medibank

[frenchmummy]

HEllo,
I am with Medibank (for about 2years now)
and I went to see them the other day to make sure (and also upgrate) that I will be cover for a private hospital.
The women who explained to us, was not that usefull she was a bit like that : :ecomcity: :D, butshe told us that we could go private and that we will be insured
A lot of my friends told me that they had to wait 12 months to get a refound on private hospital...
so I have to say I am abit lost to see if I will get refound or no if i am going private..

Anyway..
thank you for your help

[smiles]

If you are not pregnant yet, you may meet the 12 month waiting period, if you are pregnant, it is too late to upgrade your cover to include obstetrics.

I just spoke to Medibank yesterday about the same thing. We want to conceive now, so there was no point upgrading, but it's possible that it might take 3 months to conceive anyway, but we chose not to upgrade just in case.

And we have a fantastic Midwife program up here, which I will use again when we get the chance :)

But I still have basic hospital & extras cover - it's called "Healthy Plus".

[halloweenmum]

Hi,
It depends on what type of cover you have. You need to make sure that the type of cover you have includes pregnancy/obstetrics in order for you to be covered and you also need to have had the pregnancy/obstetric type of cover for 12 months before you can claim.

I am with Medibank and I am fully covered for all pregnancy/obstetric hospital related services. My cover is called 'Intermediate Hospital' but it does cost approx $100 per month.

[frenchmummy]

ok,

It is a bit confusing, I just upgrated for blue ribbon.
she told me that I will be refund for everything..
So I guess, I just have to take an appointment with my OB and then see if I am refund or no..

It is funny to see sometime how people can be so bad at their job...
I don't know for you but, I am very very short temper et the moment :)

And, Smile, I am pregnant, 8 weeks!!!!

Thank you for help

[kel87]

I'm with medibank top cover and what they dont tell you is:-
* all your obstetrician fees are NOT covered UNTIL you are actually in the hospital giving birth (ie 20 week management fee, ultrasounds, weekly/monthly visits - medicare contirbutes to these but depending on your ob it might not be a lot!)
* for you not to be out of pocket for the delivery your ob has to be covered under the Medibank Gap agreement
* the above point is also the same for the anethetist (sp!) which you will have if you get an epidural or have a c-sec

I was not out of pocket at all for the hospital stay, but was out of pocket for the anesthetist $200 and havent got my refund yet for the obstetrician - also check that you dont have to pay you OB before you claim cos we had to come up with 2k after the birth to pay for it!

all that being said I have birth in a private hospital in perth so it may be different in other states, but check that you OB and hospital you plan to go to don't have any out of pocket expenses - or if they do - ask for an estimate.

[frenchmummy]

god, I don't have medicare as I am not australian....
That why I ve got this private insurance...
this lady assured me that I will be refound by medibank...

I am going to north shore hospital, It is just very hard, I am already alone( i mean I ve got my partner and he is VERY supportive) but everything sound so complicate...
I am freaking out and really stress about everything..I wanna go private cause I don't trust manly or worst monavale hospital..
:(

[Izy]

ok, It's definitely time for you to change cover if you haven't medicare entitlements yet.

When did you first get cover? What was it, and when you upgraded it was to blue ribbon hospital?

These answers will help answer what can be done for insurance purposes.

Ideally you should be covered under a visitors product so that your private insurance pays in place of medicare.

Feel free to post or PM, and include french if needed (I so want an excuse! :p)

Oh, and happy 14th of July :sleeping::goodvibes::banghead: (c'est le plus proche de 'bleu, blanc, rouge" que je pouvais faire :laughing:

[frenchmummy]

I got cover with Medibank 2 and a half year ago, as a OS student..

I did upgrate my insurrance for blue ribbon the other day, a week ago...
As she wasn't very sure ( the :ecomcity: lady)
she called and they told her that I was cover...
Now I just receive my OB thing and it 6000 for the Ob, plus anesthesit, it says in the letter that I would be refund by medicare...
I won't have medicare till I am doing the defacto w my BF, even then I am not sure that I am allow to have it...

des bisous

[nicw]

I would call them again and have it confirmed what you will and won't be covered for. If your policy included pregnancy prior to upgrading to blue ribbon you should be covered for all hospital expenses. In terms of bills that are normally covered by medicare, because you don't qualify you will have to submit them to medibank. You may only get the schedule fee amount back. Even for Australian citizen's/permanent resident's we are not 100% refunded for out of pocket expenses. Ultimately we all end up paying some sort of gap payment. Take in the pregnancy item numbers to medibank in order to get a better idea.

The system is getting worse for everyone in Australia not just overseas visitors, making it less affordable to go private to have a baby as a consumer, but more lucrative for private obs who charge these expensive fees. As of next year Australians are no longer entitled to the 80% rebate for certain obstetric item numbers. This will mean minimal rebates for the lovely $6000 bill they love to send us! So keep in mind that out of hospital bills are about to get very expensive.

I don't blame you for freaking out. I would politely demand that medibank have someone who specialises in this area to give you a call and confidently explain the process and hopefully tell you how much you are likely to be out of pocket.

I personally think going private was the best decision i made despite the expenses i incurred. Congratulations on your pregnancy!

[Izy]

First of all you need to call medibank and tell them that they should never have changed you to blue ribbon, and that you would like to revoke the change so that you never changed.

The cover you held is basic visitor I think. That one has restricted benefits for obstetrics. This means that it will pay towards it, but you might have some fairly significant out of pockets for the birth admission.

The lead up consults will also be covered, but any out of pocket normally happens because the fund only pays the medicare schedule fee (cause they are in essence taking medicares place) and the Dr's/ob/scan clinic, can choose to charge more than this schedule.

Let me know if they let you revoke (so you can claim your dr's visits) and I can further explain the system for you. :thumbsup:

[frenchmummy]

Hey Izy,
I don't want to revoke it, I took this insurrance blue ribbon also because it s covering phisio and chiro...I had a hernie discale( in french sorry) deux years ago nothing was cover as I have to see twice a week a chiro...cost me so much money!!!!! that I rather to pay a bit more every month...

Other way I am not under visitor, but under OS student...

Izy, Tu es francaise???

[Izy]

J'ai les parents francaise. :D
hernie discale - Herniated disc

You should still revoke the change but elect to have taken out an extras policy with the visitors cover. I will explain why.

Regular private health insurance works with medicare (this is what Ble ribbon is).
It does not pay for Dr's fees or anything that is not part of a hospital admission, as all this is considered to be medicare covered services.

The private health insurance would only pay towards in hospital (known as inpatient) treatment. This works with medicare again.
Medicare will pay 75% of the medicare schedule of fee costs for Doctors. Your fund pays 25%. Your fund also pays for the hospital expenses (the cost of actually being there).

If you have a private hospital cover but no medicare one of two things will happen:
1- It doesn't pay anything
2- It pays it's usual 25% of the schedule of fee and you have to pay the 75% medicare would have paid.

What you can opt to do instead is have a visitors cover for medical and hospital expenses, then have a seperate cover for ancillary (chiropractic, physio etc).

This way you have coverage for your dr's visits, ob visits and scans, and also have seperate cover for chiropractic and things associated with your back (which you will probably need more of in pregnancy ;))

Does that all make sense?