Publication: Herald Sun
Date: 11 September 2011
Article excerpt:
The medical gap... has become the bane of those with private health insurance. It's not so much a gap as a chasm for some.
And now toss into the mix the threat to the 30 per cent private health insurance rebate and it is no wonder many thousands of Australians are questioning if private health insurance is really worth the pain.
The Federal Government does its bit. It pays for public health care through Medicare. Even when patients choose to go through the private system, our taxes still cover 75 per cent of in-hospital costs.
The rest is charged to the patient and that is why people take out insurance as protection. All that is fine and sensible. But here comes the tricky bit. When a private doctor charges above the scheduled fee, patients may end up with a medical gap.
This is described on the website of the private health insurance ombudsman as any out-of-pocket expense incurred by a patient for their medical treatment during their stay in hospital.
It says it reflects the difference between the total fee charged by the doctor and any Medicare rebate plus health fund benefit.
And although some doctors have an arrangement with a health fund and do not charge a gap fee, you have to shop around to find them and then it depends on your level of cover whether or not you have to pay some of the costs.
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