Does Private Health Insurance Cover Orthopedic Surgery?

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  airal3rt on 20/12/2017 - 03:34

  +7

  Well, it depends on the level of cover specific to your individual insurance policy.

  They said it wouldn't be covered over the phone but I'm assuming they would always say that as surgery would likely be upwards of $10k.

  You think they are lying about what's included in your plan? What?

  Insurance companies are scumbags who go over every claim with a fine-tooth comb to find any reason to avoid paying out, but if you ask them what is/isn't covered in your plan they will tell you…

• 

  bobbified on 20/12/2017 - 07:48

  At the very minimum, does the surgery you need have a Medicare item code?

  If I remember correctly, private health only covers items that are listed under the Medicare Benefits Schedule.

  And then from the MBS list, what's actually covered will depend on your own policy that you've purchased.

  http://www.mbsonline.gov.au/internet/mbsonline/publishing.ns…

  Your doctor might be able to tell you about his past patient's experiences with their health cover.

• 

  [Deactivated] on 20/12/2017 - 07:55

  +1

  I think you can assume way upwards of 10k

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  ChrisLevo on 20/12/2017 - 08:09

  We are with BUPA, and had:
  Hip replacement for me in 2010,
  Knee replacement for my wife in 2012,
  Achilles reconstructions in 2016 and 2017 for my wife.

  All at Sportsmed in Adelaide, and no payment required as BUPA picked it all up.

  The policy is quite clear, and they paid as advertised.

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  Chris Topher on 20/12/2017 - 16:29

  I have top cover and had a hip replacement. What wasn't expected was the infection I got (a MRSA variant) and the complications that followed, including a revision. Now I have antibiotics for life. It was all covered.

  Bottom cover or the public system? I'd be dead by now.

  2 places to avoid in life, hospitals & court rooms.