No lymphoedema rebate - a South Australian issue

LucyELucyE Member Posts: 295
edited October 2017 in General discussion
I recently found out that the cost of gloves, sleeves and other items needed for people with lymphoedema are not covered by a rebate here in SA. It sounds like we are the only state not to have a rebate. I’m just wondering if anyone from BCNA is aware of this and is looking into it. 

It sounds like health funds like Bupa are starting to refuse to cover these items unless they are specially measured and designed for individuals. A glove is measured and fitted so It is specifically tailored for individuals by a physio who then needs to write a letter indicating this. Some people are having more success if they take their claims into Bupa and other health funds instead of lodging them online.

As lymphoedema is a chronic condition, issues like this one and the ongoing cost of treatment impact on survivors in a massive way. Physio and laser treatments are expensive and the waiting lists are often long. Garments contribute to managing lymphoedema and ultimately reduce costs as the condition is treated and does not progress, hopefully. It is stressful enough having this, there should be support to make it easier to deal with it. I look forward to the time when people with lymphoedema in SA get the support we deserve. 
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Comments

  • primekprimek Broken HillMember Posts: 4,115
    Insurance companies always finding a way out. Disgusting. 
  • LucyELucyE Member Posts: 295
    edited October 2017
    I agree Kath, they are charging more and providing cover for fewer services. I’m going to write to Bupa and to some politicians to complain about this. 
  • UnicornkissesUnicornkisses Central CoastMember Posts: 395
    NIB in NSW covers sleeves and 2 mastectomy bras a year, but only if you have the highest level of extras cover. 
  • mum2jjmum2jj Member Posts: 3,386
    Each state has different policies.  In Qld you can get garments through the public system, but in regional centres like Cairns it is often hard to get seen publicly if you had your surgery or treatment privately.  The health fund rebate is well short of what is needed.  I need two garments every 6 months custom made.  That adds up to $2000!! I was lucky enough to just sneak into the public system 6 years ago where Breast care nurses could refer you.  The hospital make it very hard for me to stay there, but I persevere as I can't afford the garments even with private health. It is a bit of a rigmarole with referrals needed from my GP every 6 months but I do it. I think my health fund covers $500  a year and it comes under "artificial appliances" but other things like my swimming prosthesis, wigs etc come under the same thing. There is also the assumption that if you have health insurance you are wealthy which is more often than not incorrect.   It is so wrong! Lymphedema is not something that goes away, but something you manage. I really feel for you not getting any rebates at all.  It is criminal.  Even the states where there are rebates are heavily screened.
    If you haven't already check out the lymphoedema action alliance  They are working hard to make changes.
    Paula xx
  • Ann-MarieAnn-Marie Member Posts: 1,158
    Hi @LucyE I just wanted to let you know that @Kirsten_BCNA (KP) is heading up our State of the Nation project that looks at issues like this all over the county. Check out some of the conversation already happening here. Feel free to reach out to KP.
  • Jane221Jane221 Central Coast, NSWMember Posts: 966

    Hi @LucyE, I totally agree, this is a major cost issue for a number of us who have to manage this condition for the rest of our lives.

    In NSW I am not eligible (you basically have to be on a pension) for any rebates for garments except through our private health insurer (Medibank - as a medical / artificial appliance) but their rebates are almost tokenistic when, as Paula said, you need new garments every 6 months. I also had better luck fronting up to request a rebate with my sleeve and glove than applying for anything online.

    I do get 5 reduced cost physio sessions via my GP Allied Health Plan and some physio costs back via Medibank but as I've needed some intensive sessions (weekly for some months), these rebates have quickly run out and so for the past few months I've been trying to string the sessions out a bit more until the end of the year when I can start a new Health Plan. Hopefully my arm won't swell too much in the meantime :(   


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