Self-funded private hospital care

Self-funded surgery

• What costs are included in my self-funded surgery?

  The hospital fees cover the cost of nursing care, accommodation, and non-medical services such as catering and housekeeping as well as fees associated with the use of an operating theatre and prostheses.

• Could the actual costs of my hospital care be different to the estimate?

  Yes, there may be some circumstances where the cost of your treatment and care is different to the amount you were estimated. This could occur if your needs change during surgery or if you require additional or less time in hospital to recover.

• Will there be other fees?

  Yes, the estimate of fees we provide relate to your Hospital Fees only. Below is a list of other fees you may incur:

  • Surgeon fees: charges by surgeons vary because they consider their costs in delivering services and may differ due to their individual techniques.
  • Surgical assistant: your surgeon may require the assistance of another medical practitioner when performing your operation. Only one surgical assistant can charge a fee, which can be no more than 20% of the surgeons’ fees.
  • Anaesthetist: the fees charged by your anaesthetist will vary depending on the complexity of your procedure and how long the anaesthetist spends with you.
  • Other medical practitioners: during your stay, your doctor may request that medical specialists with different expertise treat you. Each doctor that visits you will also charge a fee for their service.
  • Pathology: tests of blood, urine and body tissue also attract a doctor’s fee and some costs can be recovered from Medicare.
  • Radiology: X-rays, ultrasounds, CT scans, Nuclear Medicine, PET and MRI also attract a doctor’s fee and some costs can be recovered from Medicare.
  • Pharmacy: new medications related to your hospital admission will be provided by the hospital, through a third-party pharmacy provider. Medications that you were taking before admission and discharge medications will be charged directly to you through a third-party pharmacy provider.

• Will I get anything back from Medicare?

  There is no Medicare benefit for private hospital costs. However, other costs related to your care (surgeon, anaesthetist etc) are recovered under Medicare. The Federal Government sets a Medicare Benefits Schedule (MBS) for most services. The MBS fee is used to determine what Medicare will pay towards your treatment. Each procedure involved in your treatment will have an MBS ‘item number’ and there is normally a schedule fee set by Medicare for each ‘item number’. Your doctor will charge more than the schedule fee, and this is known as the out-of-pocket.