Hidden cover in Private health insurance

Heathber
Heathberon Thursday, December 17 2015
29 Comments

Hi folks, I'm more than half expecting this entry to get censored(after all this site is sponsored by a health insurance provider).  But I really feel the need to say this.  Did you know there is Therapy support hidden in your private health insurance?  The Health insurance brochures/benefits statement etc. and the people on the insurance phone support lines don't mention this, and when I rang to ask about it because what the hospital was telling me sounded too good to be true.  I got told in no uncertain terms that what I was asking about did not exist.  But it certainly does exist, I'm using it. It appears that you have to get the rehab specialist and/or hospital to ask on your behalf.  There is cover in my health insurance for over 100 outpatient rehabilitation clinic visits per year.  This is part of the hospital cover, not extras and not medicare.  So when they tell you there is no outpatient cover in your plan don't believe them.  I'm getting botox/spacticity, gait assessment and PT covered as the rehab specialist has prescribed them. 

 

I had to get a GP referral to the rehab specialist first, but there's been no out of pocket cost since then.

I wish I'd found out about this a few years ago I stopped official therapy once I was deemed functionally independent by the public hospital. I asked at the time if there was a way to get more help/therapy as I was not satisfied with quite a few of my physical deficits.  And when I was told no, I setup my own training/recovery program using a private neurophysio and personal trainers (who I had to teach how to help me)  and it cost me many $s and still does ( I get some assists from extras health cover, but that doesn't come near to making it affordable.)

 

I guess it helps that I'm starting this new hospital outpatient program with more skills and strength than I had when I first asked about doing more so I'll get more from it now than I would have then, but where would I be at now if I'd had this help earlier?

 

29 Responses
Valerie avatar
Valerie

Very interesting. I will follow up with my husband's doctor tomorrow. We have mostly continued on with our own therapies since leaving hospital. For those eligible the myagedcare.gov.au has also been helpful at very low financial cost. 

Heathber avatar
Heathber

Hi Valerie, I'll have a look at the myagedcare.gov.au but as a younger survivor I've been through that argument before and not sure I want to bother again.  On my first returning home I needed home care assistance which has to come through council aged care services but their first question is how old are you and without a GP referral already in their hands they were reluctant even to give me an appointment with their assessor.  Also cost is means based and as an employed person usually higher than going to a private provider (at least it was for home care.)

Valerie avatar
Valerie

So sorry to hear the problems you faced. It sure is a bumpy road and so very frustrating at times to get the most basic information. I am hoping this enableme site will make the journey from stroke so much easier for all in the future for both survivors and carers. I used to read your blogs on stroke foundation site. Can't seem to access it now. 

Valerie avatar
Valerie

That's a bit of a shame. I learnt a lot from reading what others had to say on that site. Also of course the Stroke Connect magazine on line from America. I have gained a little reading Stroke Survivors and Stroke Caregivers on Facebook as well. Unfortunately I could gain no real information from the hospital my husband was in in Tasmania. I so hope in future the stroke foundation will ensure all new stroke survivors and their caregivers are given more information while in hospital. When I approached Tasmanian Stroke Foundation they said they were trying to do so. I have spoken to Richard Cullen from Enableme and he said he is going around hospitals now. So hopefully information will be more readily available in future when first needed. 

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