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Choosing a private health fund - advice needed.

LustStarrrSenior Contributor13 Aug 2015, 10:58 am AEST

Choosing a private health fund - advice needed.

I have recently been diagnosed with BPD, the recommended treatment for which (an intensive DBT program which runs for 6 months, 2 days a week) is financially impossible without private health cover. I'm currently overwhelmed by the various health funds, their inclusions & other conditions, so I'd like some advice on which ones to go for, or which to avoid, for mental health issues.

Thanks! 😊

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In response to: Choosing a private health fund - advice needed.

Unknown userMember13 Aug 2015, 11:54 am AEST

Re: Choosing a private health fund - advice needed.

Hi @LustStarrr

Thank you for sharing. It’s great that you have a potential treatment option and it sounds like you’ve already done a bit of research into the practical aspect of covering the cost of treatment. These things can be complicated but I’m sure it will be worth it in the end.

The Forums are a great place to share your story and exchange support and ideas with others who are going through a similar experience, perhaps starting treatment or having had DBT themselves. However, our guidelines don’t allow members to provide recommendations around specific practitioners or, in this case, specific insurance companies. You can read more about our guidelines here.

As members won’t be able to recommend health funds here, you might want to take a look at this site from the Australian Government which can do some comparisons for you:

http://www.privatehealth.gov.au/dynamic/compare.aspx

I looked into private health insurance not long ago and it all seems a bit overwhelming at first, but once you’ve done a bit of reading the lingo will start to make sense. You could also give a few of the companies a call and tell them what you’ll be needing coverage for. Perhaps even ask your psychologist – they might know which health funds provide the best rebates for psychology appointments.

In the meantime, there are some great threads about BPD on the Forums which you might like to check out, if you haven’t already seen them:

@Chris talks about his experience with DBT here. I believe @Ode and @dwoods77 have also had some experience with DBT. @Chris, @Ode and @dwoods77 do you have any thoughts to share around your experience with DBT?

@LustStarrr you might also like to checkout this Topic Tuesday on BPD: Debunking the myths.

Thanks again for sharing. I look forward to hearing how it all goes

In response to: Choosing a private health fund - advice needed.

chookmojoSenior Contributor14 Aug 2015, 12:08 pm AEST

Re: Choosing a private health fund - advice needed.

If you have a specific person you will be seeing for this treatment, then definitely talk to them, or their office person, about which health fund they are affiliated with as many health funds require the provider to be affiliated with them in order to grant you with the benefit, and just about all of them will allow you to claim more from a 'Members Choice' provider.

Your treatment will almost certainly fall under Extras cover (which means you may choose not fork out for Hospital cover) and will likely have a waiting period of two months before you are eligible to claim, though you can sometimes get the waiting periods waved as part of a promotional deal - whoever you sign up with ASK if they can waive this - never hurts and sometimes they have leeway to do so.

Maximum benefits for psychology usually don't add up to all that much (4-500 per year is pretty typical), and each visit will still have a 'gap' that you have to pay out until you use up all of your allowance against the category.

Given that you are looking at regular long term treatment look for the highest overall amount in a fund accepted by your psychologist, rather than the highest rebate per visit as either way you are going to use up the full total, and generally the more you get back per visit the more expensive the cover is.

Source: Used to sell Health Insurance for a living.

In response to: Re: Choosing a private health fund - advice needed.

LustStarrrSenior Contributor15 Aug 2015, 1:51 am AEST

Re: Choosing a private health fund - advice needed.

Hi @Former-Member, my decision to post this question here was a last, desperate attempt to get information, having spent hours, over the course of a couple of weeks, trying to weigh up options myself. Having utilised the comparison site you recommended & several other sites like it, visiting individual health fund websites & asking for advice from mental health organisations & my medical care providers, I was confused & at the point of desperation, having found nothing which even came close to covering the treatment I need. Every policy that seemed suitable, on closer inspection, had exclusions, restrictions & limits on claims which make them financially out of reach, just as treatment is to me now without any health cover. My 10 free counselling sessions under the Mental Health Care Plan are almost finished, & my GP & psychiatrist can't provide the intensive treatment necessary to achieve recovery, so I'm trying for help wherever I can. The fact that treatment for BPD isn't accessible under the public system is bad enough, but being faced with the possibility that even health cover wouldn't help me is petrifying. All I was asking was for someone to point me in the right direction, & if this forum isn't the place to request that, I don't know where to look next.

In response to: Re: Choosing a private health fund - advice needed.

LustStarrrSenior Contributor15 Aug 2015, 1:55 am AEST

Re: Choosing a private health fund - advice needed.

Thank you, @chookmojo - this is information I can use to search policies more efficiently, just the kind of advice I was after.

In response to: Re: Choosing a private health fund - advice needed.

AppleblossomSenior Contributor15 Aug 2015, 12:38 pm AEST

Re: Choosing a private health fund - advice needed.

Sometimes its just being able to ask someone and break down the isolation. There are a couple of places in Victoria. A lot depends on where you are..

In response to: Choosing a private health fund - advice needed.

Ali585Senior Contributor26 Feb 2016, 5:34 pm AEDT

Re: Choosing a private health fund - advice needed.

Just wondering how you got on? I cant believe how hard it is to get into a DBT program without private health insurance! Mine covered it (although I ended up doing a different group program in the end) and only had a 2 month waiting period for psychiatric hospital benefits (which included the outpatient day programs)

I wish there was more public services offering DBT and that private health insurance was easier to understand!

In response to: Re: Choosing a private health fund - advice needed.

mrkotterSenior Contributor03 Mar 2016, 8:08 am AEDT

Re: Choosing a private health fund - advice needed.

I'm pretty interested in this topic too - would like to have hospital as a just in case.

Also interested in extras. I'm paying a small fortune for therapy at the moment as medicare doesn't cover skype sessions.

Does anyone else have any interest in starting a new thread about this?

In response to: Choosing a private health fund - advice needed.

EmzSenior Contributor14 Mar 2016, 8:02 pm AEDT

Re: Choosing a private health fund - advice needed.

I'd also like to know about this MrKotter.

And LustStarrr, just letting you know that you can access some DBT exercises free online if you look on Google. I have BPD but have still managed to make some major progress without DBT, so don't stress too much if you have to wait or can't access it. The mental health system sucks, but I hope you can find a way through it!

In response to: Re: Choosing a private health fund - advice needed.

mrkotterSenior Contributor25 Mar 2016, 11:07 am AEDT

Re: Choosing a private health fund - advice needed.

The AMA's 2016 report card into private health insurance might be useful for some people.

https://ama.com.au/ama-private-health-insurance-report-card-2016

In response to: Re: Choosing a private health fund - advice needed.

LustStarrrSenior Contributor08 Sept 2016, 2:52 am AEST

Re: Choosing a private health fund - advice needed.

@Ali585 , I got cover through a major insurer, with the same waiting period of 2 months you mentioned. Long story short, was screwed over by both the insurer & the clinic, got to attend one day of the program, so I cancelled my health cover. Now I'm searching for treatment options yet again! The government needs to realise the cost-effectiveness of funding programs of this nature - given the over-representation of BPD diagnoses among emergency room suicide attempts & self-inflicted injuries, it's honestly the logical conclusion people should be treated BEFORE they present.

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