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Default Health insurance question

Default Health insurance question

Old Jun 26th 2019, 9:17 am
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Default Default Health insurance question

The wife of a friend of mine has recently been diagnosed with cancer in one kidney and is on the category one priority list to have the kidney removed meaning the operation is promised to take place within a month on Medicare. The friend and his wife have private medical insurance and he believes the operation can be fast-tracked on private and understandably he is very worried so is urging her to do that. But she is of the opinion that it wont make any difference time-wise and will only mean that on private they will have to pay for the fees that the health insurance doesn't cover whereas on Medicare everything is paid for. Is she correct? Does anyone have any experience of this that they can share? Thanks.
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Old Jun 26th 2019, 10:27 am
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Default Re: Default Health insurance question

Originally Posted by lamdeptunhien9x View Post
The wife of a friend of mine has recently been diagnosed with cancer in one kidney and is on the category one priority list to have the kidney removed meaning the operation is promised to take place within a month on Medicare. The friend and his wife have private medical insurance and he believes the operation can be fast-tracked on private and understandably he is very worried so is urging her to do that. But she is of the opinion that it wont make any difference time-wise and will only mean that on private they will have to pay for the fees that the health insurance doesn't cover whereas on Medicare everything is paid for. Is she correct? Does anyone have any experience of this that they can share? Thanks.
Hi, sorry to hear about your friend's wife.

Couple of things - your friend's wife's specialist is the only person who can say with any degree of confidence whether immediate surgery would be better than waiting a month. Although I can certainly understand your friend's anxiety, and also his wife's fear of a big bill.

If it's agreed that the surgery is best performed asap, if it were me I'd do this.

Your friend's wife phone the specialist/surgeon she's seeing (they'll get the receptionist or secretary which is fine, they'll pass the message on), to ask whether or not they would be able to operate on her as a private patient, and if so how long would the wait be. If the surgeon can operate earlier if she goes private, ask for a surgery date, and ask which anaesthetist he/she would be using and which private hospital/s he/she has operating privileges at. Then your friend or his wife needs to phone their private health insurer and get a 'quote' for the surgery by advising who her surgeon is, who the anaesthetist will be, and at which hospital the surgery will be done. Most private health insurers have 'no gap' arrangements with specific private hospitals, and similarly with specific anaesthetists. A quote will tell your mate and his wife whether or not there would be out of pocket payment required, and if there is, how much that would be.

Of course, if your friend and his wife are advised by her specialist/surgeon that waiting a month won't make any difference, then all the above becomes moot.

I wrote this in a bit of a hurry so don't hesitate to ask if anything's unclear. Best of luck to your mate's wife, and to him too.

Last edited by spouse of scouse; Jun 26th 2019 at 10:30 am.
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