Understanding orthopaedic surgery costs can be challenging, but it’s important to have clear and transparent information. The private health system in Australia provides comprehensive care, and Mr Chua aims to help you understand the various fees involved in your orthopaedic surgery.
How Are Orthopaedic Surgery Fees Determined?
Mr Soong Chua sets his fees based on the standards established by the Australian Medical Association (AMA). This ensures that orthopaedic surgery costs remain consistent and fair for all patients undergoing the same procedure. By aligning with industry standards, you can be assured of a transparent fee structure for your surgery.
Types of Fees Associated with Your Surgery
When undergoing surgery with Mr Chua, you’ll be provided with an estimate outlining the anticipated fees for your hospital admission. These include:
- Mr Chua’s Fee: Mr Chua’s surgical fees are based on the AMA’s recommended fees, ensuring high-quality care aligned with industry benchmarks. His fee covers the surgery itself and the initial post-operative consultations, known as the aftercare period, which usually lasts six weeks.
- Anaesthetist’s Fee: Your anaesthetist will provide a quote for their services before the surgery. The fee may vary depending on the duration of your procedure and the extent of your health insurance coverage.
- Surgical Assistant’s Fee: The surgical assistant’s fee is generally up to 20% of Mr Chua’s surgical fee. This fee is billed separately and will vary based on the specifics of your surgery.
- Hospital Bed, Theatre, and Equipment Costs: If you hold private health insurance, the hospital bed, theatre, and equipment fees are usually covered by your health fund. However, it’s important to confirm with your health fund that your specific orthopaedic procedure is included in your policy, as some procedures may be excluded. You might also need to pay an excess to the hospital upon admission, depending on your insurance policy.
- Pathology, Radiology, and Pharmacy Costs: During your hospital stay, you may require scans, blood tests, or medications, which may lead to additional out-of-pocket expenses. These costs can vary, so it’s advisable to discuss them with your health fund if you hold private insurance.
What is the Gap in Orthopaedic Surgery Costs?
The “gap” refers to the difference between Mr Chua’s surgical fees and the rebates provided by Medicare and your health fund. Here’s how it works:
- Medicare covers 75% of the Medicare Benefits Schedule (MBS) fee for your surgery.
- Your health fund covers the remaining 25% of the MBS fee.
However, because Mr Chua’s fees are based on the AMA’s recommended rates, which are higher than the Medicare rebate, there may still be an out-of-pocket cost (‘gap’) for the surgery.
Variation Between Health Funds
Each health fund offers different levels of coverage, and the amount they choose to cover for each orthopaedic procedure can vary. Some health funds may provide more comprehensive coverage, while others offer less, depending on your chosen policy and level of cover. It’s essential to check with your health fund to understand what portion of the costs they will cover for your specific surgery.
Unexpected Costs
In some cases, unexpected findings or unplanned, extended hospital stays may incur further costs that aren’t covered by your health fund. It’s important to be aware that additional expenses could arise depending on your specific situation.
Discussing Your Orthopaedic Surgery Costs
We understand that navigating orthopaedic surgery costs can be overwhelming, but we’re here to help. Mr Chua is more than happy to answer any questions you may have about the fees or to clarify any information. Clear communication is essential, and we want you to feel confident and well-informed about the costs involved in your orthopaedic surgical care.
