- What will my anaesthetic cost?
- How do I claim from my health fund?
- Why doesn't my health insurance cover my full anaesthetic fee?
- Where can I get more information?
Q. What will my anaesthetic cost?
We will send you anaesthetic information via text message or email as soon as we are notified of your procedure by your surgeon's rooms. This will include information about your anaesthetist and your anaesthetic fee.
Our anaesthetists are committed to a sustainable private health care system and set their fees accordingly. The anaesthetic fee varies for each procedure, and is separate from the surgeon's and hospital's fees. This fee is calculated based on a number of factors including the length and nature of the procedure as well as your general health.
Some anaesthetic fees will be fully covered by your fund, while others will require you to pay a 'gap'. A 'gap' is the portion of the anaesthetic fee that is not covered by Medicare and your health fund.
Q. How do I claim from my health fund?
For partnered health-insurance patients:
With the exception of NIB-issued policies (see below), we will claim all rebates on your behalf, meaning you won't have to put in a claim. It also means you will only need to pay the gap, rather than the full anaesthetic fee. This assumes that your procedure and anaesthetic is covered by insurance from an approved provider. It is your responsibility to ensure your insurance covers your procedure and anaesthetic.
For NIB-issued policies:
NIB requires patients to pay the full anaesthetic fee before claiming any rebates. NIB-issued policies include APIA Health Insurance, Qantas Assure Health Insurance, Suncorp Health Insurance, AAMI Health Insurance, and possibly others.
Medicare / Self-funded patients:
Self-funding patients are required to pay the full anaesthetic fee prior to their procedure. A Medicare rebate is often applicable for anaesthetic fees and we will let you know the estimated rebate prior to your procedure.
Q. Why doesn't my health insurance cover my full anaesthetic fee?
A gap exists because Medicare and health fund rebates over time have not risen in line with the costs of providing anaesthesia services.
Health funds have different rebates for surgical and anaesthesia fees and unfortunately this is not well advertised. Some health funds have programs to limit the amount of gap you have to pay to a reasonable amount. Some funds have poor rebates with no programs to limit any gap, as well as imposing onerous conditions on doctors.
The following diagram demonstrates each component of your anaesthetic fee:
Q. Where can I get more information?
The following resources provide further information about anaesthetic fees:
The Australian Society of Anaesthetists has an excellent guide to how your private health insurance works:
The AMA produces an annual "report card". Page 8 of the 2018 guide provides a good comparison of health fund rebates (dark green is best, dark red is worst). It is important to note that these are the maximum rebates, and may reduce to the "MBS Fee" (left column) if the gap exceeds the "known gap" (bottom row).