Health insurance cover is complex and confusing. Due to inadequate indexation over many years, the rebates provided by Medicare and the health funds will usually be less than the anaesthetic fee, resulting in an out-of-pocket (gap) expense. Time permitting, most patients will receive a written estimate of the anaesthetic fee prior to admission to hospital.
A fee will be charged for the specialist anaesthetic services provided to you or your child. My fee is separate to any other fees you may incur. The total anaesthetic fee is determined by the type, complexity and length of the procedure.
I usually send the account directly to your health insurer but if your insurer does not cover the entire fee, there will be a gap. The amount reimbursed to you by your health fund will depend on which fund you belong to and your level of cover. There are three major groups of funds:
Group 1. Medibank private, Australian Unity and over 40 other Australian Health Service Alliance (AHSA) funds: These funds cover the majority of the anaesthetic fee with their known gap facility. For your convenience, I will send the insured portion of the account directly to the fund and the gap will be sent to you.
Group 2. GMHBA, Latrobe, Druids, Mildura: The insured portion will be sent to your fund. However, these funds pay a lower rebate. The gap will be sent to you.
Group 3. HBA, HBF, MBF, NIB, funds: These funds do not have a known gap facility and unfortunately cover less than 1/3 of the anaesthetic fee. The total account will be sent to you for payment before a rebate is received. The gap for these funds is much higher than for Group 1 funds, although the anaesthetic fee is no different.
Uninsured patients will be required to pay the estimated fee prior to their procedure.
A fee will be charged for the specialist anaesthetic services provided to you or your child. My fee is separate to any other fees you may incur. The total anaesthetic fee is determined by the type, complexity and length of the procedure.
I usually send the account directly to your health insurer but if your insurer does not cover the entire fee, there will be a gap. The amount reimbursed to you by your health fund will depend on which fund you belong to and your level of cover. There are three major groups of funds:
Group 1. Medibank private, Australian Unity and over 40 other Australian Health Service Alliance (AHSA) funds: These funds cover the majority of the anaesthetic fee with their known gap facility. For your convenience, I will send the insured portion of the account directly to the fund and the gap will be sent to you.
Group 2. GMHBA, Latrobe, Druids, Mildura: The insured portion will be sent to your fund. However, these funds pay a lower rebate. The gap will be sent to you.
Group 3. HBA, HBF, MBF, NIB, funds: These funds do not have a known gap facility and unfortunately cover less than 1/3 of the anaesthetic fee. The total account will be sent to you for payment before a rebate is received. The gap for these funds is much higher than for Group 1 funds, although the anaesthetic fee is no different.
Uninsured patients will be required to pay the estimated fee prior to their procedure.