What is ‘the gap’ in healthcare costs?

11 October 2022|Advertisement, Community News| Off Comments off on What is ‘the gap’ in healthcare costs?|

AS an inpatient in hospital, you are likely to hear about a fees gap (also known as patient payments or out-of- pocket expenses) and it’s important to understand what this means.

What is the gap?
There are fees charged for hospital accommodation, surgeons, tests, anaesthetists and other expenses as a private patient.

Medicare pays a set amount for each treatment or procedure as listed in the Australian Medical Benefits Schedule (MBS).

As a private inpatient, Medicare will pay 75 per cent of the MBS cost. The remaining 25 per cent is paid by your health insurance if you are covered, or by you.

Your doctor may charge more than the MBS cost. The gap between the MBS and the doctor’s charges has to be met by you, and cannot be claimed against health insurance.

How can you reduce the gap?
While paying for our health is worthwhile, there are ways to reduce the gap and minimise your expenses.
Most of us are not used to ‘shopping around’ for medical providers, but you certainly can and it may save you a lot of money.

Research has shown there is not a direct relationship between higher medical costs and better providers, so don’t feel you have to pay a larger gap to be well cared for.

At HCi, we have relationships with a number of doctors and private hospitals around the country who charge a lower gap for our members. Some doctors will not charge you a gap at all, while others will ensure you know the gap ahead of time and will not change that cost.

Remember that you are entitled to ask your doctor about costs, including asking your GP to refer you to a non-gap specialist or surgeon.

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About the Author: Glenorchy Gazette

The Glenorchy Gazette is your monthly community newspaper, reaching over 24,000 homes and businesses in the Glenorchy municipality. It is the product of Nicolas Turner, Justine Brazil, Ben Hope, Simon Andrews, Tobias Hinds and guest contributors, with support from advertisers.

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