FEE & CHARGES
If you have private heath insurance
For simple procedures - for e.g. endoscopy, excision of superficial lesions - it is likely to have no out-of-pocket costs.
For all other procedures, gap (out-of-pocket costs) will apply and it may vary between health funds, and with the type of procedures (complex cases will incur higher costs). The gap is usually up to $500 (with some exceptions).
For elective procedures, gap will need to be pre-paid prior to surgery. An invoice with payment instructions will be sent to you via email and SMS.
For emergency/after-hour procedures, an invoice will be sent to you via email, SMS, and to your postal address after surgery.
If you don't have private health insurance
Patients without private health insurance will need to prepay the total anaesthetic fee for the procedure.
An invoice with payment instructions will be sent to you via email and SMS.
For elective procedures, the fee must be paid prior to surgery. An invoice containing payment instruction will be issued to your postal and email addresses.
A receipt will be issued after payment, which can be used to claim for Medicare rebates.
Why is there out-of-pocket fee?
Anaesthetic fee is separate and additional to surgical and hospital charges. Medicare and health funds may not cover the entire cost of anaesthetic services - the difference is the out of pocket (gap) fee.
Anaesthetic fees are based on many factors, including but not limited to the type of surgery, patient's age and health condition, the difficulty of delivering anaesthesia, the duration of surgery, the nature of surgery (elective vs emergency/after-hour), and the need to travel in specifically for your surgery (applied to emergency/after-hour situation).
It is your responsibility to confirm with your health fund the level of your cover. If the cover is lower than advised, or if you have not served the appropriate waiting periods, the anaesthetic fee (and other medical fees) could be more costly than you expect. It is always good practice to conduct your own due diligence prior to committing for surgery.
If you are interested to find out more about Medicare and health insurance rebates for anaesthetic services, please read here.
The diagram below demonstrates each components of your anaesthetic fee. It shows that most anaesthetists charge only 60% of the AMA (Australian Medical Association) recommended fees, giving patients a 'hidden discount' that anaesthetists don't usually speak about:
