A substantial portion of healthcare expenditure in Australia is devoted to cancer care.
Due to an increase in population, lifestyle changes, and environmental factors, cancer patients have seen a steady rise annually.
As such, the amount of equipment, workforce, and medication is proportionately becoming scarce and hard to access for many cancer-stricken patients.
There are different types of cancer, each of which requires another form of treatment.
This is why the cost of an individual’s treatment can only be known after a thorough diagnosis has been conducted.
However, according to the experts from centres like https://www.targetingcancer.com.au/, there are a few things you can keep in mind before paying out-of-pocket costs.
There is a set amount of fees subsidised by the Australian government for medical services through Medicare.
To know how much Medicare will pay for each subsidised service, you can check the Medicare Benefits Schedule list.
These subsidised fees are also known as Scheduled Fees.
Keep in mind that some doctors charge more than the Scheduled Fees.
If you avail of a service that is not subsidised by the MBS, you have to pay the entire fee out-of-pocket.
If your doctor charges anything more than the Scheduled Fee, then the difference will have to be paid out-of-pocket as well.
This difference is known as the gap fee.
If you’re treated as a public patient, then you don’t have to worry as Medicare will cover the costs of your treatment, medications, and follow-up consultations.
If you are a private patient, then Medicare coverage will extend up to 75% of the Scheduled Fee for services provided by your doctor.
In the event of the doctor charging more than the Scheduled Fee, you will have to pay the remainder out-of-pocket.
Sometimes, your health fund can cover the gap fees for you. Medication, accommodation, and operating theatre fees will be chargeable in this case.
If you have private health insurance, then depending on your policy, If you have private health insurance, then depending on your policy, your insurance provider may cover these fees.
When you approach a doctor for a consultation, you should always ask about the amount you are expected to pay.
This is because some doctors prefer to bill their services in bulk and bill Medicare directly.
Means that they will accept the Medicare benefit to fully deliver their services, leaving you free not to pay anything.
Some doctors will charge separately for their consultation.
It implies that you will pay the account directly at the consultation time and claim the Medicare coverage later.
For most cases, Medicare pays for the following:
- 100% of the Scheduled fee when visiting a General Practitioner
- 85% of the Scheduled fee when visiting a Specialist
- 85% of the Scheduled Fee when getting approved imaging tests, scans, and blood tests
It is important to note that any private health insurance does not cover these out-of-hospital charges, and you will have to pay the gap fee as usual.
According to renowned doctors, you must always take the route of Informed Financial Consent.
This means that when you agree to be treated at a radiation therapy centre, they should provide the complete list of fees covered by Medicare and the out-of-pocket charges.
If there are any additional costs, the centre should inform you about that as well. In short, don’t accept any charges that weren’t disclosed to you before the treatment.