Post Reply 
Australian Health Insurers - CPAP benefits?
Author Message
Moriarty Offline

Master Members

Posts: 177
Joined: Jul 2012

Machine: Respironics Auto
Mask Type: Nasal pillows
Mask Make & Model: Fisher & Pakel Pilairo
Humidifier: Respironics
CPAP Pressure: 8.5-20
CPAP Software: SleepyHead

Other Comments: Image above is my CPAP machine...

Sex: Male
Location: Toowoomba - Qld - Australia

Post: #1
Australian Health Insurers - CPAP benefits?
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?
09-13-2012 12:17 AM
Find all posts by this user Quote this message in a reply
zonk Offline

Master Members

Posts: 5,671
Joined: Feb 2012

Machine: S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: H5i
CPAP Pressure: 9/14
CPAP Software: SleepyHead

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #2
RE: Australian Health Insurers - CPAP benefits?
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

Take everything with a grain of salt and evaluate on your own
09-13-2012 03:25 AM
Find all posts by this user Quote this message in a reply
Gillian Offline

New Members-b

Posts: 1
Joined: Nov 2012

Machine: Resmed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Mirage FX for Her
Humidifier: H5i climate line
CPAP Pressure: 6-12
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Female
Location:

Post: #3
RE: Australian Health Insurers - CPAP benefits?
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
11-21-2012 04:23 AM
Find all posts by this user Quote this message in a reply
zonk Offline

Master Members

Posts: 5,671
Joined: Feb 2012

Machine: S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: H5i
CPAP Pressure: 9/14
CPAP Software: SleepyHead

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #4
RE: Australian Health Insurers - CPAP benefits?
(11-21-2012 04:23 AM)Gillian Wrote:  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

Take everything with a grain of salt and evaluate on your own
11-21-2012 04:56 AM
Find all posts by this user Quote this message in a reply
zonk Offline

Master Members

Posts: 5,671
Joined: Feb 2012

Machine: S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: H5i
CPAP Pressure: 9/14
CPAP Software: SleepyHead

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #5
RE: Australian Health Insurers - CPAP benefits?
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

[Image: goldingapple-200x0.jpg]
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

Take everything with a grain of salt and evaluate on your own
01-17-2014 06:31 PM
Find all posts by this user Quote this message in a reply
DeepBreathing Online

Master Members

Posts: 333
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: Quattro Air
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 6 - 15 PS:3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth

Post: #6
RE: Australian Health Insurers - CPAP benefits?
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.

Regards from Paul in Perth
CPAP - it's better than waking up dead!

Bed
01-17-2014 07:46 PM
Visit this user's website Find all posts by this user Quote this message in a reply
zonk Offline

Master Members

Posts: 5,671
Joined: Feb 2012

Machine: S9 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: H5i
CPAP Pressure: 9/14
CPAP Software: SleepyHead

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #7
RE: Australian Health Insurers - CPAP benefits?
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

Take everything with a grain of salt and evaluate on your own
01-17-2014 08:37 PM
Find all posts by this user Quote this message in a reply
DeepBreathing Online

Master Members

Posts: 333
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: Quattro Air
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 6 - 15 PS:3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth

Post: #8
RE: Australian Health Insurers - CPAP benefits?
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.

Regards from Paul in Perth
CPAP - it's better than waking up dead!

Bed
(This post was last modified: 01-17-2014 09:14 PM by DeepBreathing.)
01-17-2014 09:13 PM
Visit this user's website Find all posts by this user Quote this message in a reply
me50 Offline

Master Members

Posts: 1,816
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i set at 86/4
CPAP Pressure: 18/8 how this is auto I dunno
CPAP Software: ResScan SleepyHead

Other Comments: DONATE TO APNEA BOARD IF YOU HAVE RECEIVED BETTER INFO THAN YOU GET AT THE DOC OR FROM YOUR RT!

Sex: Undisclosed
Location: USA

Post: #9
RE: Australian Health Insurers - CPAP benefits?
(01-17-2014 09:13 PM)DeepBreathing Wrote:  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.
01-18-2014 05:06 AM
Find all posts by this user Quote this message in a reply
Sleepster Online
Wiki Editor
Moderators

Posts: 3,012
Joined: Feb 2012

Machine: PRS1 BiPAP Pro Model 650P
Mask Type: Nasal pillows
Mask Make & Model: Nuance Pro
Humidifier: PRS1
CPAP Pressure: 12 IPAP / 9 EPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #10
RE: Australian Health Insurers - CPAP benefits?
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.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-18-2014 05:39 AM
Find all posts by this user Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Why US health care costs so much JJJ 25 581 03-13-2014 01:14 PM
Last Post: mjbearit
Exclaimation Drinking demineralized water is bad for health PaytonA 4 456 02-05-2014 04:20 PM
Last Post: zonk
Question Best health fund for Sleep apnea claims libbyau 5 544 01-24-2014 04:18 PM
Last Post: zonk
  Some Australian Doctors see the problem with Driver Reporting Moriarty 30 1,616 01-04-2014 03:02 AM
Last Post: Moriarty
  Australian scientist finds new causes of obstructive sleep apnea mdh235 6 768 11-26-2013 04:32 AM
Last Post: DeepBreathing
  A Letter My Sleep Health Center and Follow Up Schnauzers 5 29 2,910 03-30-2013 08:25 PM
Last Post: Ugly
  Insurers push clinic sleep testing into homes zeeser 13 1,985 02-08-2013 10:02 AM
Last Post: zimlich

Forum Jump:

Who's Online (Complete List)