Estimate the out-of-pocket cost of common medical procedures. All figures are estimates — actual costs vary by provider and location.
Medical procedure costs in Australia have several components:
Surgeon's fee: The doctor performing the procedure. Medicare provides a rebate (75% of the MBS fee for in-hospital, 85% for out-of-hospital). The surgeon may charge above this — the difference is your "gap."
Anaesthetist fee: If needed. Separate bill, separate Medicare rebate, separate gap.
Hospital/facility fee: Operating theatre, bed, equipment, nursing. Covered by Medicare in public hospitals. In private hospitals, covered by your health insurance (minus any excess).
Prosthesis/device costs: Implants, mesh, lenses etc. Covered by insurance in private hospitals (usually).
In a public hospital as a public patient, all costs are covered by Medicare — you pay nothing, but you don't choose your doctor and may wait longer.
Go public. Public hospital treatment as a public patient is free under Medicare.
Ask about no-gap or known-gap. Many health insurers have agreements with surgeons who agree to charge no gap or a known (capped) gap. Ask your insurer and your surgeon.
Get quotes in writing. Ask your surgeon's rooms for a written estimate of all costs before agreeing to a procedure.
Check the Medicare Safety Net. Once your annual out-of-pocket costs exceed the threshold, Medicare pays a higher rebate. See our Safety Net Calculator.
Ask about in-rooms procedures. Some minor procedures done in the GP's rooms or specialist's rooms attract a higher Medicare rebate (85%) and avoid hospital fees entirely.