what does this mean

I just went on to iselect to compare health funds and one of them showed

Surgical Weight Loss Procedures waiting time as 2 months (unless pre existing) what would that mean.

If the surgery was pre existing I would have to wait, or if my obesity is pre existing I have to wait ?


I also found this note on there : Typically includes gastric banding, providing it is deemed medically necessary by a doctor.

Does that mean it won't cover the sleeve ?

Obesity is always considered pre existing as no -one gets fat overnight. If you had previous insurance with another company that had covered WLS then you will not have to serve extra waiting periods. All weightloss surgery must be considered necessary by doctor they don't just perform it on people who could have a chance of losing weight by themselves. Most of these statements are just to cover the applicable health insurance company. I think looking up insurance comparison sites are fine but never sign up for any unless you have thoroughly checked with the applicable company to see if they do cover WLS. There is a Government comparison site also it covers all health insurance companies Australia wide look up that site. Then ring the ones you like to see they cover gastric sleeve.

Sorry to say but it looks like a 12mth wait if you have never had insurance or your cover didn't have WLS in it to begin with upgrading a cover still means serving the waiting periods for pre existing for the new condition..

Hi Ineedasleeve,

Like you I started my search on iSelect, found it was good as you were able to select weight loss surgery or the like as the specific health concern you wanted cover for. It seems most health insurance companies cover the sleeve if gastric banding is mentioned.

Through this forum I found out that each procedure has medicare item numbers - gastric sleeve (Sleeve Gastrectomy) is 31575 and 30390 so I emailed the Health Fund I thought I would go with and got them to check if the cover would cover these item numbers. 

Also hopefully you have researched surgeons in your area and figured out one or two that you would like to go with. I'd check with the Health Insurance that they have an agreement with the surgeon/hospital as well - they might cover the procedure but not at the hospital you want.

I found email was the best so you would have a hard copy record if the company tried to change it's mind later on. I went with Teachers Health and Top Hospital and Extras which is about $93 a fortnight. Seems a bit pricey but with the gastric sleeve I was only out of pocket about $3000 and got dental work done in the year waiting period.

I had to do the year wait and in the beginning it seems rather depressing because you've made the decision to go ahead with surgery but then you have to wait a whole year! Believe me though it goes really quick! 

Whilst you're waiting for the year to tick over I would strongly suggest calling the surgeon/s office and making an initial appoint to go see them. I was very naive and thought that the whole process would be super quick so I waited till December to contact the surgeon (3 months before my 12 month wait was up) thinking I'd get an appointment to see the surgeon in Dec or Jan and be having surgery in March. I couldn't even get in to see him just to speak to him until March and when I saw him he was only just able to squeeze me in for surgery 3 months later at the end of June. If I knew what I know now I would have called as soon as I got my health insurance!

Also good to note that you need a referral letter from your GP to the surgeon, you must take this when you have your first appointment in order to be able to claim back with medicare. So that's another thing you can organise now.