Pre-Exisiting Condition - Health Insurance

LFrankenbeanie on 13/05/2016 - 12:43
Last edited 13/05/2016 - 16:21 by 1 other user

Hi all

My missus needs an op which would cost us $9072.
$8219 of which would be out of pocket.

The cost break down is:

Specialist fee = $3100
Assistant fee = $620
Hospital expenses $3,725
Pathology services $233 - $328
Anaesthetic fees $1,300

Medicare rebate would only be $853 for specialist and Assistant fees.

A bit of background: She was here on a visitor visa for three months and we did take out an overseas visitor's cover for her and this is when she was diagnosed with the problem but we couldn't get the op done because of the expiring Visa.

Now She is back on a permanent visa and we do not have that private insurance cover any more.

So my question is if we go back to the same Insurer to get a new policy would they consider the condition as pre-existing even though she was covered when diagnosed ? Just trying to find a way to subsidise the costs. There is an option to go via the public system where she would be placed the medium priority queue (within 3 months), but just trying to see if can go private and get the health insurance to cover some of the costs.

Thank you.

• 

  toniyellow on 13/05/2016 - 13:04

  +2

  They will all have different fine print and you haven't mentioned which insurer so hard to predict, best bet would be to call them and ask.

  It is possible with some insurers to suspend coverage when you are overseas, and resume it when you get back, keeping coverage for pre-existing conditions.
  http://www.health.gov.au/internet/main/publishing.nsf/Conten…

  But it does not sound like you did that, your particular insurer might not offer it anyway, and your situation seems complicated with the changing visas

  3 months doesn't sound like a bad wait - sounds like she has already been living with the condition for a while, and has been able to travel overseas with it.

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  jimbobaus on 13/05/2016 - 13:19

  +1

  couple things
  1) Medium Queue (3m) i was on that list once, rang at 3m to ask how i was progressing and was told at least 12 more months to wait.. waiting periods in Australia for public are terrible

  2) Most insurers have a 12m waiting period for pre-exisiting and that starts from when you take the policy, if you had cover with someone else you would need to transfer the waitig periods across but that can only be done if the other cover is still active.

  I suggest you will be waiting 12 months if you go private, and maybe minimum 12 months if you go public.

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  TheCutter on 13/05/2016 - 14:37

  As above
  You can always try by filling out a pre existing form that your doctors will do their best with but if there are referral letters mentioning the problem then you can't argue with those dates

  Some funds will help more than others , generally those with share holders will screw you. NIB is the worst and Medibank following

  But a 3 month wait!?! My public wait used to be 2 years. Sounds like a no brainer.

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  Frankenbeanie on 16/05/2016 - 11:12

  @tonieyellow , it was with Bupa and overseas covers cannot be suspended hence i had to cancel it. I will give them a call to see what they have to say.
  yes three months doesnt sound like a bad wait but only if they guarantee that it will be done within three months. I am afraid it might turn into a 12m period as member jimbobaus suggests.

  @jimbobaus, could you please tell me how long ago did you have your 3m queue turn into a 12 m queue, was it in recent times? the specialist said we would be given priority because the cyst my wife has is rather large and could burst anytime which would be then become an emergency.

  @thecutter, I am willing to wait three months but there is a chance that the cyst would burst and it will be a lot more problematic to deal with then thats why we are considering paying for the private treatment.