| Imagine you have taken a bad fall, and your specialist | | | | fee is greater than that set by the MBS, this 'medical |
| has diagnosed you with a hip fracture, brought on by | | | | gap' becomes an out-of-pocket expense that you |
| osteoporosis. As with many hip fractures and other | | | | may need to pick up. Some providers offer special |
| hip problems caused by osteoarthritis and rheumatoid | | | | coverage for this gap, so make sure you check. You |
| arthritis, you'll need a total hip replacement. | | | | can also speak to your private medical insurer before |
| While your doctor is likely to suggest a specialist, if | | | | selecting your specialist/surgeon, as they may |
| you have private health insurance, you can select | | | | arrangements with many providers where there is |
| your own. Perhaps you'd like to choose one that is | | | | little or no gap. |
| located close to you, or maybe a family member has | | | | Pack comfortable clothing, a robe, slippers and |
| already seen a particular specialist. Hospital cover | | | | personal grooming items, but leaves valuables at |
| makes it easy to investigate your options, find a list | | | | home. Also bring any relevant x-rays and your regular |
| of fully covered specialists for in-patient treatments | | | | medication in its original package. Your doctor may |
| and make your selection. Go armed with a list of | | | | give you instructions about fasting prior to admission |
| questions (see our checklist), and takes notes. | | | | time. Upon arrival, the admission staff will prepare the |
| A hip replacement will replacement will require a stay | | | | paperwork associated with your stay and talk to you |
| in hospital for around eight days. Thankfully, in | | | | about any out-of-pocket costs. |
| Australia with private health cover you won't need to | | | | Once admitted, a nurse will take your medical history, |
| go on a lengthy public hospital waiting list to have the | | | | confirm your medications and allergies, and take you |
| procedure. Plus, you can usually choose the hospital | | | | to your ward. In surgery you'll have the surgeon, |
| where you would like the procedure. | | | | anaesthetist, specialised nurses and possibly a |
| As soon as you know you're going to hospital, | | | | pathologist on hand. |
| contact your health insurance provider to check that | | | | Back in the ward you'll have a urinary catheter, an IV |
| your level of cover includes the treatment. Have the | | | | line in your hand and a tube to drain the wound - |
| names of the hospital, surgeon and anaesthetist on | | | | these are usually all removed over the next 24 to 58 |
| hand, the item numbers fro the treatments and | | | | hours. After seven to 10 days, once your mobility is |
| whether it will be a day or overnight procedure, so | | | | good, you'll be able to head home. Full recovery will |
| that we can provide you with a quote. Also discuss | | | | take about three months and driving should be |
| what benefits you'll receive for accommodation, | | | | avoided. |
| theatre fees, specialist fees and medications, and | | | | As a private insurance member, you won't usually |
| what your out-of-pocket expenses might be. | | | | receive an account after your hospital visit; this goes |
| When staying in hospital you may need to account | | | | straight to insurer. You will only receive a statement |
| for the 'medical gap' that might be applicable on the | | | | of benefit and this is where any out-of-pocket costs |
| specialist's / surgeon's fees, and any excess and | | | | will be listed. Private health insurance gives you the |
| co-payments you might have on your policy. Under | | | | flexibility you need when you need it most, and can |
| the Medicare Benefits Schedule (MBS), Medicare pays | | | | cover unexpected costs. But remember, once you're |
| 75% of the schedule fee and your provider pays the | | | | injured - it's too late to apply. |
| remaining 25%. However, if the specialist's/surgeon's | | | | |