Medicare and Insurance

Do I need a referral to make an appointment?

Most medical specialists will accept only referred patients. This is partly to try to ensure that the specialist you are seeing is appropriate for you and your condition, and also because Medicare pays higher rebates for specialist services if you have been referred.

What about your fees?

The fees set by this practice are a private fee calculated to optimise health care delivery to patients. In most instances there will be a moiety of your surgical fee which will not be covered by Medicare and your health fund. This is because the medicare rebate set by the government has not kept pace with infaltion and does not cover the expenses incurred by medical practices. Additionally, while most health fund policies cover the various hospital costs which are quite considerable, the funding offerd by health funds for doctors fees are also inadequate. It is for these reasons that a gap exists. If there is any problem with this it is important that you ask about this gap. Our staff are fully informed with changes and rebates and will be able to help you navigate you way through this area of your procedure.

What are your acceptable means of payment?

Fees will be reviewed with you at the consultation visit. Payment during the consultation is appreciated.

Bank cheque, personal cheques, cash or credit cards (MasterCard, VISA) are acceptable means of payment. We do not accept American Express cards.

Do I need to have private health insurance?

Private Health insurance allows you and your family to access the right health services at the right time. You have control of your health care and can choose the provider, facility and timing of your treatment. With the security and protection of private health insurance, you have access to an extensive range of private hospitals and can rest assured that your health is in good hands.

How can my family doctor help me to obtain specialist medical care?

Before seeing any medical specialist, it is always preferable to talk to your own family doctor, who can discuss your condition with you and advise on whether any specialist care is appropriate. If it is, he or she can help you to choose the specialist best suited to your needs. Your family doctor can help the specialist to care for you better by providing relevant information about your health. Communicating with the specialist will also enable your family doctor to care for you better during and after your specialist treatment.

What are the Medicare rules about referrals to specialists?

If you want Medicare to help to pay for specialist medical services at the referred rate, it is essential to discuss your condition and possible referral with your family doctor before you see the specialist. Please note that the backdating of referrals is illegal and can result in heavy fines and prison sentences. If you have any questions about seeing medical specialists or about the Medicare benefits system, please ask your family doctor or contact Medicare on 13 2011.