Jump to content

PHI confused


  • Please log in to reply
9 replies to this topic

#1 GreenEyedGirl

Posted 21 January 2013 - 02:40 PM

I have PHI with medibank pvt & am having orthopaedic surgery tomorrow for a broken ankle at Wesley Brisbane.
Confused what will be covered by PHI
I have had IVF and my doc and stay have been covered but anaesthesiologist has not. Wondering if this will be the same.
Anyone know?
Tried calling medibank but can't get through!  huh.gif

#2 handsfull

Posted 21 January 2013 - 04:38 PM

Ring your surgeon and ask what the out of pocket (GAP) will be for the surgery and what the anaesthetist is going to cost you.

PHI covers your hospital stay but if the Dr charges a gap they do not cover that and you have to pay them that.  You can claim back at tax time.  Also depends on the level of cover you have as to what is covered, ie. some levels of cover only do certain types of surgery, top hospital cover normally covers every type of surgery.   Depends on which one you have.  MBP are generally very good.

GL for tomorrow.  Hope the gap is not too much.

Edited by handsfull, 21 January 2013 - 04:39 PM.


#3 GreenEyedGirl

Posted 21 January 2013 - 04:45 PM

Well I have mid hospital 250 excess + smart choice extras

Regardless I have to have the surgery whatever it ends up costing. Will ask when go into hospital though.

Would the fact that I was in hospital 3 mnths previously make any difference.

So confused what between what medicare covers and PHI covers!!!

#4 JRA

Posted 21 January 2013 - 05:23 PM

you need to understand these things. You are paying a lot of money for PHI.

A specialist I believe must, if not should, give you details of your out of pocket expenses.

The amount out of pocket depends on so many things. The anaesthetist will be covered. But often for an anaethetist there can be a LARGE out of pocket.

Your PHI may may have an arrangement with the hospital/surgeon/anaethetist that means there is no out of pocket. Once again you can check.

They should have given you a quote including how many "units" or such of anaethetist time/billable units.

Good luck

#5 rjflc69

Posted 21 January 2013 - 05:33 PM

My experience with Medibank Private (with the same cover) and out of pocket expenses

$250 hospital excess (resets in January so you will have to pay this on admission)

Anaesthetist - some covered by PHI & Medicare but paid a gap (we paid between $120 - $250)

Surgeon - some covered by PHI & Medicare but paid a gap with some not others (up to $500 if Medibank preferred surgeon)

X-rays/scans while in surgery - some covered by PHI & Medicare but paid gap every time (up to $120)

Hope that helps a little and good luck with your surgery

Fiona

#6 barrington

Posted 21 January 2013 - 05:39 PM

Your orthopaedic surgeon should have given you the name and contact number of the anaesthetist that will be doing your case tomorrow, so that you can call their rooms directly for a quote.

If it is a non-urgent case, in most cases the anaesthetist's rooms will call you in advance with their fees.  But if the surgeon does not notify the anaesthetists rooms (in situations where you are added to their list at the last minute), then they are unable to call you to give you their fees in advance.

The fact you were in hospital three months ago will make no difference to how much you are charged by the anaesthetist.  I would be expecting to have an out of pocket cost.

Good luck tomorrow.

#7 GreenEyedGirl

Posted 22 January 2013 - 08:54 AM

Last surgery I had was an emergency ectopic removal and I obviously got no quotes as found out and was rushed straight into hospital.
The anaesthetics bill was $650 when I got it. It said not to go to my PHI or Medicare as they would file directly, so not sure if anything got rebated there... been so caught up in things I have not checked.

Again this surgery is pretty urgent to and I saw the surgeon yesterday and having the surgery today.

Anyway as I said I have to have the surgery regardless of costs involved. Just wanted to get an idea .... i will ask  when I go into hospital

#8 Expelliarmus

Posted 22 January 2013 - 09:03 AM

The anaesthesiologist has been covered but you have to pay a gap fee. It's standard to send you a bill for the gap and they file for the Medicare and PHI rebates on your behalf. $650 gap for anaesthetic is fairly standard, a little higher than I usually pay but not by much. They should have given you, or you can request, an estimate before surgery.

#9 MrsLexiK

Posted 22 January 2013 - 09:11 AM

Oh you will also get stung with excess again as it is once year sad.gif

#10 GreenEyedGirl

Posted 22 January 2013 - 10:29 AM

The anaesthesiologists office called and said out of pocket I should be $200 so they will bill me for that.
So that is all good.
Surgeons office is finding out what my out of pocket expenses will be and letting me know soon.
Hopefully it is not too much.

More than this its me not being able to work for 4 weeks that is going to sting!
sad.gif




1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users

 

Abbott's childcare changes will 'reduce access and add complexity'

The government's childcare assistance package threatens to confuse and intimidate many parents, experts say.

Be careful what you wish for

Remember that chubby little baby who rocked on all fours? Remember how you wished he would start to crawl? Then remember how you felt once he did?

William Tyrrell's parents plead for information as anniversary looms

As the one-year anniversary of William Tyrrell's disappearance draws near, the missing four-year-old's parents have again pleaded with the public for information that could help bring their son home.

Family sleepovers: a tribute to my 1970s childhood

My memories of those nights in my childhood are all about fun: sleepover excitement, staying up late, watching movies we probably weren't supposed to watch ... freedom.

43 minutes of terror: family's agonising wait for ambulance for toddler

It was terrifying. As the minutes ticked by little Cooper Harrison's parents felt more and more frantic.

What not to say to a new mum

Some phrases just pop out before you really think about them, but there are some things you should try to not say to a new mum.

Mummydesking: the new hotdesking

It is a paradise that only working parents of small children can understand: a place to sit for three hours without any interruptions while someone looks after the kids.

Charlize Theron adopts baby girl

A few months after splitting from Sean Penn, the actress Charlize Theron has adopted a baby girl.

Facebook CEO Mark Zuckerberg shares painful truth behind wife's pregnancy

Facebook chief executive Mark Zuckerberg has shared a brutally honest truth about pregnancy in the hope it will help others through dark periods.  

Sugary drinks blamed for removal of toddlers' rotten teeth

Children as young as 18 months are having multiple rotten teeth pulled out as parents feed toddlers soft drinks through sipper bottles, and chocolate biscuits and Milo as bedtime treats.

Mum accidentally fake tans baby

Many of us have fallen foul of a bad fake tan or two, but this little guy's started a bit earlier than most.

Does this three-month-old say 'I love you'?

YouTube user Ted Moskalenko was filmed by his wife, Michelle, as his baby son, Ben, engaged in some baby chat.

Kids break out of daycare centre, cross busy highway

Two children broke out of an early childhood centre and wandered across a four-lane road.

Why I'm glad to be an indulgent granny

The phone calls started a couple of weeks ago. At about 5.30 each evening - if I am lucky - I will be greeted by a sweet, excited voice declaring: "'Allo Annie".

Newborn found in toilet at German airport

A newborn baby found abandoned and extremely ill in a bathroom in the Munich airport is doing well.

Is this the worst relationship advice ever published?

You sometimes have to wonder whether relationship/sex advice from magazines is designed to help or humiliate.

How you talk to your baby now can impact social skills later

People used to think that social skills were something kids were born with, not taught.

Three truths about C-section mums

Lately I've been thinking about the caesarean stories and the brave women who birth their children with strength and beauty.

Scientists predict when you should start a family

Scientists have calculated at exactly what age you need to start trying to get pregnant to have the best chance of realising your dream. 

Differently abled child

When 'protecting' a child is really a cover for judgement

Why are people so concerned for this happy child and his mother?

Get your FREE Baby & Toddler Show ticket!

Get your free ticket to the Sydney Essential Baby & Toddler Show for September 25-27 - register online now.

 
Advertisement
 
Advertisement
 
 
 

What's hot on EB

When toddlers have strange obsessions

When it comes to two-year-olds and birthday cakes there are a few requests that are usually at the top of the list. But a cake featuring a local personal injury lawyer?

When Mama Bear strikes

When we become mums, our instinct to protect our children and keep them safe from harm is so strong we're often likened to a Mama Bear protecting her cubs.  

Immunity boosters for kids

There are no guaranteed ways to avoid the dreaded winter illnesses completely, but there are ways we can boost our children's immunity.

Yes, you can get pregnant before your period returns post-baby

After giving birth, the last thing you want to think about is contraception. But you can get pregnant before your period comes back.

Mum shares portrait of her proudly breastfeeding three-year-old

Jade Beall usually chooses to breastfeed her son, now 3, in private. This week, however, she shared portraits of her breastfeeding her preschooler.

Dealing with a toddler's morning tantrums

Your schedule is not important to your two-year-old, and you cannot convince her otherwise. So what can you do?

My baby's first seizure

It was 1am on a cold winter's night when I woke suddenly to the screams of my 12-month-old son. Our lives were about to change forever.

MP breastfeeds baby during parliamentary session

An Argentinian mum and politician has caused a stir on social media after being filmed breastfeeding her baby.

Heartbreaking moment mum kisses her one-week-old goodbye

At 11.07am on April 2 this year, Sarah Marriott welcomed baby Sebastian into the world.

The best age to get married (according to the latest study)

Not too young, and not too old. That's reportedly the best age to get married. Not everyone agrees.

Fellow diner rewards mum after toddler's tantrum

Parents of toddlers everywhere know the feeling. After working up the courage to take your child out for lunch or dinner in public you are rewarded with a mid-meal meltdown. 

IVF gender selection being considered for Australian parents

Couples using IVF may be able to choose the gender of their babies and women could be financially compensated for donating their eggs.

The amazing Tee Pee bed and kid-friendly Frankie Bunk bed

These kids' beds definitely fit the brief of providing personality and personal space for little people who are moving up in the world.

The funny things kids say when you're pregnant

Since becoming noticeably pregnant, my son has taken more of an interest in the sibling he'll soon have.

The real problem with having one child

In this age of political correctness, it seems the one subject still subject to discrimination is that of the Only Child.

The fire hazard in more than 70,000 Australian homes

So far, 206 Samsung washing machines have caught fire and some have exploded. But many remain in people's homes.

How having a baby can bring on OCD

We all know that having a baby can turn your life upside down - and it can also bring a raft of new anxieties and worries.

IKEA begins massive safety campaign after two toddler deaths

Two children were killed when pieces from their Malm furniture line tipped over.

Which beauty treatments are safe in pregnancy?

Is it safe to use fake tan, hair dye and nail varnish during pregnancy?

A dad's guide to hyperemesis

I am in no way qualified to advise women on how to cope with hyperemesis, but I've learnt some lessons that might be worth sharing with other partners.

The five ways I know my 'baby' is no longer a baby

The truth is, I can no longer deny that my walking, babbling, somewhat-independent little miss is no longer a bona fide 'baby'.

 

FREE TICKET

See Pinky McKay live in Sydney

Get your free ticket to The Essential Baby & Toddler Show and save $20 - register online now!

 
Advertisement
 
 
Essential Baby and Essential Kids is the place to find parenting information and parenting support relating to conception, pregnancy, birth, babies, toddlers, kids, maternity, family budgeting, family travel, nutrition and wellbeing, family entertainment, kids entertainment, tips for the family home, child-friendly recipes and parenting. Try our pregnancy due date calculator to determine your due date, or our ovulation calculator to predict ovulation and your fertile period. Our pregnancy week by week guide shows your baby's stages of development. Access our very active mum's discussion groups in the Essential Baby forums or the Essential Kids forums to talk to mums about conception, pregnancy, birth, babies, toddlers, kids and parenting lifestyle. Essential Baby also offers a baby names database of more than 22,000 baby names, popular baby names, boys' names, girls' names and baby names advice in our baby names forum. Essential Kids features a range of free printable worksheets for kids from preschool years through to primary school years. For the latest baby clothes, maternity clothes, maternity accessories, toddler products, kids toys and kids clothing, breastfeeding and other parenting resources, check out Essential Baby and Essential Kids.