thread: Do you have to go private if you have private health insurance?

  1. #1
    Registered User

    Jan 2009
    5,235

    Do you have to go private if you have private health insurance?

    I have PHI, but was wondering, if something happened in an emergency - say, appendicitus and I had to have surgery, am I obligated to tell them I have PHI and go private or can I just go through the public system for free?

  2. #2
    Registered User
    Add Little Chicken on Facebook

    Mar 2010
    Melbourne
    1,855

    No you don't, but you might as well get your money's worth.

  3. #3
    BellyBelly Member
    Add Yeddi on Facebook

    Aug 2010
    In a library somewhere...
    788

    No, you don't - I went public so that I could access the midwife based care program rather than needing to have an OB, but if you want OB-based care I would go private to get your money's worth as LC said.

  4. #4
    Registered User

    Dec 2006
    In my own private paradise
    15,272

    No you don't, but you might as well get your money's worth.
    in an emergency situation, they'd almost inevitably put you through a a public patient - at least around here they would - the private hospital here is for non-emergency surgery or for illness that requires hospitalisation for prolonged period. they don't do middle of the night emergency things - it's all done on a booked in basis.

    you are under no obligation to use PHI - but in a public hospital, some PHI can help to get a private room so worth mentioning it (esp if you have no gap fee in your coverage)

  5. #5
    Registered User

    Sep 2005
    whoop whoop or not, not sure yet!!!
    1,347

    you can be a public patient in a public hospital or a private patient in a public hospital - if you notify the public hospital you are a private patient - in addition to possibly a single room and/or direct consultation with the head consultant rather than just the junior staff (which was an extra (could be good or bad) I didn't expect when I was a private patient in a public hospital) they will receive money from your private health insurance to fund your stay (no where near what the private hospitals get but still income).
    Last edited by jaspen; May 24th, 2011 at 02:01 PM.

  6. #6
    Registered User

    Jan 2009
    5,235

    No you don't, but you might as well get your money's worth.
    Depends though - I have $500 hospital gap, then if the surgeon wasn't a no gap surgeon, you'd be up for charges there too. I have PHI for things I want to choose not to wait in the public system for, but if it were an emergency thing, I would likely opt to go public - given that I now know that's an option.

  7. #7
    Registered User
    Add Little Chicken on Facebook

    Mar 2010
    Melbourne
    1,855

    True, but you might find some surgeons and anesthetists who work in the public sector don't charge as much as those that work exclusively in the private. Also some public hospitals will give private patients freebies as well like free tv and papers, some even do gift vouchers to the gift shop. Not enough to make up the excess, but could make a long stay more comfortable. Some will even organize for you to be transferred to a private hospital post emergency.

  8. #8
    Registered User

    Dec 2006
    In my own private paradise
    15,272

    True, but you might find some surgeons and anesthetists who work in the public sector don't charge as much as those that work exclusively in the private. Also some public hospitals will give private patients freebies as well like free tv and papers, some even do gift vouchers to the gift shop. Not enough to make up the excess, but could make a long stay more comfortable. Some will even organize for you to be transferred to a private hospital post emergency.
    i guess the main thing to be aware of is that you are not obligated to use the private hospital system - even for elective surgery - if you deem it to be non-urgent in nature and you're happy to wait for a bed, you can go public. DH and I have both had dental surgery privately - his could have waited but our local hospital were owned by the health fund so no gap - mine couldn't - i had a small gap as i had to go to a non-local hospital. it wasn't deemed emergency surgery, but to get it actioned asap to stop more severe and permanent damage, we forked out. had i chosent to go public, i would have waited many many months and possibly ended up with permanent damage. for DH to wait for public for his would not have caused further damage. had we had a significant gap for his, we likely would have waited for public spot (does that make sense)

  9. #9
    Registered User

    Aug 2006
    On the other side of this screen!!!
    11,129

    Just be aware that if you go into a public hospital as a private patient the hospital has no obligation to treat you any differently to any other patient - this means in many public hospitals that single rooms are assigned on a needs basis and not whether your health fund is paying or not.

  10. #10
    Registered User

    Dec 2005
    6,706

    It's private room based on availability and need, from my experience. So when I was admitted in the early hours of one morning with pretty bad OHSS I found myself in a shared room with one HG patient (oh the joys!), one who kept to herself and was quiet, and another who was pretty much straight out of surgery for endo. She SNORED!

    When the nurses saw me in the morning with tears pouring down my face because I'd had no sleep, they arranged for me to transfer across the walk way to the private instead of the public. Generally, for a short-term emergency thing, I'd just go public. You either won't be in long enough to mind or you'll be too sick to care. For a longer-term hospital stay, I'd be going private.

    BW