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Elective caesarean in public hospital


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#26 born.a.girl

Posted 17 July 2019 - 07:45 AM

I don't know about pregnancy, but doesn't PHI cover the gap between the ?75% (in hospital) charge, and the medicare scheduled fee?


That's what I've got back when I had (other) surgery in a private hospital. It's the fact that the scheduled fee is so far below what the surgeon charges that's the issue.

#27 Kiwi Bicycle

Posted 17 July 2019 - 07:55 AM

No, your health insurance only pays for things Medicare doesn't pay. So if you get a Medicare refund, private insurance doesn't top you up the difference.
So frustrating as in NZ, your Private Health covers everything less any excess up to a maximum amount, none of this a bit here and a bit there business.

#28 blackcat20

Posted 17 July 2019 - 08:01 AM

I had a $3k management fee and a $500 excess. Both OBs were covered by insurance, as was my anaesthetist and the hospital. It can be done relatively cheaply if you choose your specialists carefully.

#29 born.a.girl

Posted 17 July 2019 - 08:03 AM

View PostKiwi Bicycle, on 17 July 2019 - 07:55 AM, said:

No, your health insurance only pays for things Medicare doesn't pay. So if you get a Medicare refund, private insurance doesn't top you up the difference.
So frustrating as in NZ, your Private Health covers everything less any excess up to a maximum amount, none of this a bit here and a bit there business.


This is from Medibank:

https://www.medibank...-gapcover-work/


It's what I've received for PH surgery: 75% from medicare, 25% from health fund (Aust Unity), of the scheduled fee.


That's aside from all of the complexities about arrangements etc.




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