FAQS
WHY DO I NEED A VALID REFERRAL?
A valid referral is required in order to access medicare and health insurance funding. Your referral should be written by your regular GP and be addressed to Mr Jones. Most GP referrals are valid for 12 months. Referrals from other specialists are valid for 3 months.
WHAT DOES MY PRIVATE HEALTH INSURANCE COVER?
Health insurance usually covers most aspects of a private hospital admission, including operating theatre expenses, surgical implants, and accommodation costs. Health insurance does not usually cover all of the surgical and anaesthetic fees, and does not private services when you are not admitted to hospital, such consultation fees.
WHAT IF I DON'T HAVE PRIVATE HEALTH INSURANCE?
Uninsured private healthcare can unexpectedly become very expensive. Mr Jones has a public appointment at Sandringham Hospital where he cares for uninsured patients. There are unpredictable waiting lists at public hospitals, and a specific surgeon cannot be guaranteed, but there are typically no costs to patients with a Medicare card managed in an Australian public hospital.
Knee or hip replacement surgery in a private hospital without insurance typically costs approximately $25,000. Unexpected additional costs may arise, however, potentially at short notice. For example, an unanticipated blood transfusion may cost more than $1,000 per unit of blood, and an unexpected private ICU admission following joint replacement surgery may additionally cost tens of thousands of dollars.
HOW MUCH DOES IT COST?
Our fees are based on the AMA Fees List. Fees are subject to change, do not include assisting or anaesthetic fees, and in some circumstances may be higher than the examples given here.
Standard Knee or Hip Replacement: $5130 upfront.
Typical rebate (medicare + health fund): $1537 approx.
Out of pocket gap: $3593 approx.
Standard Knee Arthroscopy: $2895 up front.
Typical rebate (medicare + health fund): $774 approx.
Out of pocket gap: $2121 approx.
Further information regarding surgical fees and why there is an out of pocket gap can be found at www.ama.com.au