Dr W in Bunbury mid December last year and at that time the fee was $1600 which was called the booking fee and I got close to $900 of that back through Medicare and I got no other bills for any thing,all was billed direct through hbf, when you get the knock out man make sure he works along with hbf so that part is covered. I know Dr Ws fees have just gone up so the percent that Medicare refunds may differ now. If with hbf you can claim part of your dieticians fees too. I only shared my hospital room with one other girl.
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Jasmellea
Newbie


Female
Number of posts : 90
Age : 41
Location : Bunbury
Registration date : 2012-10-03

I'm new and need help with private health cover... Empty
PostSubject: HBF   I'm new and need help with private health cover... EmptyWed 29 May 2013, 2:20 pm

I am with HBF smart saver hospital and extras package. I still have to pay a "booking fee" of $2600 for the surgeon as well as the pre op consultation appointments and I imagine there will be a medicare gap for the initial anaesthetist visit. I have also had a $70 fee for the dietician. Otherwise I think I am fully covered for a shared room. There is a $70 per night extra fee if I want a single room. Appart from the single room costs I think this is fairly standard costs. Usually the pre op stuff is medicare rather than private health insurance except for the dietician. I think I can get something back for that. I haven't been sleeved yet so there may be some more costs I haven't found yet. I don't know of any private health insurance companies that don't have less than 12 month waiting period.
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bluebags
Top Poster
Top Poster


Female
Number of posts : 2204
Age : 63
Location : Sutherland Shire
Registration date : 2013-01-21

I'm new and need help with private health cover... Empty
PostSubject: Re: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyWed 29 May 2013, 1:57 pm

Welcome

I am with BUPA I have full hosp and extras but if you have only hosp that is fine just make sure it is full cover for private hosp tell them what you are considering they will point you in the right direction no matter who you go with make sure you tell them you are considering Gastric sleeve.

As you have to wait 12mths you don't want to make a mistake and take to low a cover the funds that have stated they are not covering it is mostly there low level covers.

Good luck with your journey
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Suzie Q
Newbie


Female
Number of posts : 4
Age : 45
Location : Nsw
Registration date : 2013-05-28

I'm new and need help with private health cover... Empty
PostSubject: I'm new and need help with private health cover...   I'm new and need help with private health cover... EmptyWed 29 May 2013, 1:32 pm

Hi everyone,

I am new to the site and after reading peoples experiences, I have made the decision and get the sleeve done, I had researched lap band about 18 months ago but decided it wasn't for me. I have been overweight all my life, I'm 39, 5.6, 111 kgs and bmi of 42, this is the heavist ive been even at 9 months pregnant, i feel really ashamed, unhealthy and ugly, so ive decided its time to take action.

Only problem is, I need to wait 12mths for health cover to kick in.
I have read some info on health cover on the forum, but I wanted to know if someone can recommend the best provider. I want hospitals and extras, I have looked at some and they all have a 12 month wait period, does anyone know if you can get instant cover?

Any advice would be greatly appreciated

Thanks


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