This is probably a silly question but....

[Nef]

We have family cover with top hospital and top extras with no excess. What I was wondering was if something happened to either myself or the kids e.g broken arm, raging temp do I take them to the private hospital emergency ward or just the normal hospital?

Hope it's not such a silly question but feel better asking here than the insurance company and having them laugh at me!! ;)

[Sheer Bliss]

Most private hospy's don't have ED's (do they?? the 3 here don't) so you just go to the normal public hopsy ED. DD broke her leg, and was treated at the public hospy, didnt' need an op or pins or anything, so no specialists needed.

I think, that private hospy's usually only deal with specialist type things that involve surgery, rather than regular stuff. So if you broke your arm, and needed sugery to put a pin or something in, and wanted a specific surgeon to do the op....you can opt to be a private hospy in a public hopsy, or be referred to a private surgeon and go to a private hospy.

When DD broke her leg....we are in a smaller town, so would probably have ended up with the same drs no matter what we did - they were all brilliant in the kids ward anyway.

[Nex]

Don't just turn up to a private hospital expecting an Emergency room. Most don't have one!

In the first instance you go to the public hospital emergency room. Having private insurance means you can be treated by the specialist of your choice after you have had emergency treatment.

When I broke my arm, I went to the ER for treatment, then was transferred to the care of the specialist and was treated straight away.

Though an injury or a broken bone is something that will get you instant treatment under the public system too, you may not get to choose your Dr.

Private insurance is really good for non-urgent medical treatment like joint problems etc. Means you don't have to go on the waiting list.

[Ashleigh<3]

Your best bet would be heading over to the Public hospital Emergency room, if you show up at a private hospital they will more than likey direct you to a public hospital, regardless of your private health they don't usually have emergency waiting rooms in place, they work on scheduled appointments/operations.

If you or your family members wind up needing surgery, it would more than likely be scheduled at a private hospital. But your care can be managed then and there at a public hospital.
I have been well take caren of at a public hospital with full private health coverage.

EDA: Having private health insurance has never pushed me forth on the waiting list though. Public emergency rooms work on priority and I support that 100%. I don't expect my private health stance to be my Golden ticket to the front of the line, it has never occurred in my experience.

In my experience with seeing specialists, majority allow a certain amount of work within the private hospitals (this is usually their full time day job work), but also do public hospital operations for the public waiting list and/or when desperately needed. (On call).

[Nef]

Ok thanks so much for your answers, saved alot of embarrassment!!

[Izy]

Nef I suggest you take the time to check out your local facilities. Some private hosptials do have emergency rooms, but they also normally charge an aditional premium for the priveledge.

In some cases it might be worth the extra ($50-$300 on average), but in most cases just call an ambulance. Let them know you have private cover if it makes any difference they will take you to the appropriate place. (and safer than stressed mum trying to drive AND look after the kids at the same time) A public facility will be your frst port of call 99% of the time though

[teenie]

As the PP said - check out whether the private hospitals in your area have an ED. All 3 private hospitals where I live do - and over the years I or my family members have been to the emergency departments of all 3, and also to one of the public hospital EDs.

Here are the differences:

Private health does not cover a visit to an ED in a private hospital. I've found the cost to be around $130 (you get about $30 back from Medicare). Any scans/xrays etc are extra cost. If you are admitted to the hospital - then your private health kicks in.

The biggest difference is the waiting times...in my experience anyway. The longest we waited in a private hospital ED was about 1 hour. When we went to the public hospital we waited approx 5 hours (both times).

The medical care each time was great.

For us it depends on the situation. My DH is highly allergic to wasps. When he got stung 4 years ago and went fluro red and started having difficulty speaking etc we went straight to the private hospital. I was glad because there was simply less congestion there - we could walk straight up to the counter with no fuss.

When I was very unwell last year with severe abdominal cramps we went to the public hospital. It was so packed and hard to get anyones attention (at that time - it was a weekend). There was a guy there who'd come off a motorbike and was very badly injured (he had a dislocated shoulder among other things) and even he didn't make anyone bat an eyelid (except maybe me :rolleyes:). I'm not criticising - it was just SOOOO busy.

Sorry for the ramble but I think differing situations might lead to different decisions being made about where to go.

[mum_I'm_hungry]

:iagree:

I would only go to a public emergency room now for true trauma (car accident etc.) or if my kids needed attention (private emergency departments don't often have paediatric emergency specialists working there all the time).

I would check out your cover, as I really don't think it will cover the private emergency fee (no need for embarrassment, though!). And check out your local hospitals to see which ones have private emergencies (two of our local hospitals do).

We've used them in the past for: pneumonia (admitted within two hours), an appendectomy (into surgery within two hours), a broken collarbone (seen instantly) and another pneumonia admission (again admitted quickly) :thumbsup:

[jag5000]

the hospy nearest me that I always use (private) has an emergency, BUT for a long time now they have been privatised so they still charge and that isn't covered on health insurance. Ours is $230 just to walk in the door, payable upfront. Really gets my goat! the amount of $ we pay in private health and unless we pay those charges have to go to a public ED! grrr

[Izy]

To clarify a point... no private hospital cover will pay a benefit to emergency department treatment. The reason for this is the ED is classed as outpatient. The funds are not allowed too.

You are not an 'inpatient' or actually admitted to the hospital untill they give you a bed in a ward. Thats when the fund kicks in.

Medicare pays the same benefits to a public facility as a private facility for outpatient services as it's based on the schedule of fees for the item no billed. The difference is private facilities often run at a higher cost (hence the difference in service) and since they can't recoop from the funds, they recoop from the patient as an aditional emergency room premium. Sometimes it's done by charging over the schedule of fees for independent item no's. Other times it's a complete seperate item.

[jag5000]

I never knew that private A&E attracted a medicare rebate! I've never claimed before. Thanks for that info! :)

[Izy]

It may have already been claimed on your behalf. Most private ED receipts I have had the 'pleasure' of seeing were for an aditional charge only. The item no's were already claimed electronically between facility and medicare.

Check if your receipts have 5 digit item no's. If they do take em to medicare now and get some cash back :D

[lilli]

In my experience with seeing specialists, majority allow a certain amount of work within the private hospitals (this is usually their full time day job work), but also do public hospital operations for the public waiting list and/or when desperately needed. (On call).

This is a good point. I could have had my surgery in the public hospital next door by the exact same surgeon and not paid a thing (in the private hospital I had to pay $1000 in gap fees). Sure, I got my own TV with foxtel in the room... but it wasn't worth $1000 :no:. I won't make that mistake again!

Remember just because you have private health insurance, doesn't mean you need to use it. Eg. I'm having bubs at a public hospital for free vs private with gap fees.

Private health insurance is great for when you need non critical (yet painful) things like wisdom teeth out, tonsils, hip replacements, stuff like that. Otherwise you get put on a long waiting list in the public system.

[mum_I'm_hungry]

This is a good point. I could have had my surgery in the public hospital next door by the exact same surgeon and not paid a thing (in the private hospital I had to pay $1000 in gap fees). Sure, I got my own TV with foxtel in the room... but it wasn't worth $1000 :no:. I won't make that mistake again!

That usually doesn't happen, however. In the public hospital system you are most likely to be operated on by a registrar training in his/her particular specialty, sometimes with a fully qualified specialist in attendance, sometimes not (depending on how long he/she has been training). If you go private, you will have a fully qualified specialist.

Which is why I'm keeping my private health cover!