Find out how to avoid unexpected out of pocket costs and know what to ask when you need to use an anaesthetist.
Have a question on anaesthetists? Ask us in the comments below.
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Has anyone read this. I have had Bupa for ever. I am always out of pocket min $1000 because of the anaesthetists charging way more than Bupa pays. I always use their 1st choice hospitals too.
This has happened at least 3 times, the last time only last year.
So unless i’m reading the info you supply incorrectly, you have the numbers wrong, i think.
The linked article is updated to March 2024. Second guessing the data I have had 3 private surgeries in the last 3 years. The anesthetists gap in 2 was $500 and the other $373, all in metro Melbourne, 3 different surgeons and hospitals.
The advice to ‘move your surgery’ to minimise gap costs is almost comical. No-gap contracts limit the list of providers so while it has economic benefits it might not have a wide choice of providers. Many providers only provide statistics about how many of their procedures are no-gap or the percentages that fall in gap ranges. All are reluctant to discuss costs until the ‘quote’. If not happy, back to the GP ($) for another referral to another surgeon ($$$$) who will ‘say hello’ and provide their quote.
I wonder if the authors ever tried to do that and how it went. Last time just getting 2 quotes was $750 out of pocket in consultations/referrals. My experience is the surgeon advises where they operate and you take your pick. Some provide the name of the anesthetist and some provide lists of possible anesthetists, often from multiple practices with differing fees.
Getting fees might be possible, but in a practical sense it seems impossible until one ‘signs up’ with a surgeon for the procedure.
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While the following is not about the particular cost of anaesthetics provision, it may be helpful to those who have high out of pocket medical costs during any calendar year. The safety net benefits reset each year at the beginning of January.
There are safety nets for Medicare. Once a person/family exceed those safety net requirements, there are higher rebates available of the costs, and these can be substantial. Once an individual, couple or family reach the basic safety net value of $576 in a year, then the rebate is 100% of the scheduled fee. If the extended safety net threshold is reached, then the rebate is 80% of the “out of pocket expense”. If a family or a couple, this access to Safety Net coverage needs to be registered with Medicare. If an individual, this registration is automatic.
Thresholds (as there are different maximums depending on circumstances)
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While the safety net is good, to temper expectations for rebates the caveat is ‘scheduled fees’. More providers are charging above scheduled fees all the time. Whether recent government policy announcements will reverse or slow that trend remains to be known.
Last year I had significant medical bills but most were In-hospital costs, eg surgeon and their associated providers such as anesthetists and assistants fee rebates are not included. We only reached about 50% of the threshold.
It is important to read and understand the underlying details of what counts and what does not. It is efficacious for those who need to see their GP or a specialist regularly, but not in hospital.
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