letsStart13 11 Report post Posted February 25, 2013 I'm so new to all of this, it's quite overwhelming I'm still at the "taking out insurance stage" and I'm wondering if anyone who took out insurance solely for Gastric Banding, can you share information on what needs to be in the policy to cover as much as possible of the cost. I realise there'll be out of pocket expenses which I'm preparing myself for. I don't want to pay a fortune for things I don't need, so finding the right type of policy is important ... Thanks in advance Share this post Link to post Share on other sites
Happyfrog 694 Report post Posted February 25, 2013 make sure it covers the lap-band i think the number is 30511, hcf dont use that number just ask them. Share this post Link to post Share on other sites
letsStart13 11 Report post Posted February 25, 2013 Thanks, for that, every bit of info helps Share this post Link to post Share on other sites
Happyfrog 694 Report post Posted February 25, 2013 i just rang them and said i want insurance and it needs to cover the lap-band and went from there Share this post Link to post Share on other sites
letsStart13 11 Report post Posted February 25, 2013 Great I'll get on to it and make that as a starting point. If you don't mind me asking Trina, what insurance company have you used? Share this post Link to post Share on other sites
Happyfrog 694 Report post Posted February 25, 2013 i went thru HCF i have cover for my whole family. Share this post Link to post Share on other sites
RahRah 61 Report post Posted February 25, 2013 30511 is the item number. also ask them if they have preferred providers that charge no out of pocket costs. Share this post Link to post Share on other sites
letsStart13 11 Report post Posted February 25, 2013 RahRah, Do you mean by, charge no out of pocket cost as "the gap" or do certain PHI cover the whole expense, if you use their preferred provider? and thanks Trina for that. Share this post Link to post Share on other sites
RahRah 61 Report post Posted February 25, 2013 yeah out of pockets or the gap lol there may be some health insurnce co. that pay everything if u go to one of their preferred providers. i dont know of any that do, but your gap comes from how much the dr charges u over and above the scheduled fee. the scheduled fee for 30511 is only approx $860 yet dr's charge $1000's more than that. the scheduled fee is the amount the government/medicare have set for that particular procedure. Share this post Link to post Share on other sites
kazbo 5,052 Report post Posted February 25, 2013 I had/have basic hospital with HCF and my out of pocket expenses were around $7,500-$8,000 I believe that, for a lot of money, that MBF (?) has PHI that covers every thing known to man kind with no gap. It is very expensive though! Share this post Link to post Share on other sites
Happyfrog 694 Report post Posted February 25, 2013 i have basic and my out of pocket was $3900 Share this post Link to post Share on other sites
letsStart13 11 Report post Posted February 25, 2013 Thank you all so much for this info, I have a great starting point that no longer seems to be overwhelming! I'll start the ringing around tomorrow to see who and can provide the right policy to suit my needs. Trina did you have your band done in Canberra? $3900 is very reasonable for out of pocket. 1 Share this post Link to post Share on other sites
kateye_diamond 44 Report post Posted February 25, 2013 im wiht MBP my Out of pocket is about $1750 and im going private. i also get to claim a lot of that back becasue i get a 'bonus' every year in my PHI that i can use for anything, therefore my 500 excess will be claimed back... therefore only costing me about $1750 Each PHI is different as is each Dr you see. Share this post Link to post Share on other sites
RahRah 61 Report post Posted February 25, 2013 Thank you all so much for this info, I have a great starting point that no longer seems to be overwhelming! I'll start the ringing around tomorrow to see who and can provide the right policy to suit my needs. Trina did you have your band done in Canberra? $3900 is very reasonable for out of pocket. iselect.com.au is a great starting point for comparing health insurers. just make sure u are aare of any restrictions or exclusions in any policy. My health fund only has top hospital with no restrictions or exclusions. your gap/out of pockets is determined by your dr. not the health fund. i paid $500 out of pocket. but my work paid $1000 of inpatient out of pockets and my $500 excess Share this post Link to post Share on other sites
Happyfrog 694 Report post Posted February 25, 2013 i also went thru iselect but remember they only compare 4 companies i think it is, i was banded in bowral, i paid the clinic $3900 then i had the anethatist $1300 and excess for hospital stay $450 so my 'gap' was $3900 but had a few extras after claiming thru medicare for the anethatist i am out of pocket around $5500 total from the beginning - seeing my GP for a referral, first appt with surgeon etc to leaving the hospital after the op if that makes sense Share this post Link to post Share on other sites
letsStart13 11 Report post Posted February 25, 2013 Thanks Trina, it makes perfect sense. Kazbo, it is MBF that offers the Medical No Gap Scheme and yes it is very expensive! I've been surfing around iselect and other PHI to see what's out there, especially looking at the restrictions or exclusions, I just wish I could take a little bit from each PHI provider and make my own policy, life would be great ... All info given is appreciated especially now I have an idea of what it all means (the jargon). Next step sort this PHI out and take the big step to attend an information night. Cheers Guys Share this post Link to post Share on other sites
kazbo 5,052 Report post Posted February 25, 2013 If I earned a squillion dollars a year, I'd get the MBF top cover, no gap thing...but I am but a poor, humble administration officer with 3 other semi-dependant adults relying on my income 2 Share this post Link to post Share on other sites
letsStart13 11 Report post Posted February 26, 2013 Just want to share with you all, that I have found a PHI Provider that I am happy with and made sure to ask all the questions. I have also signed up for the next meeting on March 25th (waiting on confirmation) with Canberra Bariatric so I am pretty stoked with myself for talking the first step. Thanks everyone for all your info, it really helped when I was talking with the insurance guy on the phone, it really made me sound like I knew what I was talking about LOL 6 Share this post Link to post Share on other sites
Happyfrog 694 Report post Posted February 26, 2013 Well Done!!! 1 Share this post Link to post Share on other sites
cdazzle 106 Report post Posted March 1, 2013 Wel done I'm with cua health , the hospital insurance has no exclusions , we have worked our costs out to be 7900 out of pocket , this included our 1000 excess:) I rang them and emailed them to make sure it's covered , but there are no exclusions lol . But I just wanted to make sure Share this post Link to post Share on other sites
letsStart13 11 Report post Posted March 1, 2013 I got cover through HCF and it covers what will need to be done. HCF provide throughout any of there hospital covers (basic to top) offer the "no gap medical scheme" the only thing that disappointed me was Canberra Bariatric do not participate in this option, unsure as to why, maybe it's like drawing blood out of stone for the doctors from the Insurance company, just would be great to utilise this ... Anyhow I'm preparing for my cost to be around that amount as well, I'm training my brain to accept it All the best with your Op Cdazzle 1 Share this post Link to post Share on other sites
