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Wanting to have gastric sleeve done PHI help


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18 replies to this topic

#1 Brighter future

Posted 22 April 2017 - 08:27 PM

Hello I am looking at having the sleeve done and
have been advised to have phi, I do but not hospital..
I have done a little research and OMG it is SO expensive.
I am with HCF we pay $66 pf with extras...
I don't  myself have alot of super (was a SAHM)..
It is becoming very daunting any advice or help
will be greatly appreciated.....:)
TIA

#2 sueratbag

Posted 22 April 2017 - 08:35 PM

I've heard some people do well with the hypnosis 'virtual gastric band'. Maybe have a go at that first? If it works, bonus! If not, you can still have the real thing.

#3 Kafkaesque

Posted 22 April 2017 - 08:35 PM

If you took PHI you would have at least a year long wait to get the surgery but you would be covered for a large portion of it. My DH had a sleeve and it only cost us $2000 out of pocket. That includes ultrasounds and appointments prior to surgery.

My concern having it some without PHI is that if something went wrong and you needed further ops or time in hospital you wouldn't be able to fund it.

#4 Soontobegran

Posted 22 April 2017 - 08:39 PM

I have not had one but know several people who have.

You need top PHI to be covered for this surgery now. Unfortunately I don't think your $66 with extras per fortnight will be enough :(

You could up your cover if possible and wait the 12 months waiting time.
Even with top private PHI the last person I know to have this last October was $6k out of pocket. The surgeon's bill was just under $4 k and the rest were anaesthetists, assistant surgeon, psychology and dietitian costs plus the hospital excess.

#5 Soontobegran

Posted 22 April 2017 - 08:41 PM

View PostKafkaesque, on 22 April 2017 - 08:35 PM, said:

If you took PHI you would have at least a year long wait to get the surgery but you would be covered for a large portion of it. My DH had a sleeve and it only cost us $2000 out of pocket. That includes ultrasounds and appointments prior to surgery.

Can I ask when and where this was? This is at least $3k less than around these parts and that was for several surgeons quotes. :(

Self funded sleeves were quoted at $20k plus.

Edited by Soontobegran, 22 April 2017 - 08:43 PM.


#6 Kafkaesque

Posted 22 April 2017 - 09:55 PM

View PostSoontobegran, on 22 April 2017 - 08:41 PM, said:



Can I ask when and where this was? This is at least $3k less than around these parts and that was for several surgeons quotes. :(

Self funded sleeves were quoted at $20k plus.

WA in late 2015. From speaking with others here it's fairly standard.

#7 SeaPrincess

Posted 22 April 2017 - 09:55 PM

There are public surgeons. There might be a wait, but you'll have a qualifying period with PHI as well.

#8 galba

Posted 22 April 2017 - 09:58 PM

I took out separate PHI cover just for myself - 3 years ago it was $73 a fortnight.

Then I saved $120 dollars a fortnight from my pay and put it straight into a separate account that I didn't touch.  Once the 12 month waiting period was done I had over $3200 in the account.  The rest (about $2000) was put on a credit card.

TBH I think I saved that in food in the first year.  I am now almost 3 1/2 years and have maintained my 40kg loss. It was the best thing I ever did.

ETA - I have very little super so that wasn't an option.

Edited by galba, 22 April 2017 - 09:59 PM.


#9 DM. 2012

Posted 22 April 2017 - 10:33 PM

Without PHI you will need to pay the hospital fees ($12 000 something where I work in Brisbane) plus the amount above the Medicare rebate for the doctors fees.

If you are prepared to wait a year and join a hospital level of cover, make sure you are having the operation for medical reasons (you'd need to discuss that with your doctor because I'm not sure what is deemed "medical" but most people don't have this operation just to lose a little bit of weight) because funds will generally only cover this op for medical reasons. Also, some funds have "benefit limitation periods" for this (and some other) procedure which means that after the initial 12 month waiting period, they will only pay "minimum/default" benefits (not much) for the next 12 months so make sure you read everything about the cover before joing up.

#10 paddington_

Posted 22 April 2017 - 10:39 PM

You will need mid/top hospital cover depending on which health fund you use.  Triple check the policy you take out covers weight loss surgery.
It will be a 12 month waiting period.
From there,  your out of pocket expenses will range from $1,000 (gold coast) to up to $7,000 for some surgeons.
My advice is price is not indicative of surgeon skills or patient outcome.

I paid $345 for my surgery out of pocket with an amazing surgeon who chooses to help people rather than profit.

It has changed my life.  Best decision ever.

#11 ~elle~

Posted 22 April 2017 - 10:41 PM

Have you tried going the public route?? My GP referred my last NOV - 5 months has  gone so fast - plus I've heard the 2 yr wait she advised is like a worst case scenario.

Some ppl are  getting through in about a year which is at least - what you'd have to wait for the PHI qualifying period.

I'm still keeping up the momentum by watching so many youtube videos of what ppl have been thru and looking a support groups and tracking my diet, exercising and trying to get my weight down abit. It all will help - because no way will I ever be regaining this weight.

#12 Crazyhouseholdof6

Posted 22 April 2017 - 11:23 PM

I had my op done in November last year. I didn't have PHI but used my super. All up including tax it was nearly $29k but if I didn't have enough I could have used hubby's / parents etc. is that an option for you? If not look up Peoplecare, you only need medium hospital with them as opposed to top with the big name companies and I'd just get it for you, it's about $20 a week. Not sure where you are but QLD closed its public doors in October last year to anyone not on the wait list already as it was over a 7 year wait. I do not regret it at all, best decision I ever made. Good luck, you won't regret it.

#13 cardamom

Posted 22 April 2017 - 11:50 PM

View Post~elle~, on 22 April 2017 - 10:41 PM, said:

Have you tried going the public route?? My GP referred my last NOV - 5 months has  gone so fast - plus I've heard the 2 yr wait she advised is like a worst case scenario.


Wow - maybe it varies a lot state by state but I enquired with my GP back in November 2014 and when she referred me the pubic registry people told me my BMI (around 45 at that stage) meant I would be looking at a 5 year wait!

#14 Roxi

Posted 23 April 2017 - 12:19 AM

Get cover just for your self, its much much cheaper. Good luck. My husband did it, and I think it's worth the money.

#15 Kafkaesque

Posted 23 April 2017 - 01:47 AM

View PostDM. 2012, on 22 April 2017 - 10:33 PM, said:

Without PHI you will need to pay the hospital fees ($12 000 something where I work in Brisbane) plus the amount above the Medicare rebate for the doctors fees.

If you are prepared to wait a year and join a hospital level of cover, make sure you are having the operation for medical reasons (you'd need to discuss that with your doctor because I'm not sure what is deemed "medical" but most people don't have this operation just to lose a little bit of weight) because funds will generally only cover this op for medical reasons. Also, some funds have "benefit limitation periods" for this (and some other) procedure which means that after the initial 12 month waiting period, they will only pay "minimum/default" benefits (not much) for the next 12 months so make sure you read everything about the cover before joing up.

I think will find that these days it's pretty easy to get it done. Despite my husband being more than 60kg over weight he had no ill health or even signs of precursors. All the clinic info said you must be certain BMI and have at least one significant health concern. He only has the BMI.

#16 Soontobegran

Posted 23 April 2017 - 09:04 AM

View PostKafkaesque, on 23 April 2017 - 01:47 AM, said:

I think will find that these days it's pretty easy to get it done. Despite my husband being more than 60kg over weight he had no ill health or even signs of precursors. All the clinic info said you must be certain BMI and have at least one significant health concern. He only has the BMI.


In the private system it is very easy.....just BMI, in the public system there must be comorbidities and then there is the waiting list which in Victoria is growing larger by the minute due to the number of people trying to access this surgery.

For may people the waiting list will only result in further worsening of those comorbidities.

#17 Gossipgirl22

Posted 23 April 2017 - 09:46 AM

If you have a partner, who has decent super, try going that route.

#18 Soontobegran

Posted 23 April 2017 - 09:58 AM

View PostGossipgirl22, on 23 April 2017 - 09:46 AM, said:

If you have a partner, who has decent super, try going that route.


I know this is quite a common route but it is quite a commitment and it gets up my nostril that surgeons charge so much whilst at the same time recommending patients do this.

Nobody should have to put their future financial position at risk for surgery...it's as life saving as many others that occur in the public system.

#19 born.a.girl

Posted 23 April 2017 - 10:15 AM

View PostSoontobegran, on 23 April 2017 - 09:58 AM, said:

I know this is quite a common route but it is quite a commitment and it gets up my nostril that surgeons charge so much whilst at the same time recommending patients do this.

Nobody should have to put their future financial position at risk for surgery...it's as life saving as many others that occur in the public system.

Absolutely. The fact that super companies are even prepared to release money for weight loss surgery shows that they see how important it is, and I say this as a household who'll never (fingers crossed) need it.


Nephew and his parter (both early 30s) had it done last year, and they'll now be paying tax for much longer than they would otherwise have been doing, no doubt.   (Not that that should count, but a healthy population is financially better for all of us, so it's daft to make it harder and so expensive.)




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