1. Ask about fees before booking your first appointment
The Australian Government pays a fixed fee for health care appointments through Medicare. However, some doctors and health professionals charge more than what the government pays back. This is what's known as the 'gap' payment, or your 'out-of-pocket' expense.
Sometimes consultations, medical procedures and investigations may be 'bulk-billed'. In these situations, the health professional accepts the fixed fee (that is, the Medicare rebate) as the full payment, so there is no out-of-pocket expense.
It’s helpful to know the fixed fee and gap costs in advance, so you know what your out-of-pocket expense will be. Simply call the doctors’ rooms or hospital and ask about the fees before booking your appointment. Feel free to ask if you are eligible for a discount – if, for example, you have a concession or health care card.
Quick tip: Public hospitals can also be a good provider of specialist appointments and/or medical procedures if you can’t afford private fees, but it’s important to be aware that there are often waiting lists.
2. Ask for the Medicare item number for your procedure
In Australia, medical procedures and services – whether they are done in or out of hospital – have what is known as a Medicare item number.
When asking about fees before your first appointment with the specialist or hospital, be sure to also ask for your procedure’s Medicare item number. You can then use this number to compare fees provided by other doctors.
3. Compare apples with apples
One you have your Medicare item number, call a few different specialists and see if there is a difference in price. This fact sheet also comes in handy when deciding if your doctor’s fees are good value. It is available in several languages.
It can help to ask your GP for two or three referrals for recommended specialists so you have a good starting point and know who to call and compare.
4. Check what’s covered and what’s not
It’s always worth investigating a little further so you’re not hit with any unexpected expenses. This includes:
- checking with your private health fund (if you have one) on what’s covered and what’s not
- checking what’s covered by Medicare
- ensuring you include any incidental or additional costs such as extra hospital fees, parking or hospital meals, if these expenses are not included.
5. Keep good records
As a final step, it’s a good idea to keep all your medical bills, information and referrals together in a safe spot or file. This way, you can quickly find any important paperwork when you need it, and once your appointment or procedure is over, you can focus on your recovery.
As a final word of advice, Jean Hailes specialist women's health GP Dr Amanda Newman advises against basing your healthcare decisions on price alone, where possible.
"The skill and experience of the health professional, as well as their communication style and the convenience of their location, are among other important factors to consider too," she says.