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Doctors to Reveal Gap Fees Charges to Patients

The doctors have been forced to disclose details about their out of pocket expenses following radical overhaul of health insurance premiums// by the Federal Government. In an attempt to encourage young people to take out private health cover, it has been further planned to abolish the two five percent lifetime surcharge on premiums.

The new plan which would be accompanied by the sale of Medibank Private, would be unveiled by Tony Abbott, Health Minster, in the forth-coming weeks. The difference between the doctor’s charges and the health insurer’s refund, commonly referred to as the gap payment would have to be revealed by the doctors.

In most of the cases, the gap payment for hospital procedures, on an average approximates to $720 (>20% of the patient’s medical cost). This often out of pocket expenses go unnoticed by patients. The change commonly referred to as the Informed Financial Consent, will help patients to shop around among doctors. The main target of the new plan is putting downward pressure on charges.

An educational campaign for doctors would soon be launched by the Australian Medical Association (AMA). However, if the specified targets are not met within a pre-defined time frame, the Government would participate in the regulatory process. The new package will increase the number of medical procedures performed outside the hospitals, the cost of which can be claimed.

Medical tests done for detection of heart disease and diabetes can be claimed for, provided, these tests are conducted outside hospitals. Anyone who has been with the health fund for 10 or more number of years would have a abolishment of the surcharge (2%), irrespective of their age.

The present system, charges an additional 2% contribution for very year delay in joining a health fund, after 30 years of age. A website would also be established for the benefit of the consumers using which informed health fund decisions can be taken.

An online hospital and doctor’s search facility would also be established to help patients identify which doctors or hospitals are under insurance cover in a specific area. The issue of whether to completely de-regulate health insurance premiums is under consideration. A proposal to put health insurance packages outside the 30% rebate provided it included acupuncture and gym membership was rejected by the Federal Cabinet.


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