Ok i dont know wether to be peev'ed or not..

Ok so heres a basic run down on my current situation..

Have been with Latrobe Health Insurance since 11/1/2010 and so will be eligable for claiming my surgery on the 11/1/2011. Ive recently just been through my first appointment with the surgeon etc and been givin the costs run down form.

Im going through Lapsurgery Australia and have taken a picture and linked it just below so you can see / understand me better no doubt lol

https://img.photobucket.com/albums/v720/Grommitt/IMG_0239.jpg

It says in the middle column that Rebate claimable after surgery is a total of $1419. And then in the next column the Out of pocket expense is $5660. So what im somewhat confused / peeved about is that are my PHI only going to cover me for that measly $1419 dollars ? Is that what ive waited a whole damn year for now.. to be covered for that.

Im a structural designer by trade and make a good salary if id of known this was all they were going to help me with id of just payed cash and had the operation months ago.

I maybe going off the handle to quickly here and not reading things properly but if anyone can explain things better / tell me the % of how much my PHI will cover of the surgery thatd be awesome.

Thanks
James

PHI covers your hospital bed too.
My 4 nights in hosptial came to $11000 which was totally covered by PHI.
The costs for your surgeon and anaesthetist is on top of your hospital bed.

So my years worth of PHI cost me basically $960 but it saved me over $11000 +.
Bargain at twice the price I reckon.

Ok this is the sort of stuff I haven't been told / never really understood due to never having had or used PHI before.

Of you have any other run downs on costs please post them as I'm
interested to see the ins and outs of this.

J,

I had the same confusion when my surgeon first gave me the pricing breakdown, but it is the hospital stay that is apparently the most important part that you PHI covers. My out of pocket is around the $5K mark, but much better than the 12K that they quote. My PHI covers everthing in hospital, including a private room for 3 days, all i pay is my excess of $250. From my research, it seems that only the very highest level of cover will cover you for the entire surgery. I looked in to it and it was almost $200 per month. Instead, i just upped my hospital coverage and saved for the out of pocket cost.

I have heard that you can also claim some of your expenses on tax. Does anyone have more info on this?

James..ring latrobe health and ask them..that is pretty much what I paid out of pocket but I didnt have PHI.. we paid about $9k after we got rebated with the medicare and tax moneyetc

that is your surgeons cost. the real money the insurance pay out is your hospital room and theatre fees. that is the big bucks part.

applesauce

Hi,

The PHI will save you so much money. Although it doesn't cover the cost of the actual surgery it covers your theatre fees, hospital stay. I had my band out last week, i was in hospital for three nights and the theatre fees all up came to $5000, which my PHI covered.

With claiming on tax you can claim anything over $1500 for your incurred out of pocket expenses for the year. You receive 20% back on when you get your tax return. So when you lodge your tax return you will need your itemised statement of benefits from Medicare and one from your PHI as well.

eg: My surgeon fee was $4950 - $1500 = $3450

So i get 20% of that back ...$690 back at tax time

Good Luck, def worth while having the PHI

Therese

Hi. Have not had my surgery as yet either, though the PHI will cover the daily hospital charge in a private hospital. Yep! I know you could have it EVENTUALLY in a public hospital, may be a lot longer wait most likely; though you will get your choice of doctor and not the one the public hospital assigns you. I actually want the best to operate on me! (I would hate to get someone less experienced and get complications). Then as Therese says, claim the rest back on your tax return; or at least you get a reduction on your tax payable; and that is for yourself, partner and all your dependent's Net Medical expenses combined. (one of you claims it)

Hi J

The 100 odd dollars is what they are going to pay for your surgeon etc. Unfortunately no matter how good your insurance, 98% of the doctors who do weight loss surgeon charge over what medicare and halth funds pay, usually signifcantly.
However be assured you did not join PH for no reason, it will cover your hosoital stay/theatre costs etc. Without complications this is around 7000 - 10000 depending on the hospital. And then you can be assured that if you had to stay another 5 nights , you don't have to cough up anymore to the hospital as your fund will pay :)

PHI is there to cover the hospital costs - they never cover much of a doctor's bill. Just imagine if you had to pay for your hospital stay - that could be many thousands. I've heard people say the total cost for self-paying people is around $12,000.

Caz

Also you never know when you need it for other things I have a shunt replacement last year my gaps were $1200 they fund paid out in excess of $19,000. Remember this surgery is an elective one so they have more out of pocket costs, you also get 20% after $1500 on tax. My logic is we insure our cars/homes why not our health? Benefits are great, choice of dr vs Public pot luck, high chance of own room and other little things like wi-fi (bonus for 3 week + stays). better TV. Just to name a few.