Bupa silver + hospital cover -out of pocket expenses $3100 of $4500 bill (operation only) not including anaesthetist, tests, scans or specialist appointments etc.) for wife’s breast cancer surgery. Medicare $1000 approx. Bupa ‘Hospital cover’ $ 400. Yes …the room only, not the doctor or surgery. Be very careful what you think ‘hospital cover’ actually is. We were not prepared. Fair to say Bupa ‘Hosptial cover’ relies on your specialist being ‘signed up’ to the Bupa gap scheme. Even then there are still significant out of pocket expenses. Out of pocket tool - worth checking prior to any private hospital surgery … alternatively (preferable) choose another health insurance provider.
For clarity would it be correct that neither or either of the surgeon or the hospital were in the BUPA network? Or were those out of pocket with using their in-network providers?
Hospital is a Bupa network hospital. I checked these fundamentals and medical conditions etc. that were excluded from the hospital cover prior to admission.
2 Likes
The very next visit to the surgeon / specialist my wife was fundamentally ‘bullied’ by the receptionist to pay the full bill with her card then seek both medicare and health insurance remibursement herself.
2 Likes
The AMA, essentially the doctor’s union, is not exactly unbiased or just community minded since it primarily looks after its members, but many interesting points have been made.
1 Like
On one hand the AMA is saying,
In 2022-23, the amount of money returned to customers from hospital insurance policies fell by 81.6 per cent in 2022-23.
On the other the ACCC annual report to the Senate on the performance of the Private Health Insurers notes:
Referring to any comparisons relative to the period 2019-2022 can provide abnormal results due to Covid impacts on consumer use of private cover.
I can’t reconcile the AMA statistic to what the ACCC has reported for the previous 4 years for the total value paid out by insurers for hospital claims. The total amount paid overall has increased over the previous 5 years.
Start here.
‘Private health insurance report 2019-20 | ACCC
P.S.
Perhaps the AMA is trying to say something else about refunds for hospital cover?
