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article on phi payout changes :/

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Just came across this article. I'm with medibank and was gonna swap to bupa but apparently those are the 2 funds that will become very strict/difficult. Any suggestions for who else I can swap to? Do I need the absolute highest cover or the one below that. It says anything covered by medicare is included, but should I look for something that exactly says plastic surgery? Oh and has anyone had a dr not give them medicare item numbers? Don't want to increase my cover if I won't even be covered in the end lol http://www.smh.com.au/national/plastic-surgery-crackdown-as-health-insurers-target-false-claims-20140621-zshad.html

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Guest Cosmetic

I am lucky with my insurance company but will not disclose it... AHM try them shop around

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Arghhhh, this sucks. All I can do is give recent experience. I was diagnosed with moderated - severe CC 4 months after BA. I waited until 12mnths PO on 3 surgeons advice, and only got around to calling BUPA last week. Anyway, I was seriously concerned about the whole pre-approval business, but it's either been ditched, or it hadn't come in yet, not sure which. But I'm like Flynn for mute idiom next week. PHI will cover z25% of the scheduled fee, my hospital fees, and replacement implants.

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I am lucky with my insurance company but will not disclose it... AHM try them shop around

why would you not disclose it? Someone who is asking others for info on costs? Tit for tat my friend, this community works because we share info, not because we're shifty on what we know whilst asking others to be frank...

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I am with BUPA and had everything covered other than my surgeons out of pocket cost. He sent off a medical claim form with item numbers etc and was approved within 24 hrs (mine was a true medical need so he had no doubts it wouldnt be approved).

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I'm with Defence Health and the process has been fantastic so far.  I don't have my surgery though until 7 November so I guess anything could change between now and then haha My PS and the accounts lady at the hospital said that the only fund they have issues with is Medibank Private.

I am also with Defence Health, an insurer that not everybody is eligible to get cover with. I spoke with them prior to my surgery as I'd heard some insurers require you to fill out an approval in principal or something a rather otherwise they can reject the claim afterward. They informed me that they didn't need that at all that it really was as simple as them using the claim through medicare two way and if Medicare were fine with it then they were too. I had a half medical and half cosmetic BA so got a portion of the total costs back. Was all very easy and was very happy with it all.

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I have posted this a few times now so sorry if you have seen before.

TT and breast reduction with Medicare item numbers no pre approval

required, hospital fully covered, I had no problems plus claimed rebate for surgeon and anaesthetist

all hassle free

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Guest Cosmetic

I've just changed to nib and they said they'll definitely cover it as long as a medicare rebate applies, which is hopefully as simple as the dr sending medicare the codes or something. So confusing

 

That's the worst health fund to be with they don;t pay out much in comparasion with other health funds ...

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Guest Cosmetic

Hi Ladies, 

 

do I have to get top hospital cover or will basic be ok as long as I have an item number from Medicare?

 

Thanks :)

 

Allways get top cover as your out of pocket will be less

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Guest Cosmetic

Medki bank will be soled off this year or next year wich means tighter restrictions !!!

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I was with AHM and changed to Medibank Private in March, had TT in July and had no issues with regards to declining procedure.

 

I know a few people have had issues, where they've had to get the surgeon to submit extra paperwork to prove the procedure is reconstructive etc and not cosmetic.

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Guest Cosmetic

So if medibank, bupa and nib all aren't the best, who should I change to? This is all so confusing

 

Best Option is to get a overseas health Insurance...

 

I admited lots of overseas patients and there cover is way better then local health insurance!

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Guest Cosmetic

What? Can we get coverage here in Australia from overseas PHI?

 

Yes! and it's much better then our local health insurance  as you will have no out of pocket expense!  Just google worldwide health insurance . 

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Guest Cosmetic

Medicalfees.com.au hope that link helps if you need help inbox me I'm in expert on private health insurance and don't get any commission

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