Avoiding out-of-pocket costs when going to hospital

Avoiding out-of-pocket costs when going to hospital

We all hope our hospital stays are few and far between. But at RT Health, we like to make things simple. And, we want you to get great value from your cover. That means avoiding as many out-of-pocket costs and unexpected bills as you can.

With just a few simple questions at stages throughout the planning for hospital process, you’ll be able to get the info you need to be prepared for your hospital stay.

As an RT Health member with private hospital cover, you can choose to be treated in either a private or public hospital. Your choice will depend on your level of cover and the type of treatment you’re having.

Keep in mind that even as a private patient in a public hospital, it’s possible you’ll be placed on a waiting list.

TALKING TO YOUR DOCTORS

Visit your GP

You might know the drill. You need a referral from your GP to see a specialist doctor (like a surgeon, for instance) to kick off the whole planned procedure process.

Finding a specialist

Finding the right specialist for you is important when it comes to managing your health and avoiding or limiting your out-of-pocket costs. Your treating doctor is really your choice.

You have the right to ask your GP for another referral if you’re not happy with the specialist they’ve suggested, or you can also ask for an ‘open referral’. This means you can choose from a list of appropriately qualified specialists and select the one who suits you best.

(Remember, any specialist consultations or treatments you receive outside of hospital can’t be claimed under your private hospital insurance. Hospital insurance only applies once you are admitted as an inpatient to hospital.)

Our Find a Doctor tool can help you see if your doctor/specialist has previously participated in our Medicover program.

DON’T BE AFRAID TO ASK QUESTIONS

It’s important to make sure you fully understand your planned procedure. Knowing all the relevant information is part of informed clinical consent. You want to get the best value from your private hospital cover as well, so asking your specialist about any out-of-pocket costs is vital.

RT Health’s Medicover program can help curb out-of-pocket costs. It’s a ‘gap cover scheme’ that helps us provide benefits to cover some or all of any gap payments.

Doctors can elect to participate on a case-by-case basis, so you’ll need to check in with your treating specialists to see if they’ll participate for your treatment (more on this below).

GET INFORMED

When you visit your specialist, you’ll learn about the treatment options recommended for you. Now’s the time to gather information, so make sure you receive an itemised quote to help guide your decision making.

Your doctor should be able to give you a breakdown of the cost of your treatment. This is known as informed financial consent. You should also ask about any out-of-pocket costs that you may incur from other treating specialists or care providers (like assisting surgeons, anaesthesiologists or pathology testing).

Here are some questions to ask your specialist when it comes to your medical costs.

  • What are the MBS item numbers for my treatment and what will be the charge for each of these items?
  • Can I have a written quote or advice on costs of my procedure (and any out-of-pocket costs), including fee estimates for any other treating doctors, so I can review before agreeing to the treatment?
  • Will you treat me under RT Health’s Medicover program?
  • How and when will I be billed for any out-of-pocket costs?
Talking to your hospital

If you choose to go to a public or private hospital that’s contracted with RT Health, your hospital fees should generally be covered (as long as you’re covered for the treatment you’re having). However, it’s always good to ask some specific questions of the hospital before your admission.

Here’s a few handy questions that will help you find out if you’ll be up for additional hospital costs:

  • Will I have to pay a gap for my hospital accommodation?
  • What costs will I have to pay out of my own pocket during my time in hospital? (It’s good to know that things like TV, internet, parking, magazines, newspapers aren’t included).
  • If you have an excess, when does it need to be paid, and how?
Give RT Health a call

As soon as you know that you’ll be having a hospital stay, give us a call. We’ll be able to confirm with you that your hospital fees will be covered, depending on how you’re being treated (public vs. private).

We’ll also be able to help you have peace of mind knowing what bills you may expect to get from your treatment (hopefully very few!). We’ll chat with you about:

  • the treatment/procedure you’re having and making sure you’re covered
  • any restrictions you may have on your cover
  • making sure the hospital you’re booked in with is contracted with RT Health
  • any waiting periods and/or pre-existing conditions (if you’re a newer member or have recently changed your cover)
  • making sure your membership is paid up-to-date and any payments you’ll need to make before your treatment
  • your excess (if you have one).