Does anyone understand the private healthcare system?

[Cat 10]

Hi all, I'm so confused... we have good private insurance, our local hospital is SJOG Murdoch, and Fiona Stanley right next to it. My son was unwell recently, so we took him to Fiona Stanley children's ED. It was all covered by Medicare.

 

If we we need to go to the ED again, what's the difference whether we go to Fiona Stanley or SJOG? Could we end up with a bill for some things if we go to SJOG. I understand the difference if we are going for a scheduled op or treatment, but emergency treatment is confusing.

 

Thanks!

[ali 189]

I'm not sure if your private health insurance covers ED visit to SJOG - you would need to check with your health care provider or check your policy

[Arwen 25]

Our private doesn't have an ED so I always opt for public treatment in an emergency. My understanding is that if you choose private treatment at the ED if any other kind of consultant is required then fees could apply. A friend's daughter a number of years ago had a fit and was taken to ED by ambulance. They chose private on arrival and ended up with massive fees as the consultant that dealt with them wasn't on their funds list of recommended providers.

[Ktee 11]

I have plenty of experience with private but not ED as we never had a private ED. I know as a private patient you have to be an inpatient to be able to claim for tests etc.

[Rossmoyne 98]

From personal experience at SJOG Murdoch ED, if you are treated and then sent home, you are totally liable for all bills, xrays, blood tests etc. However if you are admitted into the hospital, your medical insurance will take over and pay for whatever level of cover you had. I had a fall breaking up a dog fight... ended up being ambulanced in SJOG as everywhere else was "ramping". I spent 7 hours being xrayed (6 broken ribs) blood tests, ECG etc then sent home. The bill was in excess of $2500 and the only component covered by health insurance was the ambulance visit. This was about 12 years ago but from comments made by a friend who was ambulanced there recently, the situation is still the same. It is better to start out at Fiona Stanley and take it from there privately if you need to.