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private medical aid


dale
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Hello,

We have heard so many conflicting things about private medical aids. Does anyone have any advice on which private medical aid is good for covering costs and has a good selection of doctors when you want to have a baby?

We have seen Medibank has a special on at the moment and have checked the "iselect website" but not sure which would be suitable.

We are based in Adelaide and do not have any children yet but would like to start a family soon.

Thanks

Dalene

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I see you are on PR.

If you choose to go private you will be billed for all gynae appointments throughout the nine months and the hospital bill as well. We heard of people on private medical that paid $3000 for the hospital over and above what the private medical aid paid.

We are Pr and have medicare and have private medical aid, but we chose to go public. The whole nine months and a C sect cost us $15.00.

The difference is that on private you get to choose your gynae. But to be honest, in all likelihood the doctor who looks after you during the nine months will be the one who does the delivery. The other difference is that public patients, in our case, were 2 moms to a room whereas private had solo rooms. If you have $3000 extra to spend on a private room, then go for it. For us the inconvenience of sharing a room with another mom was worth putting up with for 1 week.

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thanks for the info Jordy. What do you use your private medical aid for and which one do you use?

We are registered with medicare but just recently found out that if we don't join a private medical aid within a year there are late joiner penalties so we thought we would rather get the info now.

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we use it for dentistry, optometry and hospital. We chose to not have maternity for a cheaper rate knowing we would go public for the new born

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I would suggest you do a search for an Aus mommy forum. I will check with my wife when gets home which one she reads.

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We are on a 457 and we are with Medibank. We took the cover that included pregnancy etc and luckily we JUST made the 12 month waiting period by about a month and a bit. We were under the impression we were going to be waiting to do IVF so our little man caught us by surprise :) Whats nice is that the 12 month waiting period is until the due date, so you could actually start trying after about 4 months of being on the plan to make sure you fulfill the waiting period.

We went private (because we do not have public) and our hospital costs were covered in full. We might have paid about $200 to book the room but I don't remember if we claimed anything back for that. We did however have to pay in $4500 to our obstetrician of which we got a pathetic amount back from Medibank. Something like $100 or something. It all depends on whether you want to choose your OB. I was not comfortable with not having one specific person responsible for me.

We pay in the region of $400 a month for 2 adults and our baby but overseas visitors cover will naturally be more expensive so it should be much less for you. I have been told to let them know once we have PR so that they can put us on a lower plan.

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Also keep in mind that even when you go private your ob might still not be the one delivering your baby. Since they swop with colleagues when they go on leave, etc. But that is more manageable I suppose.

And there has also been a few occasions where I was seen by the midwife (and they said sometimes it could be his colleagues) instead of my ob at antenatal visits.

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I saw my OB every time and he delivered my boy. When calling to initially get an OB they usually won't take you on if he is going to be on leave during your due date. I'm sorry but when I am paying $4500 out of my pocket I EXPECT him to be there!!!! If you are a more relaxed person then you won't mind the midwife thing as much. We were just a bit paranoid and very nervous of something going wrong. In fact I chose my OB knowing he wasn't known for having a great bedside manner because he was definitely known to be brilliant at his job.

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Dalene,

We are also on PR and joined HCF medical when we arrived. They have (and many others) a 12 month wait before you can use your maternity side of your insurance and my son (obviously) arrived at month 11. But, it was not a big deal, actually a blessing, because medicare is just wonderful for having a baby on. We chose "shared care" between my GP and the midwives at the RPA hospital here in Sydney. You can say to your GP that you want to only see the midwives, then it is completely free, we did pay for the 4-ish times I saw the GP. But to be honest they do exactly the same thing, wont do the GP next time. We also opted to have our own scans done privately and they were about $220 a pop, will do them on medicare next time too. Bear in mind that medical treatment is RSA is arguably heavy handed and they let you do many scans. In Aus they say you only need two to collect medical data, all others is just for your own benefit and curiosity. Of course if they suspect anything wrong they will scan you as much as needed. I am talking here about a normal mum/baby/birth, if anything is out of the ordinary they will bring in the big guns. I asked at my hospital before hand how much I would have to pay in if I wanted my own room and it was $500 per night. Ask your medical aid and they will probably pay the room and you can do the rest on medicare, mine has that option, will definitely do that next time. Although it was my first child I am a laid back person and do not give a hoot about seeing the same medical person twice as long as they know what they are doing. In the end jnr got himself stuck and they had to do a C-section in any case AND they gave me a private room, not a cent was asked of me. It looks like even the private doctors have to do a certain amount of time in the state system, my anaesthetist was some big shot professor, the nurses just about bowed when he entered the room. I cant praise medicare enough, felt that I was in very safe hands and are happy to go with them again.

I have a friend here who payed big bucks to have a private obs/gyne to deliver her baby, and when the baby came out and he had Downs, they Dr took his bag and left the room, never to be seen again. He had done his job by delivering the baby and that was it, no staying and talking the parents through the situation, nothing. It was the state medical staff that rallied around and helped them, excellent support from birth onwards, they are so chuffed with the extensive help they are getting physio/speach/occupational therapists etc, every week. Medicare has to support you when the chips are down and they are accountable. And if you find that you dont see eye to eye with someone you encounter ask to speak to another person. Simple as that.

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I have had 3 pregnancies, albeit 2 in SA. Every single one of them told me if/when they had leave planned. They don't just spring it on you. But they have also told me who their colleagues are that will be on call when they cannot attend to you. A due date is an estimated date. I haven't heard of a single person that delivered their baby on their exact due date.

You also need to keep in mind that they are only human and go through the same stuff we do. They also get sick, have emergencies and have to take leave now and then. It's unreasonable to expect an ob to be at every single checkup for every single patient.

And by the way, the midwife does EXACTLY the same things as the ob at an antenatal visit.

Edited by NadineN
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Thank goodness I don't have to worry about this again.

All I have to worry about is glasses.

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we use it for dentistry, optometry and hospital. We chose to not have maternity for a cheaper rate knowing we would go public for the new born

Hi Jordy

Is Medicare like government medical that all PR's and citizins can make use of ? Do you pay for it ? If you say they do not cover dentists, opto and hospital, what do you use it for ? GP's and medicine ? What about operations ?

Tx

Simon

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Hi Jordy

Is Medicare like government medical that all PR's and citizins can make use of ? Do you pay for it ? If you say they do not cover dentists, opto and hospital, what do you use it for ? GP's and medicine ? What about operations ?

Tx

Simon

Hi Simon,

yes Medicare is the government medical aid that all PR's and citizens get for free.

From their website:

"Medicare was established based on the understanding that all Australians should contribute to the cost of health care according to their ability to pay. It is financed through progressive income tax and an income-related Medicare levy.

Medicare provides access to:

* free treatment as a public (Medicare) patient in a public hospital, and

* free or subsidised treatment by medical practitioners including general practitioners, specialists, participating optometrists or dentists (for specified services only)"

See these threads for more info

http://www.saaustralia.org/index.php?showt...amp;hl=medicare

http://www.saaustralia.org/index.php?showt...amp;hl=medicare

http://www.saaustralia.org/index.php?showt...amp;hl=medicare

Do a search on the forum for medicare and have a look through the results.

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It is important to note if you decide to have your baby natural and you go public you only have one day stay in hospital if it is your first, two days if it is your second and three days if it is your third baby etc. If you decided to breast feed it often takes the milk 3-4 days to come properly and a lot of women often need assistance especially if they first time mothers. Usually on the 4th day a woman’s hormones tend to have a bit of a crash. So it is often good that you are in a hospital or near close family that can support you during this time. These are also factors to consider when choosing if you going private or public.

If you having a C- section in public you usually in for about 5days in public hospital. In private you can be in 4 days with a natural and 5 days or more with C –section.

You also need to remember if you chose to go public you chose to have the option that doctors that are in training are able to practice on you. There is nothing wrong with this it is something one needs to be aware of.

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My friend had her first child 3 weeks ago in the RPA (public) hospital in Sydney, natural with epidural, and stayed for 3 nights. So I think it depends on the hospital.

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A couple of factors you may wish to take into consideration.

a/. If you are young, that is 30 or below, you won't have an excess put on your premium for joining a private health fund at any stage.

An excess premium of 2% each and every year is only stuck on top of your health insurance premium once you turn 31 and you wish to join after having been in Australia for longer than 3 months without any private health insurance.

b/. Medicare is a "no frills" free public hospital system.

My youngest daughter is 22 and a full time student on the Gold Coast region in Queensland.

She had severe tummy cramps recently, went to the local public hospital, was seen by a first year intern who prescribed her pain killers and sent her on her way.

She later kept getting the pain when the pain killers ran out and so shuffled herself off to a private hospital where she spent 6 days in for severe gastro. She had been swimming in the sea when the recent floods were on and maybe some unsafe overflow had come down the river and into the sea?

Cost . . . $302 over and above what the health insurance coughed up for.

Our private health insurance is for myself and my wife and any kids, even if they are studying full time and under 25, so my youngest daughter falls into that "safety net"

She trains with other dentists and medical students in Southport Public Hospital on the Gold Coast and found the young first year intern to be understaffed and inexperienced.

Australia, like most other countries, has a dentist and doctor shortage, many coming from the Third World where their level of expertise is not so flash.

With Medicare, you have to accept whatever doctor is assigned on that shift to look after you . . . . no choice.

There is also a waiting list for some operations to be performed in public hospitals. You can't just stroll in and demand any operation, such as a knee replacement, if it isn't life threatening.

If you want an operation urgently that isn't life threatening, you can be waiting a few months with a bad knee, for instance.

If you prefer to get looked at straight away without the need for waiting months, then private treatment is often all that is available.

So . . . . if you are young and reasonable sound, you can exist from one year to the next without private health insurance, but if you play lots of sport, have not such good health personally or are older, it may pay you to take out private health insurance.

The Australian Commonwealth government pays 30% of your private health insurance premiums to make it "affordable" for everyone if they need it, leaving you to only pay the remaining 70%.

Edited by Bob
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Great info to those who contributed. i just have one question, and i know it has been asked before but there is such conflicting info.

Q: Can we choose to have a C-Section on public health care, even if it is not medically indicated?

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A couple of factors you may wish to take into consideration.

a/. If you are young, that is 30 or below, you won't have an excess put on your premium for joining a private health fund at any stage.

An excess premium of 2% each and every year is only stuck on top of your health insurance premium once you turn 31 and you wish to join after having been in Australia for longer than 3 months without any private health insurance.

b/. Medicare is a "no frills" free public hospital system.

My youngest daughter is 22 and a full time student on the Gold Coast region in Queensland.

She had severe tummy cramps recently, went to the local public hospital, was seen by a first year intern who prescribed her pain killers and sent her on her way.

She later kept getting the pain when the pain killers ran out and so shuffled herself off to a private hospital where she spent 6 days in for severe gastro. She had been swimming in the sea when the recent floods were on and maybe some unsafe overflow had come down the river and into the sea?

Cost . . . $302 over and above what the health insurance coughed up for.

Our private health insurance is for myself and my wife and any kids, even if they are studying full time and under 25, so my youngest daughter falls into that "safety net"

She trains with other dentists and medical students in Southport Public Hospital on the Gold Coast and found the young first year intern to be understaffed and inexperienced.

Australia, like most other countries, has a dentist and doctor shortage, many coming from the Third World where their level of expertise is not so flash.

With Medicare, you have to accept whatever doctor is assigned on that shift to look after you . . . . no choice.

There is also a waiting list for some operations to be performed in public hospitals. You can't just stroll in and demand any operation, such as a knee replacement, if it isn't life threatening.

If you want an operation urgently that isn't life threatening, you can be waiting a few months with a bad knee, for instance.

If you prefer to get looked at straight away without the need for waiting months, then private treatment is often all that is available.

So . . . . if you are young and reasonable sound, you can exist from one year to the next without private health insurance, but if you play lots of sport, have not such good health personally or are older, it may pay you to take out private health insurance.

The Australian Commonwealth government pays 30% of your private health insurance premiums to make it "affordable" for everyone if they need it, leaving you to only pay the remaining 70%.

Hi Bob,

What would be the monthly fee for private health care say for a family of 4? Just a rough idea would be fine, as i have heard that it was quite expensive???

Many thanks

Et

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Hi Bob,

What would be the monthly fee for private health care say for a family of 4? Just a rough idea would be fine, as i have heard that it was quite expensive???

Many thanks

Et

To get quotes on private health insurance try this website. It allows you to put in all your relevant data and gives you a list of health insurances offering the type of cover required with the cost.

http://www.iselect.com.au/index.jsp

Candice

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To get quotes on private health insurance try this website. It allows you to put in all your relevant data and gives you a list of health insurances offering the type of cover required with the cost.

http://www.iselect.com.au/index.jsp

Candice

Good morning and many thanks.

Et

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