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

 

Win a Mountain Buggy Swift

To celebrate Essential Baby reaching half a million Facebook fans, we have a Mountain Buggy Swift to giveaway to a lucky fan.

Shopping with kids: breaking the pester-power cycle

You're out shopping with your little one and they're incessantly whining that they want a treat. It's easy to say no ... the first time, at least.

eBay jacket may hold clue to murdered girl's identity

A jacket similar to the one found with the remains of a brutally murdered little girl in South Australia has been identified on eBay.

New mum forced back to work early due to paid parental leave 'technicality'

Shelley Parker had to keep driving buses until the date her baby was due and will have to rush back to work at the end of this week after being denied paid parental leave on a "technicality".

Pregnant Amanda Palmer poses naked for book drive

It has to be the most original way ever of promoting a children's book donation day.

The conception dilemma facing many parents today

Some parents who conceived through a sperm donor will be wary of telling the child, while others prefer to deal with it early on. But recent research suggests it makes little difference either way.

The wedding photo the bridesmaid would rather forget

We've probably all seen a passed-out bridesmaid at one wedding or another, but it usually happens towards the end of the night.

Pregnant TV meteorologist takes on haters

Pregnant TV meteorologist Katie Fehlinger has hit back at haters who called her a "sausage in casing".

Honest words from first-time mums

I didn't want to say anything negative to my pregnant friend, but I wish I'd been more honest.

Adorable baby experiences rain for the first time, couldn't be happier

Harper had seen rain from the comfort of indoors before, but had never had the pleasure of being outside and experiencing it first hand.

What it's really like to start a family in your fifties

Many people suppose that it must be much more tiring to have a baby in middle age, but all the mothers in the playground look exhausted, whatever their age.

'Biggest hypocrite ever': Josh Duggar admits to Ashley Madison account

An American reality TV star has been busted with a cheating website account, according to US media.

Long recovery ahead for girl hit by car weeks after baby brother's death

A little girl is more alert and starting to talk after being hit by a car a week ago, but still faces a long recovery.

How to react when a toddler lies

Q: My almost-3-year-old is starting to figure out that he can lie when asked if he ripped the book, threw the food, hit his brother, etc. Totally normal, I know. How do we respond?

The circular experience of a Centrelink client

A mum-to-be experiences the frustration of dealing with Centrelink, myGov and everything in between.

Kelly Clarkson announces live on stage: 'I'm pregnant!'

Singer Kelly Clarkson has announced she is pregnant with her second child during a concert in Los Angeles.

Hack

How to search the leaked Ashley Madison data

At least three sites are republishing Ashley Madison's user data on the public-facing internet.

Mum dances her way through labour

There are a fair few ways to distract yourself and beat pains while in labour, but it's probably a rare woman who chooses her dance her way through it.

'Rest in peace, my little lion': premmie baby Jacob passes away

Baby Jacob, whose photo of him born at just 27 weeks was deemed 'too graphic' for a fundraising site, has died.

Mum killed three young sons 'to help her daughter', prosecutor says

Niall Pilkington's death last summer apparently raised little alarm in Bellefontaine, Ohio. Tragic accidents happen, after all.

Shorter women have shorter pregnancies: study

When a group of researchers studied nearly 3500 mothers and their babies, they noticed a curious pattern.

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

The worst 20 minutes of my life

Thirty seconds was all it took to turn a shopping trip into my worst nightmare.

Top baby names for England and Wales in 2014

George has overtaken William in the official rankings of most popular British baby names - and Game of Thrones is still having an impact on parents.

Baseball or baby? Dad's tough choice

What's more important, a baby or a baseball? That's a question this dad seems to struggle with.

Childbirth choices: five star or free?

It's not often you hear the words labour and luxury in the same sentence but for some, a 5-star start to parenthood is exactly what they seek. And with a number of private hospitals now offering packages which include a post-birth stay at a sumptuous first class resort, many mums are choosing to recover in style.

'Where did your boobies go, Mummy?' and other soul-destroying comments from kids

Most women carry a smidge of baby weight after giving birth. If you're lucky enough to have an older child in the house, they can keep you on track with your weight loss goals.

Do you read me, baby?

Is it too soon to be reading to my two-month-old son? If not, what should I read?

Minimising sibling rivalry when you've got a baby

Sibling rivalry is an act of competition, but if your children feel involved and special, this type of jealousy will be minimised.

Will studying on maternity leave take you away from your most important job?

I remember when I was trying to decide if I could combine motherhood and furthering my university education.

Win a Pacapod this Father's Day

To celebrate dads and families, we are giving away a Picos Pack from Pacapod Australia filled with a few extra goodies ENTER NOW

Preschooler hit by car shortly after baby brother's death

A mother has had a frantic race to the hospital after her daughter was hit by a car, just four weeks after her infant son died.

Gay couple and Thai surrogate in custody tug-of-war

A six-month-old baby girl is trapped in the Thai capital in a bitter custody wrangle between her Thai surrogate mother and her biological father.

Couple denied IVF over parenting concerns

A mother of six has been denied access to IVF treatment in order to have another child over concerns about her parenting skills.

The book that promises to put your children to sleep

Exhausted parents from around the world are singing the praises of a "miracle" book which promises to put even the most restless child to sleep in just minutes.

5 things every parent who feels guilty needs to know

Parenthood can make you feel bad, but you're not alone.

Royals criticise 'dangerous' attempts to photograph Prince George

The British royal family criticized paparazzi on Friday for what it called their increasingly dangerous attempts to photograph young Prince George.

'No jab, no play' rule to cover Victorian kindergartens and childcare centres

"Anti-vaxxers" face not being able to send their children to childcare centres or kindergarten if they refuse to have them immunised.

15,000 birthing kits on their way to developing countries

Giving birth in a hospital surrounded by medical experts is tough enough, but some women deliver babies without a clean sheet to lie on.

Photo of premmie 'too graphic', fundraising site says

When their son Jacob was born at just 27 weeks, Christina and Jeff Hinks were thrown into an uncertain world.

The latest Bugaboo collections: cool chevron and runner prams

Bugaboo sure likes to keep things fresh, and with the Australian spring/summer season coming up, there are two new Bugaboo pram releases.

Making room for two in the bed

Mum's room or their own room? Cot or bassinets? Deciding where twins will sleep can be tricky.

 

FREE TICKET

See Hi-5 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.