- 1 Post By Libby1971
Hospital treatment and Medicare vs Private Insurance
I would be interested to hear of other people's experience of this.
Our daughter is about to have surgery. We have only just taken out private insurance and chose at the time not to have the surgery option. So far our understanding has been that Medicare will cover us. In short, are we right? This is not a cosmetic reason we are talking about.
For those concerned about the ways the healthcare system works here, well don't. In the last week she has had 3 consultants appts, 4 tests and within 10 days will have had an operation as well! In some cases, these have been arranged within hours. The speed and efficiency of it all has been breathtaking.
Never quite sure what is covered and what is not by either Medicare or my private health cover, just know that if my kids needed anything it wouldn't matter either way - they are too important.
Hope everything goes well with your daughter.
Thanks Kelly. As you say, I don't think it does matter if the kids do need something but I hear talk of a gap and I want to know if I am right in thinking Medicare picks up the tab or if there is something that we will be paying for later. I don't care what it is or how much, I just want to know if it is coming.
Originally Posted by kellyp
I have recently had a major op at Noarlunga, what an amazing hospital. I cannot fault their care and the hospital was immaculate. I did not have to pay a penny it was all covered on medicare. I am not sure of you stauts (Temp, perm res or citizen). I am a Perm resident so I dont know if this makes a difference.
What I do know was that in 1997 I was travelling in Oz when I had a miscarriage. I had to have various scans etc and I dont remember paying anything then either so maybe residential status means nothing.
Hope this helps and good luck for your daughter
If you are being told there will be a gap - it is likely you will have to pay that gap, but when you will have to pay and how much it will be is a bit like how long is a piece of string, from my experiences with the medical system, there seems to be no hard and fast rules and it is often the luck of the draw whether you are liable to pay or not. Hopefully, you won't have to pay at all. The only other thing I will add, is they don't seem in a big rush to get any gap payment if they bill you after the event, so it is no great immediate pressure.
Hope all goes smoothly for your daughter.
i agree Libby health care over here is amazing - my experience is that our private health care covered part and medicare covered the rest . we had tests, blood tests, consultant appointments and a hospital admission and didnt have to pay other than a GP consult and a CT scan. however it does depend on where you go as around the same time we had to have another scan for another family member and it was bulkbilled.. hay ho.. Hope things go well with your situation.
I had to have a small operation in April and then got an infection so was back in hospital for a week about a month later. I didn't have to pay anything. My understanding of it is that as long as you are a public patient in a public hospital medicare covers you for anything deemed medically necessary (so pretty much anything thats not cosmetic) Don't know how this works if you elect to have surgery though. I was in the Womens and Childrens and I cant speak highly enough of it..the nurses and staff were great and I even ended up with my own room!
I have had nothing but good experiences with the hospital system here, they have always let me know whats going on and have been quite fast at dealing with any problems as they arise!
I would assume Libby you are covered by medicare. Meg has an opeeration next week NOT covered by medicare to have 2 teeth removed and one tooth exposed. $650 for half a days stay at the hospital, $540 for the surgeon and the medicare gap for the guy who puts her to sleep $375!!!! If you haven't been advised of any fees before hand- you will not pay anthing.
Thanks to all for your kindness and also for the information. We do have PR and the only person who has mentioned fees and gap is the main surgeon leading the op whose secretary menioned a gap, which got me wondering if there are any more gaps, if you know what I mean
Where is Meg going for her op? If she's at WCH, I'll meet you for a coffee!!! Seriously, I do hope things go okay for her, and for you, who I should imagine is worried for her baby
Costs involved are scary numbers though, it is almost like playing with a calculator blindfolded and see what magic numbers you have when you have taken the blindfold off!
You shouldn't have to pay anything unless it is dental. Personally after talking to the girls at work I would not go private. Many are agency nurses and work in private hospitals and say for children it is just not worth it like in the UK really. WHat hospital is it. If it is the women and childrens they are good (of course I say that I work there!! lol) and I have heard good things about flinders too. You can go under private in public hospitals but as I have said before it is a pain in the arse. If you are private Drs will not make a decision (unless life or death) without talking to your own consultant which is all very well providing he is contactable and not on the golf course etc. If they cannot get hold of them you have to play the waiting game until they can get hold of them. If you are public there is always a consultant 'on' and so decisions get made more efficiently (and us nurses don't get shouted at by parents as we can't magic THEIR Dr.) Personally again if it was any of my tribe I would not bother with private and would trust the public system.
HTH and all the best to your daughter x x x