HELP - I'm so confused over health funds

Does the PHI rebate mean I get 30% back at tax time? This is all very confusing for me, I am trying to pick which Health Fund is best for me to sogn up tomorrow so I can get sleeved in a year or so. I am only getting single cover, but my income is low ($200-450 per week before tax) and my partner gets about $900 p.wk.

I looked at several funds and it appears to me thet for me, in NSW and at age 59, HCF is best. can anyone who has used them and is around my age advise me? Is HCF Top Hospital enough or should I go for extras cover too, can anyone advise? I wanted it to be no gap, so no out of pocket fees, but this seems to be impossible to achieve.

And I was considering Dr Justin Greenslade in Brisbane. he state's his surgeon's fee is $4,000 payable in advance (WEB LINK brisbanebariatrics-px DOT rtrk DOT com DOT au BACKSLASH finance-options-brisbane-bariatric-centre DOT html - I'm under 7 days, it won't let me post links yet!). Am I correctly understanding that I don't get any of that back?

Any light anyone can shed would be most appreciated.

For a single under 65 with an income of <$84,000, you are entitled to a 30% rebate on the cost of the Policy. You can take this as reduced premiums, or as a refund at tax time. So if you pay $1000.00 for PHI, you can either reduce this by $300 (making the Cost $700) or pay $1000 and claim $300 back on your tax return. There may also be a loading on PHI as you are over 30 and a new PHI member. You will need to read the policy carefully and then I suggest you ring the chosen fund and ask them to explain it to you thoroughly.

You will need to check with the surgeons office about the $4000 charge, but it is my understanding that this will be an out of pocket expense.

Hospital Cover includes just that, room fees, theatre fees, surgeon fees, pathology,prosthetic fees (staples etc) pharmacy and radiology fees etc. You may have out of pocket expenses for these. You will need to get the costs outlined by the Surgeons office (with item numbers), then ring the chosen PHI and ask them.

Extras will help with Physio, Dieticians, Psycologists, glasses, chiro, dentist etc if you require that cover.

Some people Apply to use their superannuation to cover the out of pocket expenses.

Anyway, I have probably confused you enough for the moment, so make yourself a cuppa and try to digest all this info...

Stace

Thanks Stace, it does help but boy PHI is confusing, I think they do it deliberately. I also saw on the forum here that as a Health Card holder iI get a lower fee, I didn't realise that.

It really irks me that the government and PHI will not fund bariatric surgery better, after all, in the majority of cases it probably vastly reduces costs of future health care in both visits to doctors, treatments and drugs needed.

Analog6,

I'm not with HCF so can't comment on them. My understanding is that your private health fund covers all/part of the hospital fees and associated tests etc, so hospital cover is the important aspect. Mine also covered my anesthetist as well. However, the surgeon's admin/gap fee isn't covered so you don't get anything back for that from either medicare or the health fund - or at least I didn't.

You are best checking with HCF to find out what level of cover is required for bariatric surgery.

All my hospital expenses where covered, but I had to pay the gap fees for my surgeon and aneasthetist (just under $5000).

Hi, I joined HCF for my sleeve op, the health fund fully paid the $15000 hospital charges. I only paid the $250 excess on admission. The health fund did not pay for the surgeons gap fee ($5000 but this does get a small refund from medicare), can also claim a small amount from the health fund and medicare for the gas man's bill.

I have found HCF to be very good and helpful.

best wishes.

jessied

Hi

I am with HCF, age 55 and have top hospital cover. This means that costs associated with the hospital stay - bed fee, theatre costs and prosthetic fees were cover by HCF. Radiology was partially covered by HCF and medicare however I still incurred out of pocket costs as much as $200 per test depending on what the test was for. My pharmacy was not covered - charged out at the normal cost of about $35.00 per script. Most of the patholgy was covered except for the test they do on the part of the stomach which is removed. From memory it was about $135. I also have extra cover which paid for part of the dietitian cost - I paid about $40.00 per visit and had about 8 visits before the cover ran out. Psychology was not covered until I had used up the 6 sessions provided under a mental health care plan. Most surgeons and gas Docs charge a fee that is above what is refunded by medicare and any health fund. Justin is one of the cheaper surgeons - I think the average cost which you will have to pay is between $4,000 - $6,000 and the remaining cost should be taken care of by medicare and the health fund. If you have superannuation you maybe able to access this for these costs

I hope this helps

G

Health funds can be a pain the butt, literally. HCF is a not so bad one in that you have to have the right cover for surgery. But they pay for bed fee, theatre, "tools" and associated in hospital costs. Generally you should not be out of pocket whilst in hospital, that is what they say. But I am with Defence Health and they are so good with hospital coverage.

In terms of fees outside of hospital for surgery, well different Drs charge differing amounts. My Dr at Southport charges approx $4,000 out of pocket and that includes anaesthetist and some dietician. My friend was with MBP and she only got charged $3,700 out of pocket recently, so I know the figure is correct.

Also you can claim some out of pocket costs back at tax time as you go over medical expenses amount. I got money back when I had my op.

Worth ringing around.

GL.