Australian Health Insurers - CPAP benefits?

[Moriarty]

I have just been down to Medibank Private to lodge the claim for my Respironics machine.

After first being told that I could not claim - then being told that I needed to give them the Sleep Study result because a copy of the Script and the Physicians letter of necessity wasn't enough - then my insisting that they were wrong - then them discovering that the policy 'must have been changed with out them being told' - I eventually got the pretty pitiful $500 rebate that I expected...

What I was even more surprised to learn however was that MBP do not allow claims for masks in their schedule. I was told that they do not allow claims for machine replacement tanks, hoses, or masks because they are consumable 'running costs'. WTF???

The 'manager' at the Toowoomba MBP office smugly told me that their offering was better than BUPA's - which is probably not saying a lot.

I have been with MBP for 34 years and this is the first significant claim in the last 25 years... I am not impressed with the service or responsiveness for the nearly $5000 a year they collect from me.

My question of the Australian members of this forum is - does anyone have any better suggestions for a private health fund?

[zonk]

Its the same with Bupa. It $500 for the machine (if not mistaken every 2 years) and nothing else
I was looking to buy a second machine using the rebate but the catch have to buy the machine in Australia and pay rip-off prices .
Its cheaper to buy the machine out of pocket from the supplier list especially #2

Essential Medical Equipment Payment (including PAP)
http://www.humanservices.gov.au/customer...nt-payment
http://www.humanservices.gov.au/customer...nt-payment

[Gillian]

Only just read this so it is a bit late. I am with NIB and they give 75% of cost up to $$1000. At first they didn't want to pay out because I bought in USA but after hassling, agreed to do the right thing!

Gillian

[zonk]

Only just read this so it is a bit late. I am with NIB and they give 75% of cost up to $$1000. At first they didn't want to pay out because I bought in USA but after hassling, agreed to do the right thing!

Gillian

welcome to the board. glad to hear you did manage to get the rebate
did you use one of the suppliers from the "Supplier List" ... you could just say the number ... for example supplier 10 ... Thanks
Suppliers List: http://www.apneaboard.com/forums/Thread-...plier-List

as you,re using ResScan ... the interpretation guide would helps
http://www.apneaboard.com/ResScan_Interp...-Guide.pdf

[zonk]

US accounts to 50% of CPAP sales globally but I believe it has to do with more than just market size
Think about, everything is more expensive in Australia including books, CD, cars, electrical appliances, .... even soft drinks


Why do Australians pay so much more for tech products than Americans - sometimes over 80 per cent more?
http://www.smh.com.au/technology/technol...z2qhnppXC1

[DeepBreathing]

I'm with MBP because we get a good deal through work. However they only paid $500 for my S9 VPAP Adapt - a $4,000 machine. Not happy John!

I was going to buy the machine on-line, but the VPAP Adapt seems to be a similar price in the US, and I was able to get mask, climate line hose and humidifier all included, plus a five year warranty and unlimited consultations with the Cardio Respiratory Sleep clinic.

We have discussed in another thread trying to get some action going to encourage the funds to offer a better rebate for this essential equipment. For heavens sake they give all sorts of payments for things like gym membership and highly questionable "alternative" therapies - you think they would realise that treating apnea will reduce their costs in future.

[zonk]

I have "Extra cover" which cover dentist and glasses plus other services not covered by Medicare
I don,t mind pay own way and take "hospital cover" and save the government money but they want to penalize me of not taking health insurance early in life. Last year I had surgery on my nose which did not cost the government a cent, all costs paid out pocket. For that reason, I favor US style insurance health care or even better Swiss style which Obamacare is based on

[If you do not have hospital cover with an Australian registered health fund on the 1st of July following your 31st birthday and then decide to take out hospital cover later in life, you will pay a 2% loading on top of your premium for every year you are aged over 30.

For example, if you take out hospital cover at age 40 you will pay 20% more than someone who first took out hospital cover at age 30. The maximum loading is 70%] http://www.privatehealth.gov.au/healthin...hcover.htm

[DeepBreathing]

It's all a question of economics, Zonk. They want young healthy people to take out insurance to help subsidise us decrepit oldies. If everybody waits till they're old and sick, the funds will not have enough money to cover us and all our procedures. It's the same for all types of insurance - careful drivers subsidise those who have a crash. So they've put in place an "incentive" to take out insurance early in life. Depending on your viewpoint, an incentive for one person is a penalty for others.

I don't know anything about the Swiss health system, but from what I've read about the American one (pre-Obamacare) it's not a model I'd want to follow. Our system is far from perfect but at least people in Australia don't face a choice between going bankrupt or dying.

[me50]

IOur system is far from perfect but at least people in Australia don't face a choice between going bankrupt or dying.

not sure what you mean going bankrupt or dying.

[Sleepster]

The expenses associated with catastrophic illness or injury can sometimes leave a person and their family members destitute. Their only viable option is to file for bankruptcy.