Have found a lot of valuable information on other threads so thanks all!
I'm 25, male and recently injured my knee, had MRI with following results:
Complete rupture ACL
Grade 3 torn MCL
Grade 2 torn LCL
Complete tear lateral meniscus
I do not have Private health but im reluctant to have reconstruction on public system.
My sport insurance will cover any physio, and all hospital fees (unconfirmed) it wont cover any medicare gap! So if i go through this ill be up for surgeons fees, anaesthetist, and assistant. Can anyone give me a ball park figure on how much ill be out of pocket?
Other option is join a health fund, wait 12 months! Any opinions on which health fund would be appreciated. Also what costs will i have to pay if i do have Private health? i know about premium, excess and co-payments and i know the hospital stay will be covered but with regards to surgeon, assistant, anaesthetist what would i be left to pay?
Is there a level of cover which have have me fully covered against all costs?
Sorry i have so many questions.....
All help appreciated
If your injury insurance is paying for the hospital fees then you might be in some luck.
Your private health does not give you much back for Surgeon's fees, anaesthetist, and assistant. If I recall correctly, out of the approx 5k quote for my Surgery (Including assistance fee) my private health gave me about $300 back. Same with the anaeasthetist. I got a very small amount back.
Private Health Insurance is mainly there to pay for the hospital expenses (which is actually the biggest part). Private health doesn't give you much back for the surgery fees at all.
How much you'll be out of pocket will depend on your surgeon too and obviously what's involved. It sounds like you've got a bit to fix!
I had private health and I went to a good surgeon and I ended up still being about 4k out of pocket in total (That includes Surgeon, Assistance and anaeasthetist). If I didn't have private health but somehow had the hospital costs covered, then I'd probably be paying around $4,500 out of pocket.
So I suppose you could use that as a "ball park" figure. However like I said, it'll depend on your surgeon.
I've been over the forms and it states:
Re-imbursement up to 85% of non medicare expenses (net of any recoveries from private health insurance) up to a limit of $5000. Claimable expenses are physio, chiro, osteo, naturopathy/massage/acupuncture (all following doctor referral), ambulance, dental, PRIVATE HOSPITAL (accom/theatre fees/prosthesis), and orthotics prescribed by a surgeon following surgery.
So i'd be up for the surgeon/assistant/anaesthetist fees and i can get "up to" 85% of hospital fees back only up to $5000