Time between Consult and Sugery

Hey, I was just wondering how long you had to wait between the Consult with the Doctor to actually getting surgery?

As soon as they have an opening available. There's no waiting period in Australia, provided you've done the 12 months with health insurance if you aren't paying it all yourself.

Some people have waited 3 weeks, others a bit longer. Just make sure you can get the psych and dietitian visit in though.

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Banded: 29/10/08 - Brisbane




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Thread Starter

I've only just joined a health insurance and they've told me as long as the doctor says it's medical then they will cover it etc? I'm hoping mine will be fine

As you can see from my signature, I had my consult on 10/6 and was approved by my insurance on 10/14. They wanted to schedule me for 11/5, but since I'm leaving for vacation on 11/18 I have to put it off until after, on 12/6.

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10/06/08 - Consultation
10/10/08 - Submitted to Tricare for approval
10/14/08 - Tricare APPROVED!!!
12/31/08 - Surgery

I think for me it was about 6 weeks.

So you don't have to wait 12 months? That seems a little odd to me. If I had known that I would have paid that way rather than spending $12,000 of my hard earned super.

Thread Starter

Well when speaking with my health insurance ppl, as long as it's "medical" and medicare agree then yes they tell me it's covered?

How did you manage to get your super to pay for it??

Wouldn't most claims through PHI be for 'medical' reasons??? I personally would look into that if I were you as it just doesn't seem right to me.

I called APRA and they gave me the forms in regards to taking the money out of my Superannuation. You just need a letter from your surgeon and one from your Dr. Really was quite easy although took a while. I am now close to 2 weeks post surgery and I haven't received my money back as yet.

Thread Starter

Hmmmm guess I will find out. Maybe I'm not asking the right questions to the health fund... I don't know, it's all confusing to me.

I had my operation 3 weeks after seeying my doctor for the first appointment.

You do have to wait out the 12 months for the insurance company to pay such a claim, it's a government standard waiting period that applys for all heath insurance companies, who ever is telling you otherwise I think is pulling your leg.

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yes sadly thats correct....this is a pre-existing condition
not a medical condition that has suddenly occured
so its the 12 mths wait for the health fund

but in the mean time get your referal and see the surgeon and get all pre-op things done

i was banded 4 days after my 12mths health fund kicked in
so you can get ready and then save time

and good luck

Leeanne

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Thread Starter

hmmm interesting, I'm going to call my health fund and just plainly ask them!! If not, looks like I'll be finding a way around it

Leeanne I'm assuming it was much cheaper with the Health Insurance... I mean obviously it was cheaper but much?

yes give them a call be direct and simply say it like it is....
the last thing you want is to go ahead and be given a massive hospital bill in the thousands because there was a misunderstanding

the normal rule is any obesity or weight loss surgery is a pre-existing condition and subject to the waiting period

with health fund my out of pocket expense was $4,000

plus the cost of insurance which i have kept just incase i need it

but without ins then anywhere between $10,000-$18,000
depending where you live, what state, and really what your surgeon decides to charge

I was lucky my surgeon allows it to be paid off and im still paying him rofl
but i wouldnt change it as my life has changed for the good

Leeanne

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Thread Starter

Ok, well just spoke to my health insurance AND Medicare and I need the numbers and Medicare will tell me if they will pay and if Medicare pay then my health insurance will pay... so guessing I just have to wait till my consult now...

who is your health fund

it isnt actually if medicare will pay

medicare will pay on all item numbers
there isnt a wait for them
but they dont pay very much its just a pittance

the health insurance is needed for the private hospital
thats where the waiting time is involved
and that isnt anything to do with medicare hun

unless you go on a public waiting list to go through a public hospital

medicare only pay a small percentage to your surgeon
and a percentage for the actual silicone band
and a percentage for the anaethetist

hope that helps

Leeanne

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Thread Starter

HCF and I'm just about to boot them if they can't give me the right info. They told me that if Medicare put money towards it then they do. I also need to determine if it's a "pre-existing" condition, which I'm guessing it is, I've asked them regardless to send me out the paperwork.

Part of me is just about to give up and give it one more shot the good old fashioned way, even though it's failed me, but I can't see this happening anytime soon for me :( I'm just so frustrated.