PHI Gap - To those with PHI what was your out of pocket expenses?

Another question (you can tell I'm new right?).

I have NIB Top Hospital Cover and have had for well over a year.

What other costs can I expect to arise?

Is the whole of the surgery covered? Are medications during/after covered?

I know the initial appointment is $270 with a $75 rebate.

Any advice appreciated. Thanks, Anna

Hi

Have you had a response to this as these are the questions I am asking.  I have been told that several people have had the proceedure from Dr Liew and it was only $800 due to full PHI.  i would like to know if this is actually true.  I think that he doesnt do follow up consultations and this is done with a GP.  I would like to truly know the full facts before even going to a consultation

Hi girls,

I haven't been sleeved yet, but I'm due in June with Dr Liew. He only charges the gap, so it's whatever your PHI covers. There is also the anaethetist and hospital excess. I'm not sure what else there is to expect, but there are a LOT of people who have had it done so maybe PM one of them if you need to know before consultation? Every surgeon is going to be different.

FGS.

Hey Debbie,

My surgeon has advised around $4,500. He needs a $6K payment two weeks prior to surgery and I can get around $1,500 back from PHI.

His appointment and the gastroctopy and the hospital excess are now just over $900. Another appointment will be around $200 so that will bring it to just over $7k with around $1,500 rebateable.

I was sleeved 16 months ago, and was OOP about $4500, with top cover.

Hello, you need to talk to your surgeon & see if they cover the gap or what out of pocket expenses you can expect.
They have an obligation to disclose costs involved.
Same with anaesthetist, they charge by length of surgery, some cover gap, some don't. Often they work within a group and some charge more than others. It's quite okay to ask for one who charges less, thing is it may mean your surgery would be on a different day.
Things you may be charged extra for are pathology tests or specific medications while in hospital, some may be covered by PHI & Medicare, some may not.
I had a random $24 pathology bill last surgery.
Ring your PHI with all your questions though, they should be able to explain.
All the best,
Linda

My surgeons out of pocket was 4500, with all the other bills ie psycolgist, dieticians, surgeons normal appointments I think the total was nearly 6K... that was nearly 3 years ago.
I did have a list of my costs somewere here, I can find it if you need it... but it was 3 years ago.
obviously, different surgeons will have different costs.

I'm 4 weeks post op. I had top hospital and my out of pocket expenses were:

Surgeon's fee: $4500 (includes all follow up appointments, etc.)
Anaesthetist: $1000. It was $1700 upfront but I got $700 back from Medicare and PHI
Hospital excess: $500
Discharge meds: $30

So the surgery itself was around $6000 out of pocket. I also had visits with a dietitian ($200 for 2 visits) and chose to see a psychologist too (about $40 out of pocket for each appointment), but those were separate to the surgery so I count them separately :)

Luni wrote:

I'm 4 weeks post op. I had top hospital and my out of pocket expenses were:

Surgeon's fee: $4500 (includes all follow up appointments, etc.)
Anaesthetist: $1000. It was $1700 upfront but I got $700 back from Medicare and PHI
Hospital excess: $500
Discharge meds: $30

So the surgery itself was around $6000 out of pocket. I also had visits with a dietitian ($200 for 2 visits) and chose to see a psychologist too (about $40 out of pocket for each appointment), but those were separate to the surgery so I count them separately :)

Hi Luni.....
Did you know you can get a mental health & a dietitian care plan which minimises your out of pocket with dietitian & psych?
I did not know first time round and struggled a little with all the costs involved!
This time round I am much wiser! 😉
Linda

Thanks Linda - I have a mental health care plan for the psychologist, hence why the out of pocket was only $40 and not $160! I didn't have one for the dietitian at the time of my first appointment but I have had them in the past, I should really get another one.