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Tell us your experience with rt health fund

Do you have something to say about rt health? Tell us your good experiences, bad experiences or otherwise and help inform the CHOICE Community.

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My partner has with RT health for years.
He added myself and our children to the policy last December,
I was injured in March and have been trying everything I can to get better (physio, exercises, giving it time, lifestyle modifications ect).
It is now September and it has finally come to the point of needing surgical intervention.
I contacted RT health as soon as it had come to this point with the item numbers to see if I would be covered,
I was told yes, the item numbers were covered by my policy. The staff member then asked when I was planning to have the surgery and then told me I would not be covered because it was 3 months before the end of the 12 month wait for “pre existing conditions”.
I stated that this was not a “pre existing condition and asked how I would go about gaining access to my cover,
They said they’d send me the forms to give to my gp and to the specialist to fill out.
It took them 3 days and multiple phone calls to follow up with them to have these forms sent to me.
Once I had the forms filled out and sent back to them with supporting evidence that this wasn’t preexisting prior to taking out the policy,
I was told it would take 5 days for them to make a decision…
It’s now been 5 business days, I’ve called twice to follow up and been told that they don’t know what’s happening or how long it will take to make a decision, this is adding so much stress to a already stressful situation.
I’m supposed to be admitted to hospital in 1 week today and instead of planning ahead for my recovery; I’m following up a health fund…
This injury is severely impacting my quality of life and mental health, I just want to know if they will cover me in time for the procedure.

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@Jessica2 Thanks for sharing your experience. If your injury resulted from an accident it is not pre-existing and the 12 month waiting time does not apply. I would suggest to [contact the Private Health Insurance Ombudsman] today.

It may also help to email RT Health again and inform them you have logged a complaint with the Ombudsman and informed us, feel free to cc your email to healthinsurance@choice.com.au and keep us up-to-date how your are going.

Good luck,

Uta

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The Private Insurance Ombudsman has a page that is superficially instructive prior to lodging a complaint.

https://www.ombudsman.gov.au/How-we-can-help/private-health-insurance

including COVID-19 impacts on their operations and alternative ways to contact them at

https://www.ombudsman.gov.au/contact

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