Roux-En-Y Gastric Bypass ADELAIDE AUSTRALIA anyone here from Australia

[Hop_Scotch 1,633]

This will give you an idea what is covered by medicare if you meet the criteria (which I think is a BMI 40 and greater or BMI 35 or greater with comorbities, like diabetes two etc.

https://sios.elevate.com.au/costs-finance-options/

Medicare pays 75% of the scheduled fees if there is an item number for that service, and PHI (if your particularly PHI covers WLS) pays 25% of the scheduled fees plus private hospital fees (excluding any co-payments/excesses). There will be gap payments for any fees which are greater than the scheduled fees set by medicare.

Bit of a minefield really.

[MMME 89]

16 hours ago, Mikeyy said:

That's the first I've heard about any Medicare rebate. I'll have to make an appointment with the surgery and ask those specific questions.

I was told Medicare Will only pay if you meet the standard for public surgery not private.

I've still got 10 months wait as I've just started with PHI

Tnx

I don't meet the public standard and got back $1175. I'm over 55 so no public list for me.

[elcee 3,342]

19 minutes ago, MMME said:

I don't meet the public standard and got back $1175. I'm over 55 so no public list for me.

Interesting. How do you go about claiming?

[MMME 89]

3 hours ago, elcee said:

Interesting. How do you go about claiming?

After surgery your surgeon will give you a receipt. Take it to Medicare and they will fix you up. I had no idea about it until a friend who had the same told me.

[New&Improved 1,780]

Okay that's great I'll definitely look into it. I'm only going to be 35 and i do meet the bmi as I'm at 41bmi but yes I'll definitely ask the doctors and surgeons here in Adelaide because I'm under the impression I'll be out of pocket at least 4-5000 for surgeon and anesthesist not including Optifast and Vitamins etc but if Medicare Will help that will be good i am on Medicare and pension card.

[New&Improved 1,780]

On 11/19/2018 at 12:20 PM, MMME said:

After surgery your surgeon will give you a receipt. Take it to Medicare and they will fix you up. I had no idea about it until a friend who had the same told me.

thank you

[New&Improved 1,780]

On 11/17/2018 at 5:18 PM, MMME said:

Hi Mikeyy. I'm just north of Perth and had RnY on 26 September. I have Medibank which paid for my hospital charges but I applied to use some of my super for the surgeon and anaesthetist's gap. After surgery I claimed back about $1100 from Medicare and I think I can get some back from Medibank if I send in receipts.

So far, 7.5 weeks in I've lost 17 kg. RnY is by far the best thing I've ever done.

Sounds good what was the full cost of gap and surgeon out of Pocket before Medicare rebates tnx they vary in adelaide one place is 4500 another is 2500 the higher one includes more after care which I'm not worried about.

[MMME 89]

2 hours ago, Mikeyy said:

Sounds good what was the full cost of gap and surgeon out of Pocket before Medicare rebates tnx they vary in adelaide one place is 4500 another is 2500 the higher one includes more after care which I'm not worried about.

My out of pocket was close to $9000 all up but I accessed my super for about $6000 of it. That figure includes band removal (anaesthetist fee, hospital excess of $500), pre-op Optifast, RnY anaesthetist fee, surgeon fees, prescriptions, pathology and dietician. My post op care is all bulk billed by my surgeon's office. I saw him at week 1 and week 4, but from then on I will be seeing the bariatric GP who works exclusively with the surgeon's patients for aftercare. I should get back another $1000 or so from Medibank, so after rebates from Medicare and Medibank I'll be out about $1000 total.