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

 

Australia's top baby names of 2014

The numbers have been crunched and it's official: Australian parents are having a bit of an 'O' moment.

As a guilty mum: the best advice for treating head lice

Just like a horror movie ... THEY'RE BAAAAAACK. So what works in treating and avoiding head lice and nits?

No, having a dog is not like having a human child

It's obvious these people dote on their pets, but they're barking up the wrong tree.

Confirmed: Kate Middleton is in labour

The Duchess of Cambridge is in the early stages of labor at St Mary's Hospital.

Baby-led weaning worked for us

My baby wasn't interested in food - until we tried something new. Now she's eating it all, and it often comes from my plate.

Parenting an early walker

Watching your child take their first wobbly steps is one of the best parenting highs you'll ever experience. But with that high comes a new reality.

Overdue and over it

A watched womb never labours ... or at least mine didn't.

Seven questions you should be asking about your health cover

If the last time you assessed your health cover was five years ago, there?s a chance it may no longer suit your needs. To ensure it?s still right for your family, click here for seven questions to ask.

'Paralysed bride' becomes a mum

Rachelle Friedman Chapman was preparing to marry the man of her dreams when tragedy struck four years ago.

Why the royal baby will look more like Prince Philip than Prince William

No matter what the occasion the world always seems to be waiting for Prince William and Kate Middleton.

Surprise baby born on toilet

Discovering your wife has just given birth on the toilet would be a surprise for anyone. But the shock would be even greater if neither you or your partner knew you were expecting a baby.

5 spooky photos with babies and children

These five photos show some ghostly images - but are they real? Do you believe in the spirit world?

Does it matter how much time you spend with your children?

Does spending more time with your kids help their development? This is a more complex topic than it may seem.

Rare condition diagnosed during optional scan

A mother who opted for a 4D scan late in pregnancy discovered her unborn baby had a rare brain disorder.

Cleveland captives speak about their decade of terror - and their futures

"I think we were just tired of people talking, trying to tell our stories, and they had no idea, no clue, what we went through."

Proof it's impossible to not join in a toddler's laughter

They say laughter is the best medicine. If that's true Tom Fletcher and his son should live long, healthy lives.

How I really feel about my drug-free birth

Do I feel 'smug'? No. Nor do I feel remotely superior. Each birth was valid and valuable in its own right, producing, as it did, a healthy baby.

How to talk about your pregnancy at work

The workplace isn't always a friendly place for pregnant women. Yet working women inclined to conceal a pregnancy from prying coworkers may be better off opening up and carrying on, according to a new study.

Tell us your story to win!

To celebrate Mother's Day this year we are giving you the chance to win one of five great prizes simply by telling us your story.

The Goss

Sonia Kruger: 'One baby is enough'

The popular TV host has no plans for a sibling for her new daughter Maggie.

Where to get help to help your baby sleep

There is so much pressure about having a baby who sleeps 'all night' , it's no wonder you worry about your baby if she wakes in the night.

 
Advertisement
 
Advertisement
 
 
 

What's hot on EB

Playtime guide:

A new area on our site for all your playtime and learning fun with baby - specially brought to you by Fisher-Price Play IQ?. PLUS your chance to win a year's supply of toys.

Celebrate being a mum with Offspring

This Mother's Day, treat yourself to possibly winning an ultimate Mother's Day gift pack valued at $250 including the Offspring Box Set. Enter now!

Vintage baby names having a comeback

What makes some names have comebacks while others silently fade into oblivion? A few factors come into play.

How to play with your newborn

Even though they're immobile and can't speak, there are plenty of ways you can engage and communicate with your newborn to stimulate their physical, cognitive and emotional development.

Mum of six faked cancer to get donations, police claim

Elizabeth Edmonds' husband posted some devastating news on Facebook last year.

I'll admit it: I have last child parenting fatigue

If you're a new mum and feeling ignored by the older mum/the old hand/the has-been, please know, it's not you, it's me. Blame the last child parenting fatigue.

Cobie Smulders speaks about her battle with ovarian cancer

The 'How I Met Your Mother' star has revealed that she was diagnosed with ovarian cancer at 25 - and was told she'd never conceive naturally.

Essentials your child needs to grow

What does your baby need to grow up healthy? The experts give their advice.

Coroner warns of 'dangerous' cot

A UK coroner has warned of the dangers of a bedside cot after the death of a newborn baby who choked to death this month.

Building your baby's emotional and social skills through play

Babies are social beings who enjoy being around people they know and love, especially you.

Why suicide prevention is everybody's responsibility

Everyone agrees we need to do more to care for people at risk from suicide, the problem is what.

Exhaustion is not the same as tiredness

Having a new baby isn't tiring - it can be downright exhausting.

Five posterior babies, four home births

I was on a high. I'd done it all by myself with no help from anyone.

Mum's list of birthday gift demands goes viral

We're big fans of kids' birthday parties - but this is one bash we're glad we didn't get an invite to.

Kate Middleton to receive 'loyalty discount' for second birth

Everybody loves a bargain - including the Duchess of Cambridge.

Fish & chip shop owner's sad note goes viral

A lengthy note put on the window of a fish & chip shop has gone viral due to the writer's serious doubts about the romance of travel.

Pregnant women need good nutrition advice, not judgment

Pregnant women are under pressure to do all the "right things" to have a healthy child. It results in women feeling judged about their decisions.

William Tyrrell's mum speaks out: 'We hope he is still alive'

The mother of missing toddler William Tyrrell says she has a vision that somebody "picked him up and moved him on ... that's the only way ... to explain for him not to be there".

Family comes first for 23-year-old Tommy Connolly

Most 23-year-old blokes spend their hard earned cash on fun times with mates or romantic dinners with their girlfriend, but not Tommy Connolly.

Newborn all-girl quintuplets 'doing great'

The first all-female quintuplets born in the United States were delivered last week, at 28 weeks and two days.

53 creative pregnancy announcements

Announcing that you're expecting can be a time to express your creativity, sense of humour and imagination. Check out how other parents and parents-to-be have broken the news to friends and family.

IKEA hacks for the nursery and kids' rooms

Are you one of those that know the whole IKEA catalogue by heart? Love their stuff but want to personalise it? Here's some inspiration to help you realise the potential of IKEA furniture and fittings.

 

Top baby names

Baby Names

The numbers are in and we can now bring you the 2014 top baby name list for Australia.

 
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.