Treated as a Private Patient in Public Hospital, Huh?

[Team Blue]

I'll give a brief run down...

Im due to have a hysterectomy in either Dec/Jan due to severe menstrual bleeding/boardline hemmoragging periods with a family history.

Today I called Medibank Private to make sure that I'll be covered in Dec/Jan as our 12 month waiting period without pre-existing aliment forms being completed is up.

The lady explained we will be covered and once I get the "item" number of my procedure, give them a call and they will determine if I am covered for the procedure in a private hospital.

If I am not, they will pay for it to be done through a Public Hospital instead.

Im confused and very worrried.

1. I dont think my gyno would work in the public system hospital
2. We have First Saver Hospital Cover
3. Would I have to wait the enormous public system waiting list for my operation? Im already anemic and have to wait long enough to get this done. The wait to just get an initial consult is 12 months!!
4. Why on earth do they clog an already strained public system when there is a perfectly good private system there waiting to go?
5. I'm not concerned about the level of care, Im just concerned about the information being passed on correctly, my private gyno has been with me since day dot.
6. :crying:

Can anyone please shed some light, Im so worried :(

[Mamaduke]

A lot of private practising Doctors/Specialists also practice at public hospitals so you should be fine in that respect.

The 'plus' of going to a public hospital as a private patient is that you have your choice of Doctor/Specialist and you will only be seen by them.
You don't have to pay an excess as you probably would if going to a private hospital.
I doubt very much that you'd have to suffer the long waiting lists that are part and parcel of the public system since you will have your own specialist.
The public hospital is paid for your stay by your private health fund so you're actually doing something good for a public hospital by being admitted as a private patient.

[Team Blue]

Thanks Mamaduke (good to see you around again, Im under a new username, but an old member :D)

My concern is I dont think he works out of the public Hospital, he's a gyno/OB/fertility (all in one guy LOL) specialist at a Private one and works out of their specialist centre and hospital and day theatre :(

[Bunnyhugs]

Before you stress too much, call your gyno office tomorrow and ask them for the probable item number/s for your hyster and if he works out of the public system, then call MBP and ask them if you're covered for that item number.

[Team Blue]

I would but I would doubt that they will give me the items as I have two choices, the hystercectomy or an ablation (albation has only 20% success rate for me as Im only 27) I think they would have to get the items off my gyno??
I guess I could ask them about the public hospital though. He does have an assistant who helps out (nurse) for when he's in theatre and catching babies, so I can most likely talk to her?

I wish it was straight forward!

[Bunnyhugs]

Ask them what the item numbers are for each procedure, that way when you ring MBP you can check with them if you're covered. If the gyno office can't give you the item numbers, they'll leave a note to ask him and get back to you. Trust me, people who work in medical offices are used to patients calling asking for item numbers to ensure they're covered :yes:

[Team Blue]

Thanks Tasma :D You're a cleaver cookie and always respond to my posts :goodvibes:

BTW: Your due date is a terrific date, it's my Dad's bday, a nice fiery Scorpio for you :yes:

[Bunnyhugs]

Anytime :D Yeah I'm not sure how I'll go with a fiery Scorpio after a VERY relaxed Libra :laughing: little bit scared actually LOL.

Good luck :thumbsup:

[*~alegna~*]

I don't see why Pindara wouldn't cover you lovey, they are MBP prefered I'm sure.

Anything Gynae related is usually covered, especially that procedure & your age etc, you obviously NEED it done.

Nothing to the same extent, but when I got my stitch put in I didn't so much as a $ from Hosp, they just handled it directly.

I agree with Tasma though, get as much info from Gynae & MBP 1st. :)

[lovelymum]

I am with medibank private and we have blue ribbon hospital cover (top level I think with a daily co payment of $80) and I would be sure you would be covered for a hysterectomy in a private hospital. The only reason you wouldnt would be if you eliminated gyno/obstectrics from your cover. If you are in private cover all procedures are covered except for cosmetic procedures (but some cover does allow you to drop certain procedures ie: hip replacement, cataract surgery in order to lower premiums). Sometimes all you have to do is call back and talk to a different person who may turn out to be more helpful! I have been with MBP for around 10 years and never ever had a problem with a claim and have always been treated in a private hospital. My gyno actually persuaded me to stay with them when I was thinking of changeing to save money he says they are the highest paying health fund which means less out of pocket expenses! Good luck

[Team Blue]

Thanks for the replies and information girls :D

Ive just had a look at our premium, the restricted services is Cosmetic and also Obstetrics-related services, would Gyno be involved in that? Surely not as Im not pregnant?

We didn't opt out of any services, just kept all the services covered in the premium.

Waiting on the Gyno office to open, they dont open until 9am.

[Izy]

gyno normally is fine but it depends on the item no's (always back to the item no's).

Did you end up getting the no's from the Dr and checking?

[Team Blue]

Yep, gave them a call last Friday and they wouldn't give me the item numbers as there's no actual confirmed operation yet by my gyno as I had two choices of operations (ablation and hysterectomy) and I was to let him know the decision next appointment in October when my 12 months waiting period expires (it's pre-exsisting due to having Endometriosis) :no: The lady was nice enough and everything, but her hands were tied as to giving me the numbers. She did explain that the hospital is actualy preferred by Medibank Private (As a PPer stated) but I guess I'll just have to wait until October when I see him next :no:

They have that policy so it stops people organising their own ops and getting too involved. She explained that they do it all for me when I book it :D

Sucks hey LOL

[Sparrowgal]

Team Blue I wouldn't worry too much about the item numbers or whether it's covered because just listening to what you need it for sounds like you do need it, and it's only non essential stuff which health funds are a bit balky at, and obstetrics. And if you have top cover or almost top cover it will be covered.

Just make sure your gynaecologist works at the public hospital and it will be ok :)

Not sure why they would be reluctant to give out item numbers to you, but I know that item numbers I have to claim change with length of the operation, and what extra things I have to do on the day, so that's why sometimes it's hard to give out item numbers when you're not sure what you're going to do.

[Bunnyhugs]

Yep, gave them a call last Friday and they wouldn't give me the item numbers as there's no actual confirmed operation yet by my gyno as I had two choices of operations (ablation and hysterectomy) and I was to let him know the decision next appointment in October when my 12 months waiting period expires (it's pre-exsisting due to having Endometriosis) :no: The lady was nice enough and everything, but her hands were tied as to giving me the numbers. She did explain that the hospital is actualy preferred by Medibank Private (As a PPer stated) but I guess I'll just have to wait until October when I see him next :no:

They have that policy so it stops people organising their own ops and getting too involved. She explained that they do it all for me when I book it :D

Sucks hey LOL


Ummm..... I've worked with a booking office in a private hospital and there is no way a patient could 'book their own operation' unless they knew a fair bit about it all and the procedure that hospital used. Having an item number isn't all you need to book an op. That sounds like a pretty stupid excuse for not giving out item numbers.

Sorry she wouldn't give them to you TB, have PM'd you with a few possible item numbers you can check with your healthfund :)

[Team Blue]

Thanks Tas, you are a total legend :goodvibes: Will call Medibank in the morning :thumbsup:

We only have the most basic hospital, hence why Im concerned and he definately does not work at the local public hospital, I asked the lady today.

[Team Blue]

Thank you to a very lovely Tasma for the item numbers :thumbsup:

I called Medibank today and the procedure IS covered in a private hospital :yelclap:

SO relieved!!

[Bunnyhugs]

You are most welcome TB :D Glad you feel better about it now :thumbsup: