How can I reduce my out-of-pocket expenses?
Your out-of-pocket expenses depend on things like the hospital you’re admitted to and what services are Included or Limited under your cover.
Here are three ways to help keep costs down, and avoid any unwelcome fees.
1. Choose specialists who will participate in GapCover for your treatment
GapCover is a scheme designed to help eliminate or reduce your out-of-pocket expenses for in-hospital charges. If your specialist decides to charge more than the MBS fee (the set government fee), you’ll be left with an out-of-pocket expense, commonly known as the ‘gap’. Learn more about GapCover on page 7 of the Going to Hospital brochure.
2. Find out where your specialist operates and opt for a Members' Choice hospital
We have arrangements with most private hospitals and day surgeries in Australia, so you generally get better value if you go to one of these providers.
If you’re treated in a non-Members’ Choice hospital, the amount we pay is generally lower than for a Members’ Choice hospital so you could be left with significant out-of-pocket expenses.
Find your nearest Members' Choice hospital.
3. Ask for a full breakdown of costs
It’s your right to know the full cost of your in-hospital treatment and how much your out-of-pocket expenses could be. Knowing about potential costs not only saves you worrying - it can also save you money.
Before going to hospital, ask each of your specialists for a breakdown of all the costs in writing. This is known as Informed Financial Consent. It should list the fees for each specialist involved in your treatment – your surgeon, assistant surgeon, and anaesthetist – and any other related costs.
Tell your specialists if you’re worried about cost — there may be ways to cut down on expenses without compromising your care.