Private health insurance - HIF and any recommendations

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Private health insurance - HIF and any recommendations

Postby samsprite » Tue Mar 14, 2017 4:50 pm

Hello,

Has anyone had experience with HIF:
http://www.hif.com.au/

I'm finding it impossible to obtain my own pump via a claim with them. My 12 month waiting period ended in mid-November and the claim was submitted to HIF in early/mid-December.

Back in late January/early February, AMSL and my endo said they finally found one HIF employee who knows something about insulin pumps; it doesn't seem to have helped, though, as the back and forth for different documents, more information, another signature, everything written in purple sparkly pen has continued.

(The requirement of everything written in purple sparkly pen may have been made up by me just now to express my frustration.)

After sending HIF a (very polite, non-threatening) email two weeks ago asking for an update to my claim, the response I received back from the 'benefit services team leader' was:
We sent the request back to AMSL as we required further information on the 4/1/2017, we are yet to receive anything back.

I would maybe contact AMSL and get them to follow up what further information we requested as I cant see what that was.


Besides the fact that both AMSL and my endo have been in touch with me since 4th of January giving me updates of the conversations they've had with HIF since that time, the very notion that HIF suggest I contact AMSL to find out what they - HIF - require is baffling.

And so I'm considering changing insurance funds. Does anyone have a recommendation for a provider that didn't take at least three months to process a claim for a pump?

Thanks!

Sam

PS - the reasons I chose HIF in the first place include cost (they're cheaper than other providers - I can now see why!), they're not-for-profit and so don't pay dividends to shareholders, they're carbon neutral... However, none of that matters if I can't get my mitts on a pump!
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Re: Private health insurance - HIF and any recommendations

Postby artemis » Tue Mar 14, 2017 5:51 pm

Hi Sam, I changed my PHI in July to AHM as I was told that it covers insulin pumps without any of the garbage you've been subjected to. I was with LaTrobe Health Services, and that company was nfp and had covered my last pump, but a lot of the nfp companies are now becoming non-friendly towards pumps. Check with AHM, and see what they say. I just hope that in 2 years time they will still cover a new pump. I'm in top hospital cover - always have been, but that should not make any difference.

Let us know how you get on.
Jane
Infundo ergo sum.
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Re: Private health insurance - HIF and any recommendations

Postby blueseal » Wed Mar 15, 2017 6:35 am

I am also with AHM (basic hospital) and had no issues when getting my pump. With their new hospital plans the White Classic hospital cover and above specifically mentions coverage for insulin pumps.
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Re: Private health insurance - HIF and any recommendations

Postby artemis » Wed Mar 15, 2017 8:51 am

Don't forget it comes under hospital cover, not extras.
Jane
Infundo ergo sum.
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Re: Private health insurance - HIF and any recommendations

Postby abs » Wed Mar 15, 2017 9:18 am

Sam, if you or anyone in your immediate family (parents / siblings etc) has ever worked for the commonwealth bank or associated affiliates, then I thoroughly recommend CBHS - CommBank Health Society

No issues with pumps and if you ever are thinking about CGMS, they have some rebates available there too
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Re: Private health insurance - HIF and any recommendations

Postby genix » Wed Mar 15, 2017 3:48 pm

I am with Bupa I put my claim in on a wednesday and it was approved and paid for two days later on the friday, they sent the confirmation to me of the letter they sent to the pump company. The entire process of me asking my GP for a referral to the endocrinologist to me walking home with the pump took 6 weeks and the only reason it took that long was for booking appointments for the CDE and the endocrinologist. Obviously YMMV on the Drs and CDE but I highly recommend BUPA. This was all done in Melbourne. I also have top hospital cover and pay an expensive premium however that should not matter as the pumps are on the prosthesis list and should be covered by any hospital cover.
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Re: Private health insurance - HIF and any recommendations

Postby melissa » Thu Mar 16, 2017 8:30 am

I would be calling and asking to speak directly to the surgically implanted prosthetics team. They will be the ones who assess pumps. If no luck, threaten to contact the Private Health Insurance Ombudsman. http://www.ombudsman.gov.au/about/priva ... -insurance
30+ years with D, two wonderful children
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Re: Private health insurance - HIF and any recommendations

Postby samsprite » Fri May 12, 2017 10:49 pm

Hello everyone,

I finally received my own pump; it (only!) took until the end of April...

Thanks for your input and suggestions; I am looking into my options for jumping ship and so your experiences have been helpful.

I'm now in communication with HIF to ascertain why my claim took 5 months. At the moment it's a monologue, in that I ask questions and they ignore me, but I'm hoping it will become a dialogue soon.

If not, I'll be bringing the entire issue to the attention of the ombudsman.

HIF really have been dreadful.

Genix, I'm envious of your two day claim!

Melissa, my endo and the pump rep both said that HIF apparently have one staff member who knows about prostheses (or perhaps insulin pumps specifically), and s/he was on leave for the early part of the year.

Obviously they're a small company but that shouldn't stop them being more helpful than they have been.

Anyway, as I said, everyone, thanks so much for your input; it's been great.

Sam
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