You have been having long-term hip pain and restricted movement for quite some time now, your quality of life has been affected by it and nothing seems to be improving your condition, your doctor has finally recommended you need a hip replacement and to see a hip specialist. All you can see now is dollar signs flashing in front of your eyes!
Medicare will cover the costs if you go through the public sector, however there is a significant waiting list time for public operations and you may well decide you want to go privately.
What is the Cost of a Hip Replacement in Victoria?
The average total cost of a hip total replacement is about $25,000 but can range anywhere from $20,000 – $42,000. Private health insurance covers much of these costs including hospitalisation, implants and associated costs. Privately the cost of your operation varies due to differences in health insurance rebates. Some insurers eg NIB have very poor rebates leaving patients with large gap fees, whereas others eg BUPA and Medibank have better rebates and smaller patient out of pocket fees.
What Are Out-Of-Pocket Costs?
As mentioned above, out-of-pocket costs can vary greatly with different doctors, as they can with the amount that private health insurance companies are willing to pay out for certain procedures. But what exactly are these out-of-pocket costs made up of?
Depending on your personal circumstances, the excess payable from your health insurance policy, the hospital you attend and the hip surgeon you choose, out-of-pocket costs will vary, but can include any of the following: the cost of the surgeon, the anaesthetist, an assistant surgeon as necessary, other clinicians, radiologists and any specialist consultations you may need.
Different insurers provide varying levels of benefits and maximums they are willing to pay for out-of-pocket costs, so it is important to get a quote from your surgeon for their total medical fees, and to know exactly what the insurance companies are willing to pay out before you agree to anything.
What To Look Out For When Choosing Private Health Insurance
It is difficult to recommend any one company that is best to go with, as circumstances vary greatly between individuals and their needs. The most important thing when choosing which insurance company to go for is to be sure of what your policy will and will not cover. Generally, higher tier providers e.g. Medibank, BUPA, and AHSA members have smaller GAP and out of pocket fees than other insurers like FRANK, and NIB.
Many private health insurance policies operate a tier system, but this can vary greatly between companies, so options with a Gold policy from one company may not be much better than with a Bronze policy from another. Remember that just because the hip replacement is covered, excesses, cover limits and maximum payable benefits can significantly vary.
Here at Dr. David Slattery‘s Surgery, we are open and honest about fees and are happy to discuss any and all costs with you, help you with insurance policies and even arrange a payment plan prior to surgery if it helps, so that you won’t be left wondering, how much does a hip replacement cost privately?. Don’t hesitate to call us to find out more.