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Medicare and Insurance
Do I need a referral letter?
Most medical specialists will accept only referred patients. This is partly to try to ensure the specialist you are seeing is appropriate for you and your condition, and also because Medicare pays higher rebates for specialist services if you have been referred.
What about your fees?
Information about the Consultation Fee is available on calling our office.
If you are deemed to require surgery, you will be provided with an estimate of the surgeon’s fee prior to any procedure being undertaken, so as you can make an informed financial decision. In most instances, there will be a portion of your surgical fee (“gap”) which is not covered by Medicare and your health fund. Our staff will be able to help you answer any questions regarding this area.
If you have been given an “Estimates of Fees” for a particular surgical procedure, you should take it to your health fund prior to surgery being performed to see if any further charges will be necessary. Sometimes your health fund will charge an excess depending on your level of cover.
What are the total costs and fees involved in having surgery performed in a private hospital?
- Surgeon and Surgical Assistant
- Anaesthetist
- Hospital
- Ancillary charges (pharmacy, pathology, non-rebated consumables etc.)
Our office can advise you regarding the fees and give you some indication of the costs of the other people involved in your care. You will be provided with the relevant contact numbers so you can make more detailed inquiries.
What are your acceptable means of payment?
Fees will be reviewed with you at the consultation visit. Payment during the consultation is appreciated.
Bank cheque, personal cheques, cash or credit cards (MasterCard, VISA) are acceptable means of payment. We do not accept American Express or Diners cards.
Do I need to have private health insurance?
Private Health insurance allows you and your family to access the right health services at the right time. You have control of your health care and can choose the provider, facility and timing of your treatment. With the security and protection of private health insurance, you have access to an extensive range of private hospitals and can rest assured that your health is in good hands.
How can my family doctor help me to obtain specialist medical care?
Before seeing any medical specialist, it is always preferable to talk to your own family doctor, who can discuss your condition with you and advise on whether any specialist care is appropriate. If it is, he or she can help you to choose the specialist best suited to your needs. Your family doctor can help the specialist to care for you better by providing relevant information about your health. Communicating with the specialist will also enable your family doctor to care for you better during and after your specialist treatment.
What are the Medicare rules about referrals to specialists?
If you want Medicare to help to pay for specialist medical services at the referred rate, it is essential to discuss your condition and possible referral with your family doctor before you see the specialist. Please note that the backdating of referrals is illegal and can result in heavy fines and prison sentences. If you have any questions about seeing medical specialists or about the Medicare Benefits System, please ask your family doctor or contact Medicare on 13 2011.
