Depending on the circumstances of your admission, you may have some out of pocket expenses to pay for hospital, prosthetic or medical gaps. We suggest that you ask your health fund - and your Specialist - about all the costs that you may be required to pay, prior to your elective admission.
May include any excess, gap or co-payment.
May be payable for surgically implanted prostheses (medical devices).
Medical gaps are the difference between the Specialist’s fee and the combined amount paid by Medicare and a Private Health Fund for a medical service.
Medical services that may incur a medical gap, include:
- Your Specialists fees
- Fees of other Specialists e.g. Surgeons, Surgical Assistants, Anaesthetists and Other Specialist Physicians
- Intensive Care Services - up to a maximum of $500 per hospital admission
- Pathology or radiology (x-ray) services
While you and your Specialist can plan for your elective admission - based on an expected course of treatment - unforeseen circumstances may arise. If they do, there may be additional costs that are not covered by the original estimate for which you gave your informed financial consent. The relevant Specialist will give you this information as soon as possible after treatment occurs.
Such costs may include:
- Medical gaps of other relevant Specialists called upon at short notice e.g. in an emergency
- Provision of Intensive Care Services
- Other fees for medical treatment received while an inpatient
- Gap amounts for different or more costly prosthetic devices
There will be circumstances, for example an emergency admission, where it will not be possible for you to provide Informed Financial Consent before the service is provided. In this case, information about fees and out of pocket costs for hospital, medical and prosthetic gaps will be provided to you as soon as possible after the service is provided.
In circumstances where it is not feasible to provide information directly to you, either before or after treatment, that information will be provided by St Andrew’s Hospital - and your Specialist - to a relative or person acting in your interests e.g. when you are unconscious or otherwise incapable of understanding the information.
St Andrew’s Hospital endorses Informed Financial Consent for all patients.