GU Private Health Insurance!........."Pi**ed Off"

[maisymum]

Just wondering if anyone else is out there with "G U Insurance" ......We have their top cover and it says Ambulance is covered 100% for Emergencys in WA.......So we thought we were covered. Over the last 2 weeks we have called 000 twice in which i was hospitalised with a twisted ovary very painfull there is no way of getting me to hospital any other way......we have just recieved the bills $606 each....YES $1212........because they only cover priority 1, this means you have to be not breathing.....how stupid is that! I have phoned many companies and they said some companies do that but it shouldn't be that way!.....We have now taken out extra cover with Medibank Private for $56 a yr for the family everything to do with a Ambulance call is covered even if our DD broke her arm.....thats what it should be not only if your not breathing.....So "NOT HAPPY JAN!" we now have a $1212 bill to pay even though we have the top Health Insurance coverage!.....So if any of you are with G U i would be taking out the extra coverage!

[Me]

How ridiculous is that! I'm so sorry to hear you've been burnt, but at least you've warned others so they might not be in the same boat too.

[NibbleCurlynBub]

I think once you're not breathing an ambulance may be of little use.

How stupid.. :confused:

[maisymum]

Yes this has totally made our day "SH*T"........:banghead:

[twotrunks]

We had a friend with placenta praevia who started bleeding heavily and had to be rushed to hospital... it was life or death but they still weren't covered by their health insurance!
We have cover with Ambulance Victoria which fully covers the family for like $100 a year or so, because we didn't want to rely on our health insurer. Does WA have a similar scheme?
TT

[Amara]

Yes that's a familiar story. They probably have it in the fine print somewhere in their policy booklet. I've always had ambulance membership as I've heard of this type of thing happening. That covers everything. Not sure if that's available in your state though.

[maisymum]

Yes, in WA we have St John Ambulance coverage but you can only take that out if you live in the country, we live in the city so for that you need to take out private health insurance which we did i checked the Ambulance coverage and it said they cover emergency's i thought like anyone else would that when you call 000 it is an emergency but NO you have to be not breathing!.....so today i found some extra coverage through another private health fund and they do cover you for any ambulance call out!.....Thats what they all should do!.....Still trying to get over the $1212 bill :hair::hair:

[Larski]

Thats terrible. Is there an Ombudsman or someone you can complain/ appeal to?

Thanks for warning us on BH. I will definitely check what my cover is...

[Izy]

There is a private health insurance ombudsman that you can contact to further a complaint, but you must have first explored every avenue to have the dispute resolved with the insurer.

I would be submitting a request for special consideration and clearly explain that this was an emergency as stated on the bill. Offer to complete incident reports if it helps, and perhaps later in the piece explain that you do feel thier material is misleading and that you will adress this with the ombudsman if only to have all thier booklets and advertising amended so that others don't fall into the same trap.

Slip in there that they are certainly risking your loyalty.... see if that does anything to get this $1212 paid.......

Good Luck

[leagmz]

Ouch! I didn't know much about ambulance cover when it comes to health insurance either (it varies with each state depending on whether the state govt covers you or not), but I took out health insurance with moneytime and it tells you everything explicitly.

moneytime is a private health insurance comparer (www.moneytime.com.au) and on their comparison table it tells you whether the health fund covers ambulance and whether it's emergency only (where it says 'where death or morbidity is at risk') or whether you have comprehensive cover, which means you get ambulance cover for any reason.

Next time you want to review your health cover, try them.

Good luck with contacting PHIO (the ombudsman), but I'm afraid they'll probably tell you it's in the policy fine print... :(

[Lollie86]

Yeah I dont think the ombudsman wont be able to do much but its worth a try.

I worked for a PHI and their policy was that an emergency was based on whether the paramedics determined it to be one or not. Every company is different though.