Advice for Private Insurance for a Hip Replacement

LEurobogan on 31/03/2022 - 22:22

I'm in my late 30's and have damaged my hip over the years with sports and work (was a carpenter).
I have finally come to the conclusion that I actually need to get a hip replacement after seeing four different specialists over the past 10 years. all of which were telling me to put it off as long as I can manage the pain.

I it's become so painful that it's actually affecting my day-to-day life so I'm going for the surgery.

I was given this number (49318) to quote to the Health fund to ensure that they cover the surgery.

My plan is to get a decent private health fund so I can get a hip replacement with my doctor of choice. I was wondering if anyone on here has had a hip replacement in the past couple of years and what was their experience with their health fund as in did they cover the rehabilitation afterwards, what am I expecting out of pocket etc?

any advice would be a great help

Health & Beauty Health Insurance Insurance

Comments

  • SF3 on 31/03/2022 - 22:30
    +6

    Just be mindful there is a waiting period for pre-existing conditions, you can google it up for the insurers in Australia.

    e.g. this is a HCF one https://www.hcf.com.au/health-agenda/health-care/research-an…

  • askme69 on 31/03/2022 - 22:46
    +1

    My wife needs a new hip. We went with NIB, her wait period is up soon and we are booking in for late December. Going either SuperPath or Mako Robotic. NIB cover all of them and the Hospitals they work out of as well. Rehab is not a big deal (expense), you just need to see a good physio who knows HIPS.

  • screensaver on 01/04/2022 - 04:30
    +1

    rehab is a seperate category, just make sure it is covered. The AMA has a chart of who pays the most

  • screensaver on 01/04/2022 - 04:41

    I checked the list, these had the highest rebate for this https://www.ahsa.com.au/web/fundlist

  • screensaver on 01/04/2022 - 04:46

    You can find the list here, figure 6 in the download , your procedure is there https://www.ama.com.au/articles/ama-private-health-insurance…

  • JoeBogan on 01/04/2022 - 07:05
    +1

    Hey OP, have you tried a solid progressive loading rehabilitation program with a competent physio or sports chiro before you consider surgery?

    It seems to me that you've already made up your mind given how many specialists you've seen but it is major surgery and you'll need another hip replacement in 15 ish years once you get one now.

    • EightImmortals on 01/04/2022 - 07:39
      +2

      My thoughts exactly, was pushed to surgery for a shoulder injury years ago but went to an osteo instead who gave me the right exercises to do and both shoulders are 99% now. He tells tales of all the patience he gets who are more trouble after surgery.

      • JoeBogan on 01/04/2022 - 08:44
        +2

        That is a great outcome for you but I'm in no way anti surgery but I firmly believe atleast 3 months of solid rehab should be done prior to considering surgery.

    • DashCam AKA Rolts on 01/04/2022 - 09:46
      -1

      you'll need another hip replacement in 15 ish years once you get one now.

      I had a hip replacement in 2015. No amount of progressive loading rehabilitation program with a competent physio or sports chiro will replace damaged cartilage or remove the calcium/bone spurs that develop in the joint due to bone on bone contact, or reduce the enlarged head of the femur.

      My surgeon advised that hip replacements typically have a life expectancy of 20 to 25 years. For an active person, the bearing liner of cross-linked polyethylene may wear and need replacement, but this is a fairly simple procedure and does not need a full prosthesis replacement.

      • JoeBogan on 01/04/2022 - 10:01
        +1

        Yeah loading programs don't change tissue structure but, tissue and bone structure has been repeatedly shown to have very poor correlation with pain.

        The prevalence of an enlarged femoral head (CAM type lesion) you're taking about has been shown to be 23.1%, 27%, 29% and 29.7% in asymptomatic people. These numbers are pulled from systematic reviews.

        Anecdotal evidence doesn't help much in OPs situation especially since about 10 specialists have told him that he should reconsider. The other aspect is that pain is multifactorial and there are many variables to consider that modulate this pain.

        Source: https://journals.sagepub.com/doi/full/10.1177/23259671209778…

        • DashCam AKA Rolts on 01/04/2022 - 14:28
          +1

          tissue and bone structure has been repeatedly shown to have very poor correlation with pain

          It may be considered anecdotal evidence, but having first hand experience of bone on bone, there is a very real correlation with pain. I went from competing in triathlon, fun runs and multi-day hikes to being unable to walk around the block.

          The interactions I've had with family members, an acquaintance and fellow patients in rehab have strongly re-enforced the concept of extreme, disabling pain levels with structural damage to hip joints. This is a very different situation from a congenital condition or malformation not associated with injury trauma. O.P. appears to be in the latter group.

          • JoeBogan on 01/04/2022 - 16:04

            @DashCam AKA Rolts: My knee is "bone on bone" with barely any meniscus left and I can hear the grinding with some movements but I have no pain. The problem with applying this logic to everyone is that each persons pain has different drivers, some may have a strong structural basis while others might not.

            In your case the structural features were the main driver so it seems like the right choice for you.

    • Eurobogan on 01/04/2022 - 22:10

      I have but since I have no soft tissue in the actual joint and have major restrictions on movement the only solution is going under the knife

  • salmon123 on 01/04/2022 - 08:24
    +1

    I'm in my late 30's and have damaged my hip over the years with … work (was a carpenter).

    Did you explore workers comp already? Possibly a TPD claim too…

    • Eurobogan on 01/04/2022 - 22:10

      I was working for myself so there is no workers comp in this instance

      • salmon123 on 01/04/2022 - 22:35

        I was working for myself so there is no workers comp in this instance

        Pretty sure even self-employed people are required to get workers comp (at least in NSW) … not sure about other states or countries.

  • screensaver on 01/04/2022 - 16:05

    Get proper scanning to see what is going on with the hip

    • Eurobogan on 01/04/2022 - 22:11

      I got a CT,MRI and X-ray its buggered.

  • Eurobogan on 02/04/2022 - 08:01

    Everyone I’d like to thank you all for taking your time and giving me ideas of what to do and consider.

  • Dejaar on 05/06/2022 - 08:47

    I got a referral to a surgeon and am going through the public system. Have been told wait will be 9mths with no out of pocket. Other option was to upgrade my hospital cover (I got basic cover for tax/Medicare loading reduction) and wait a year and then have several thousand dollars of out of pockets.

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