private health cover questions

[jessgray]

ok, i am looking at getting private cover and am currently browsing the iselect.com.au site. but i have a few Q's. if we were to get private cover right now, could we use it to get ds's hearing problems treated or would therebe a waiting period like on public system as currently he is on the semi-urgent list which is 12 months long just tp see the ENT specialist further waiting periods apply for treatment :(
so would we be able to use private cover to get ds treated coz its a pre-exisiting condition. i am so confused lol

[~Emmylou~]

You'd probably have a 12 month wait to have a pre-exisiting condition treated.
Normally the wait to use your insurance would be three months for "non prexisiting conditions".
Alot of health funds are waiving waiting periods atm trying to get people in so it might be worth calling around to see if anyone will waive for a pre existing condition.
good luck.

[FourAngelKisses]

Just something I've always wondered even though we aren't going to get private insurance, but would birth defects be covered?? DD needs a ton of dental work done because of her cleft lip, but would it be seen as pre-existing??

[jessgray]

thanks guys :)
i read up on the brochure for AHM they will consider some pre-exisiting condtions but you have to give info from your current treating dr etc.(sounds like lots of paperwork)
can anyone recomened a not to expensive health insurance?

[Foxy]

Have a look at iselect.com.au they can search out the best cover for you.

[jessgray]

i'm on there at the moment lol
i just dont know which one to choose

[M O P]

We're with Australian Unity. They were recommended to us through iselect. They've been good, have a baby program and the midwife asigned to me through that has been very helpful.
I used to be with Manchester Unity, as a single, they were very good too. I only changed cause Aust Unity cheaper.

[Chickadee]

Just something I've always wondered even though we aren't going to get private insurance, but would birth defects be covered?? DD needs a ton of dental work done because of her cleft lip, but would it be seen as pre-existing??
That's a tough one. I'd guess that because she was born with the cleft lip it should be covered. Also she may be covered because I assume the dental work can't be done before a certain age. But you really need to ask, the rules are confusing.

And just to note, the coverage waiting periods can vary between insurers and also vary depending on what treatment/service you are getting. It is a 12 month wait for pregnancy and obstetrics but only 2 months or less for some others such as dental or in-hospital treatments.

[FourAngelKisses]

Just had a look at the iselect site..........$269 a month. :eek: :eek: :eek: :eek:

[jessgray]

there is a ahm policy thats 220 something a month it came up when i typed in all my thingys. the other 2 were 258 and 273 a month

[M O P]

Just had a look at the iselect site..........$269 a month. :eek: :eek: :eek: :eek:
Perhaps you could try putting some money away a month away so when your daughter needs dental work you can use that money to have it done privately, so you won't have a waiting list. And you can choose who does it.
You can also get just extras from some funds, as this sounds like what you'll need most.

[jessgray]

my dp didnt want us to get private health cover till now lol
everythign changes when you are on a waiting list for something lol

[Minke]

Wow, we pay $176/month, i thought that was a lot! (that's with the 30% rebate taken out)

[jessgray]

who are you with?:)

[Minke]

Medibank Private... I think we've got Healthsmart?

[jessgray]

thanks :) i will look into them :D

[~Emmylou~]

Wow, we pay $176/month, i thought that was a lot! (that's with the 30% rebate taken out)

That's about what we pay as well, with HCF.
We have top hospital cover and general extras.

[jessgray]

wow everyone has such good deals :D
how did u find such good deals?

[Amy1978]

Hi Jess,

We're with HCF and it's $53 a fortnight to cover my husband, myself and our two kids. It doesn't cover obstetrics though.

Re the specialist, one thing we've been really unimpressed about is that private health insurance doesn't seem to cover any specialist appointments unless the specialist is seen while you're an in-patient in a hospital. So that might be something to consider too.

good luck!

cheers,

[Minke]

The deal we've got is for young families, it doesn't cover heart surgery or anything like that. It does cover dental, obstetrics, optical etc, but keep in mind there is a limit to how much you can claim for each of these as well (like dental there is $1000/year for major dental i think - or its around that). So when my other half had to get root canal and a crown, we could only claim up to the limit.

If you could get the item numbers of what you need done from the specialist, you can ring health funds and they will be able to tell you what their scheduled fee is and so what your out of pocket expenses would be. You would also need to find out the anethestist the specialist uses, item no, and how much they charge - that was our only gap that we had to pay when i had bub (other than the $200 excess) Was glad it was the only one - we were out of pocket $850. Some doctors will charge the earth, my ob was a no gap doctor - the health funds should also have a list of these in your area, or if there are none, the doctors they have agreements with, as the health fund will pay higher benefits if you see these doctors.

My point is... The monthly cost may be less, but they may pay less in benefits, so in the long run you may be more out of pocket.

Hope i have helped :D

[jessgray]

i want something that covers heart surgery coz in a few yrs DP may need it for his heart. so far the only one i have found is AHM that covers heart surgery. i am not too fussed about pregnancy care being covered.

[garfield]

Hi, Kelli79
I'm looking into medibank private too, the "smartplus" package sounds pretty good to me (family with a baby and thinking to have bub#2 within next couple of years). Are you happy with medibank??? I'm currently with MBF but i found them not as good.

Please give me some advises, thanks!

[Lollie86]

iSelect only advertises a few health funds (about 5 or 6) that pay them for their services. I'd suggest giving a few a call and getting some quotes, remembering to ask for the same thing everytime you call. Compare your apples with apples.

I used to work for a private health fund so I can tell u for sure that anything pre-existing like a hearing problem would be a 12 month wait.

The 2 month waiver of waiting periods is for preventive services like chiro, physio, some dental like cleans and check ups.

Also, the higher the excess is then the cheaper the cover will be per month.

[Lollie86]

Jess, I'd also suggest looking at funds that are primarily based in Vic as you will get a lot more services by docs and hospitals then a fund that is primarily based in NSW.

The top 3 are : Medibank Private
MBF
HBA

I'm currently with HBA as they offer a guarantee of a private room in a hospital as long as you book 24 hrs in advance. As I did work for the company, I know most of the ins and outs and can tell you that its seriously a great fund to be with (i dont work for them anymore but have still decided to stay with them after getting other quotes)
They also have heaps of Ezyclaim docs (who dont charge a gap) and they were rated Number 1 for having no gaps for their members.

They also cover Heart and Artery Related services. Try having a look at something that can have restrictions like Cataract Surgery and Hip/Knee replacement as that can also lower costs.

Just remember to really do your research and ALWAYS ask the doc for any out of pocket costs bc it is their legal responsibility to let you know of any costs that you may incur.


Good Luck! :thumbsup: