Medibank private

Hi guys just called medibank private to confirm my sleeve (which is 31 July). I am on basic cover and this will be covering me but I was told as of 28 September only their top cover will be covering any weight loss surgery. Just thought post this in case it will affect anyone.

I have PHI with Medibank and also received the letter to tell me as from 28 Sep 2015, weight loss surgery will not be covered. The only reason I went with Medibank was because they covered it on basic hospital cover!!
I'm not planning on having the surgery until mid next year.
I contacted Medibank and they confirmed, if I upgrade to top hospital cover by 28 Sept, my already served waiting period will be transferred.
To change my policy, it will cost about $130 per year more than I'm paying now. Really annoying, but worth it in the long run. I can always switch back after surgery.

Hi Guys,

I was very disappointed with the return rate for the sleeve operation by Medibank, in fact most of the rebate came from Medicare (75% of the scheduled fee) and the remaining 25% from Medibank.

Considering the sleeve is not a cosmetic surgery and is done based on doctor's recommendation to improve health and wellbeing, am astonished that we are paying so much for our private health to get so little in return.

Am not sure what the advantage of having private health really is for this operation, is it in the Hospital expense side of things? I paid the $250 excess for 2 days stay in addition to the $100 the hospital charged me in advance for medication (Panadol...etc)

The return I got for the operation was as follows:

$212 from PHI for the surgery
$637 from Medicare for the surgery

$89 from PHI for the anaesthetic
$269 from Medicare for the anaesthetic

My level of cover with MB is "Settled Families Corporate Comprehensive $250 Excess"

So, all up I paid $6,200 and only got $1,207 back (out of pocket $4,993 not including the Opti diet and the surgeon consultation fee/s)

Am not sure if this is good or bad, but that sounds like a peanuts return from a private health I have been with for over 25 years.

Yep.  
But, I think you'll find that's just the doctor fees.  The PHI would have covered most of the cost of the hospital (the bed, the nurses, the equipment etc) fees.   That is probably an additional several to 10+ grand on top of your other expenses.

It's all in legislation, but the 25% is pretty much all they cover of actual surgeon/dr fees.  They can cover 100% of other hospital fees though.

I should say too, that part of the reason you should seriously have PHI for this op vs self funding - is the unexpected.  If you had a complication and were self funded, you could lose everything.  

I took out PHI for the op - so had to pay a year first, plus the second year, plus the excess, plus the out of pocket (over the scheduled fee) gap for surgeon and anaesthatist.

I think all up, it's about 16-17 k that I forked out for the op.  And I still have the PHI, because my surgeon kinda demands it.  

I think in total (surgeon, anaesthetics and hospital fees) the op came in at about 18k.  So....yeah.  I get your point.

Wow, I didn't realise it was that expensive for the self-funded option.

Yeah, the surgeon fees is just a small part of it.  The hospital costs are way more.
And I've seen some peoples self funded costs on here be well over the 20K mark.

I think all up,including pre medical checks etc my op cost me, out of pocket about 6K.
Its been 20 months now, so I can't say for sure... hehe
(I thik I wrote it in my diary, need top remind myself at some stage).
My Health insurance statement showed they had paid about 14K to the hospital.

BoJ is right in saying health insurance is for the hospital stay and just in case if anything happened and I you have to stay in longer.  Thats were the expenses really get high.