when PHI isn't 1 year yet and you need to be hospitalised

[Turkish Delight]

Has anyone needed to be hospitalised before their private health insurance reached 12 months old?

I know there are forms to be filled out for these cases but i would like to know if anyone had to go through this process before? Is it worth it? Does it take too long to process by the PHI co.? What was your outcome? Should i just go on the public wait list?

The anniversary of my PHI is in July-August.

I hope it makes sense.

TIA

[Pandora]

Is it for a pre existing condition or somehting thats just happened - there may be a difference in whether you will be covered and for how much.

[Turkish Delight]

that is what i don't get.

It is a condition that i have had since birth but never had it diagnosed or seen a dr about until now as i didn't know it was a "condition" and thought it was just me.

It is got to do with my narcolepsy and excessive day sleepiness. I just thought i liked sleeping a lot, until my ENT specialist told me that there was such a condition.

I just diagnosed with it this year. So is this pre-existing, even though it was diagnosed this year, yet i've had it all my life?

[Pandora]

probably.
The rule they tend to use is could a doctor have picked it up in the preceding 6 months if they had checked for it.
My firned had her endo diagnosed in the year she got her PHI, and this was after 8 years of being told it couldnt be endo and she didnt have the right sympotoms. He OBGYN wrote her PHI a letter stating it would have been near impossible for anyone to correctly diagnose becuase of the way her symptoms presented, and they still ruled it preexisting - she had to wait 4 months for her 12 months period to be up.

[Cherished]

I'd ask the health fund. My dh had a nose operation before the 12 month period and it is technically something he was born with. Something about the airways restricting airflow through the nose???... I don't know the full details but he ended up with a full rhynoplasty (nose job) in the private hospital with a specialist surgeon. I guess there are heaps of things which are technically preexisting but if not actaully diagnosed than I'd say they are new, I mean lots of things start becoming a problem way before you actually notice it is a problem and get it seen to if that makes sense?

[Mother Goose]

some health funds also pay if it is a priority issue as well. But it all depends on the health fund. give them a call TD. Who are you with?

[Turkish Delight]

I'm with NIB. It is oh so confusing. I'll have to call them tomorrow and just ask. I know its not long til July August but i just want answers to something i've been battling all my life without knowing that there was treatment for it and that it was even a condition