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Nobody likes paying big bills, especially when they include costs you could have avoided. When it comes to health care, there are definitely things you can do to make sure you're paying for the great quality care you need – and not a cent more.
To start with, you need to understand your policy – what it covers and what it doesn't. At nib, we believe that knowing what is and isn’t covered should be simple. With that in mind, here are a few tips to keep your out-of-pocket expenses down.
If they want to, specialists, pathologists and radiologists can charge more than the amount that Government deems as an ‘appropriate fee’ for their service. This ‘appropriate fee’ is called the Medicare Benefits Schedule (MBS) fee and the excess that a specialist or surgeon charges isn’t covered by Medicare. That means it may have to be paid out of your own pocket – it’s called a ‘gap’ or ‘out-of-pockets’ (learn more about the MBS here). It’s always a good idea to request a written estimate of the out-of-pocket expenses from your specialist before agreeing to a procedure, however if you’d like some guidance, you can call 13 16 42 and we can give you information on the procedure’s average out-of-pockets.
If you want to be treated in a private hospital or as a private patient in a public hospital, and have recently joined nib or changed your cover, you should find out whether there's a waiting period before you can claim. There’s a two-month waiting period for most services and a 12-month waiting period for pre-existing conditions and pregnancy services. Call nib on 13 16 42 to find out whether you need to serve any waiting periods.
When you need to see a specialist, your GP will refer you and will order any tests you might need before you go. If you're concerned about how much it's going to cost, or aren't sure what you need, always ask for more information. Also, you don’t have to accept the specialist your GP is referring you to. You can ask for an 'open referral' so you can go to a specialist you choose – a great option if you have friends or family who can recommend someone!
Ideally, your GP will refer you to a specialist who is easy to get to and isn’t too expensive. Another way to find a specialist who suits you is through Whitecoat, an online tool that gives you access to more than 200,000 healthcare providers Australia-wide. You can easily search the whole range of providers, by their location and online reviews and, for some, even book appointments online.
You can ask for an 'open referral' so you can go to a specialist you choose – a great option if you have friends or family who can recommend someone!
Our MediGap Scheme is designed to reduce your hospital out-of-pocket costs. It's simple: we have a network of doctors, anaesthetists and specialists who may agree to charge us directly and ensure you don’t pay an out-of-pocket hospital expense. Before your procedure, ask your specialist whether they participate in the scheme. Alternatively, call us on 13 14 63 to check if your doctor participates in our MediGap scheme.