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Pod Surgery and Private Health in Aus

Discussion in 'Australia' started by Fitzdog, Oct 30, 2013.

  1. Fitzdog

    Fitzdog Member


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    Hi,

    I’m trying to find out some info regarding podiatric surgery and private health funds (hospital cover).

    As far as I’m aware Private health funds (Hospital Cover) have to pay a minimum of the associated accommodation costs of staying in hospital. But as Pod surgery is not recognised by Medicare yet (which I think is crap) then many funds do not pay anything toward the surgery cost and the anaesthetist.

    Does anyone know which funds currently contribute to the actual pod surgery and the anaesthetist costs? I have heard medibank private are ok but other such as Bupa contribute little if anything.

    Also if a person with current hospital cover with one fund switched to another fund (which payed more for pod surgery) would a waiting period apply? Usually waiting periods do not apply if you switch to a fund with an equivalent level of cover (assuming waiting periods have already been served)…however I am not sure in the instance where the original fund does not recognise pod surgery and the subsequent fund does.

    Any help would be appreciated. I find the whole thing frustrating and confusing
     
  2. Tuckersm

    Tuckersm Well-Known Member

    the Commonwealth Health Act requires health funds to cover the accommodation costs associated with Podiatric Surgery.

    Private health funds will only rebate on the podiatric surgery as part of their extras cover, which varies a fair bit between companies (as well as from state to state)

    Re Anesthetic fees: Medicare will rebate 75% of the scheduled fee, and the private health fund will make up the 25% if correct rebate forms completed, but most anesthetists charge well in excess of the scheduled fee.

    Re transfer, it is about similar levels of cover, so if you had podiatry cover with one fund, then it would be included in the new fund, so it can be worth shopping around to see what level of podiatry cover each health fund provides.

    The A.Pod.C use to compile a list of the rebates, not sure if they still do.
     
  3. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Steve

    My understanding was that anaesthetist fees were not covered through the MBS (or private health gap cover) for podiatric procedures. Only for attendances involving medical practitioners undertaking the surgery. This could have changed recently, but not to my knowledge.


    LL
     
  4. Tuckersm

    Tuckersm Well-Known Member

    I think you are right, with the issue being that the Podiatric Procedure does not attract a MBS benefit, as outlined below re dentistry..

    from Medicare Online
     
  5. Paul Bowles

    Paul Bowles Well-Known Member

    Hi Guys - it hasn't changed Tony you are right. It may have changed (along with a whole raft of other positives for the general profession) a while back if certain Boards had supported the ACPS medicare push. But alas, certain directors didn't see it in the best interest of the profession generally....and here we sit....again no better off for that decision. That's politics1
     
  6. Fitzdog

    Fitzdog Member

    Private health funds will only rebate on the podiatric surgery as part of their extras cover, which varies a fair bit between companies (as well as from state to state)


    Hi Steve, Some funds also rebate as part of hospital cover (not just extras).
    For example...my own personal fund with hospital cover only states that

    "Restrictions apply for surgical podiatry procedures benefits. An 85% benefit is payable only when the provider is a Fellow of the Australian College of Podiatric Surgeons and the procedure is performed in hospital. Limit $350."
     
  7. Paul Bowles

    Paul Bowles Well-Known Member



    How many "hospitals" allow Podiatric Surgeons to work in them? Public Health = 0? Private maybe a select few? most are day surgery units. So that benefit isn't really claimable at all. Also $350? Seriously? What fund is this if you don't mind me asking?
     
  8. Fitzdog

    Fitzdog Member

    Hi Paul,

    Thanks I didn't really think about that. It's with Health Partners...they are a South Australian based fund.

    Thanks for everyone's responses.
     
  9. trevor

    trevor Active Member

    The "Hospital and Medical Funds - Rebates for Podiatry services" was, I believe last updated in June 2002.
    The fees were set by the HIC in 1996. Some Health funds have plans where their rebates have not increased since then. These are the insurance company based ones, you know who they are V the not for profit funds who have increased rebates a little.
    Interestingly back in 1996 podiatry consult rebates were either 90 something % of the podiatrists fee or 70 something % of the podiatrists fee depending upon the plan. When Alison Petchel left APODC the wheels fell off and nothing has happened since. ( I am using DVA fees as a bench mark for this)
     
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