does medicare cover lap-band?

[mola 0]

hello there, i'm new here. I'm want to have lap band procedure asap... I've got medicare and centrelink benefits card. does anyone know if the lap procedure would be covered by that? how much would i have to pay for it? what doctor in sydney would u recommend?

[RestlessMonkey 7]

Sydney Australia? If so, I'm in S. Central Texas and can't help you.

[cuddles_01au 0]

hello there, i'm new here. I'm want to have lap band procedure asap... I've got medicare and centrelink benefits card. does anyone know if the lap procedure would be covered by that? how much would i have to pay for it? what doctor in sydney would u recommend?

Hello and welcome

you need to have private health insurance

medicare covers less than 1,000 cant remember the exact amount but its not very much:rolleyes2:

the public waiting list in sydney is many years long

im also on a pension but i joined a health fund and waited the 12 mths and was banded almost 12 mths ago:lol:

Leeanne

[cuddles_01au 0]

Mola there is an aussie lapband board on yahoo where you can gets lots of info on all the different sugeons etc

there is too an aussie section in here as well

Leeanne

[Shastalou 0]

I was banded on July 16th and medicare paid for mine. I am on disability due to a eye disease. I am in Indiana the only thing was the surgery had to be done in a center of exalance. Which is a center that does over 100 sugerys a year. I had to pay a small amount out of pocket.

Good luck and hope you find the answers you need

Shaz :thumbup:

[RestlessMonkey 7]

Shastalou...Medicare in the USA and Medicare in Australia is different. I'm glad you got the surgery you need!

[cuddles_01au 0]

yes hun australia's health system if very different

there are some states the waiting list for a public patient isnt so long a wait

but usually we need to take out private health insurance and there is a 12 mths wait for any pre existing conditions but after the one year its fine

good to hear you have had your done

Leeanne

[mola 0]

oh... i would like to have the procedure TODAY! waiting another year sounds painfull... so is there any other way to do it quicker? how much would that cost? what insurance company is best to do this procedure?

oh, by the way, im in sydney, australia. thanks guys for your help. i'm desperate.

[cuddles_01au 0]

you need to phone around the sydney surgeons for some quotes as they do vary quite a lot

the yahoo aus lapband message board has a lot of information so might be a good place to have a look through the threads:smile:

i imagine the cost will be around the $12,000 up depending on the surgeon etc when i enquired a couple of years ago both the places i asked wanted $16,000 that includes the private hospital costs:scared2:

you can apply to apra and use you superanuation too so thats another option if you have some:regular_smile:

without health cover it is an expensive option:crying:

I chose to wait the year for the health cover and it really goes very quickly and gives you time to gather a lot of info etc:thumbup:

Leeanne:shades_smile:

[mola 0]

i'm confused. just called mbf and there are so many policies, it's hard to chose. so how does it work? u find the doctor,who has to agree with the insurance company on payment? i'm confuuuused! where do i start?? does anyone know?

[cuddles_01au 0]

if you have decided to wait the 12 mths then yes you choose the health insurance company you want

you dont need to take out extra's cover just hospital cover and usually the highest

I went with medibank private

but MBF is good too

it personal choice nothing to do with the doctor as you will pay a gap for almost all doctors

after health insurance paid i still had a gap of $3,800 I had to pay and the majority of us have to do this

go to the yahoo lapband board and you will find more info there

Leeanne

[cuddles_01au 0]

this board is good but you need to remember its an american chat board...

and no offense intended here to our american friends

but its good to find an australian board too for the relevant info

just trying to be helpful here

Leeanne

[Ange05 0]

i'm confused. just called mbf and there are so many policies, it's hard to chose. so how does it work? u find the doctor,who has to agree with the insurance company on payment? i'm confuuuused! where do i start?? does anyone know?

No Medicare does not cover lap band surgery.

You would need the top cover. The policy must cover ELECTIVE SURGERY, if it does not include elective surgery it will not cover the operation. You will need to shop around to get the best premium, (they can vary alot).

If you joined MBF or any other heath insurance you would need to wait 12 months, there is no way of getting around it, it's a goverment regulation. Even if you paid your full years premium up front you still have to wait. The gap you would need to pay after the 12 months for the operation can be anywhere from $3000 - 5500 depending on the hospital and how much they charge for your admission.

I paid for my operation outright which was a total of $12,173 this included Hospital Costs, Surgeons fee & the anethetist.

After paying that total amount, you get a rebate of around $1000 from medicare.

My surgeon was one of the cheapest in Sydney. He also owns 3 weight loss clinic's, so basically the first step I had was meeting with the doctor, then he required me to meet with his psychologist to make sure I was mentally ready for an operation and they pretty much just check that you dont have any eating disorders etc. Then I went and spoke with his dietician. I also had to have blood tests done. After that when the Doctor has all the results and he is happy with the results they booked me an operation date and they gave me the bank account details for the doctor and anethetist, those accounts had to be paid 3 days before the operation and the hospital costs are paid on the day.

They also obviously gave me an outline of how much money goes to each person etc.

Some surgeons may just meet with you and book you an operation date after you have paid his fee etc.

I hope this makes sense.

Edited September 3, 2008 by Ange05

[mumof2 0]

I have Medibank Private blue ribbon hospital. It covers everything (including the actual band). So your insurance has to cover prosthetic devices and elective surgery and I think you would need the top hospital cover to get all that.

The out of pocket expenses (this is what your dr charges above what the health insurance pays them) was SURGEON: $3,000, ANAESTHETIST: $400, SURGERY ASSISTANT:$500. Total $3,900.

So you have to be prepared to pay your premiums for a year to serve out your waiting period plus put aside about $5,000 for your out of pocket expenses.

The good thing for me is all my follow up appointments and fills are bulk billed to medicare, so no out of pocket expenses. I think its probably the same for all Dr's here in Australia.

[Ange05 0]

Yes everything was included for me also, fills, dr appointments, dietician appointments, excercise physiologist & psychologist appts.