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Out of Pocket Health Costs

Adelaide Cardiology is a private provider of Cardiology services. As a private provider we charge a fee for our services. The government recognises the need for private providers of health care and therefore has several mechanisms in place to assist you in meeting the cost of these services. If you need to be treated in a private hospital your private health insurer will also be involved. Download a pdf with full information

Outpatient Services

Medicare
As a private provider Adelaide Cardiology sets its own fees. Patient fees charged by Adelaide Cardiology are consistent with providing quality Cardiology services. Medicare pays you 85% of the Medicare Schedule Fee for a private medical service. Unfortunately, the Medicare Schedule Fee represents what the Federal Government is prepared to contribute towards the cost of health services. It does not cover the entire cost of providing high quality care in our clinics. The gap is the difference between these two fees. Full payment on the day is required and payments may be made by Cash, Cheque, EFTPOS, Mastercard or Visa.

Be aware that some services do not have a Scheduled Fee and therefore Medicare does not provide any rebate and some services have a variable Scheduled Fee. For example, if you need an echocardiogram and choose to have it done on the same day you see your Cardiologist the Medicare combined Scheduled Fee, and therefore your rebate, will often be reduced. Therefore, your out of pocket expense will vary depending on the services you require.

In recent years, we have seen Government making arbitrary cuts to Medicare rebates by either poor or no Medicare Benefits Schedule (MBS) indexation, cutting the amount of existing Medicare rebates, withdrawing MBS funding of certain medical services and capping some Extended Medicare Safety Net benefits. At the same time, the costs of running a medical practice are increasing. Many practices are having to increase their fees to meet these costs.

Medicare Safety Net
Medicare has recognised that many patients have high health care needs and therefore has introduced the Medicare Safety Net. With the Medicare Safety Net once you or your family reach the threshold in a calendar year Medicare will then also cover 80% of your out of pocket costs over and above the rebate for the rest of that year. Families and individuals need to register for the Medicare Safety Net. Information regarding the Medicare Safety Net can be obtained by visiting a Medicare Office, phoning 132 011 or visiting the website on www.health.gov.au.

Pharmaceutical Benefits Scheme and Safety Net
The Pharmaceutical Benefits Scheme is how the government helps you with the cost of your medicines. It subsidises the cost of many medicines that are prescribed for you. In addition there is the Pharmaceutical Benefits Safety Net which helps those who have a high cost of medicines. Information about these schemes can be obtained from your pharmacist, contacting the PBS information line on 132 290 or by collecting a brochure from a Medicare Office.

Tax Rebates
Some individuals and families may be eligible for a tax rebate in relation to their outlay of medical costs in a financial year. You should ensure that you retain all your medical invoices and receipts so that you can discuss this with your tax advisor.

Inpatient Services

There will be no out of pocket expenses for services provided by Adelaide Cardiology while you are an inpatient in a recognised private hospital provided your health insurance policy covers cardiac related problems.

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