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What out of pockets will I have?
Eligible Members participating in this pilot program will not incur out of pocket costs for the following services as part of your hospital admission at participating hospitals:
- pre-admission joint school
- hospital accommodation and theatre costs
- surgical assistant
- diagnostic tests.
If a member has chosen an excess or per-day payment on their cover to lower their monthly premium, this will still be payable (for example, if you’re claiming for the first time that calendar year, you may need to pay an excess). Please contact us on 132 331 to check your product eligibility and level of cover.
If a Member seeks additional services beyond what is included in the no-gap joint replacement pilot program, fees may apply. You may incur fees if medication is prescribed during your hospital stay that is not included on the Pharmaceutical Benefits Scheme or for services that are for your comfort or convenience, such as if you wish to be transported by ambulance to a hospital closer to where you live and dry-cleaning of non-hospital items. Please speak with the Participating Medical Provider to confirm and ensure a valid Informed Financial Consent is given.
If rehabilitation care in an inpatient setting is required, we will pay benefits towards your hospital accommodation at a Members Choice Hospital and you will incur no out-of-pocket costs except for any per-day payment under your policy or any associated hospital costs like parking. There may be a cost associated if you are treated by a Rehabilitation Physician or require diagnostic tests, however the doctor will need to provide you with informed financial consent.
There may be out-of-pocket expenses associated with outpatient appointments, such as your initial visit with a participating surgeon in their consulting rooms. Please speak with your participating surgeon to find out more.
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