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  1. #1
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    Default Another Private health question

    Hi ladies

    I know the private health discussion has been done to death, but I'm just wanting to find out some specifics.

    I know that PHI only covers you as soon as you are admitted to hospital to deliver bub, but i have heard on some occasions of people still being out of pocket for the birth (hospital stay & related procedures (c-section, epidural etc) for thousands of dollars.

    Is this because the ob who delivered or the anaesthetist may not have been fully covered by their fund?

    How can i avoid being out of pocket once I am admitted to hospital?

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    Hi! I was investigating just that, as I understood it, if your fund says there is no gap, then you shouldn't have out of pocket. I found that bupa has an interesting web (google bupa beginnings), if you are w them, it is very helpful in explaining the possible costs depending on what options you choose. We also called many obs and the receptionists have been very understanding and were able to give us an idea of the costs. Hope this info helps!

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    Quote Originally Posted by cecy View Post
    Hi! I was investigating just that, as I understood it, if your fund says there is no gap, then you shouldn't have out of pocket. I found that bupa has an interesting web (google bupa beginnings), if you are w them, it is very helpful in explaining the possible costs depending on what options you choose. We also called many obs and the receptionists have been very understanding and were able to give us an idea of the costs. Hope this info helps!
    Thank you, that helps heaps!

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    Quote Originally Posted by cecy View Post
    Hi! I was investigating just that, as I understood it, if your fund says there is no gap, then you shouldn't have out of pocket. I found that bupa has an interesting web (google bupa beginnings), if you are w them, it is very helpful in explaining the possible costs depending on what options you choose. We also called many obs and the receptionists have been very understanding and were able to give us an idea of the costs. Hope this info helps!
    Thank you, that helps heaps!

  5. #5
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    Despite my OB being no gap, we were out of pocket a little over $1000 for the anaesthetist and the pediatrician (had to go with whoever was available on the day, and they didn't happen to be no gap). Using an anaesthetist was my choice (and the epidural was worth every single cent!) but the pediatrician was hospital policy (must be in attendance for a vacuum extraction - although I still would have said yes to that if asked).

    I guess it didn't help that it was a Saturday. You may have more options on a weekday or for a planned procedure. From memory, I may have paid for some pharmaceuticals in hospital, too. And we paid OOP for DH to stay overnight.

    I did at least get lucky that the women's physio in hospital was covered.
    Last edited by Gentoo; 22-06-2015 at 17:49.

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    I was out of pocket $200 for the pediatrician only because it was after hours.
    The anesthetist was covered by my policy and i went to a health fund partner hospital so no expense there (i did have a $250 co payment)

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    Thanks ladies 😊

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    I had my baby public but I chose to have our baby checked over by our private paed (so this cost us about $800). Because he had to go into NICU and a few other issues.

    Make sure you call your health fund as soon as your baby is born. As when DS was sick we had special procedures done blood tests etc some got sent overseas and some were done through PHI when I first received the bill I almost died! It was about 12k!!!! Lucky it came down to zero!

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    I rang my private health before the birth of dd and they added her into the policy as "baby kezanazz" so she was covered by the phi if she was admitted.
    Dojng this saved us 9k

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    I went private in Melb last year for my second baby and my had the following out of pocket costs from the hospital stay:
    Hosp Excess $500
    Payment for queen bed room ($70/night)
    Anaethetist gap $800 (spinal epidural and then an emergency csec on a Sunday evening)
    Assistant surgeon csec gap $125
    Paediatrician at csec and visits in hospital $200 (was about $900 but had reached safety net for Medicare so got 80% back. Medicare rebates applied for this as patient is the baby not me so not an inpatient)
    Ob gyn was no gap (amen!) but of course had a big management fee pre-labour
    Lots of $ but worth every cent to me I was so well taken care of.


 

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