HCi Factsheet

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Informed financial consent

28 January 2022

Before agreeing to surgery and procedures, you may be asked to sign a letter of informed financial consent.

When you are facing a medical procedure as an in-hospital patient, money may not be your top priority. However, you don’t want to be left with large bills once the health issue is resolved.

Finding out about the costs

Before you receive hospital treatment, your doctor or specialist should provide you with information about what costs you can expect for your treatment, and identify any out-of-pocket costs.  This is called informed financial consent, and it helps ensure that you understand what procedures will be undertaken and what the total costs (including any out-of-pocket costs) will be.

For private inpatient medical services, Medicare and your health insurer pay 100% of the MBS fee (assuming you are covered for that procedure obviously!) Any cost above the scheduled fee is known as the gap and is payable by you.

Doctor explaining consent form to a man in a hospital bed » HCi

It is perfectly reasonable for you to ask the doctor about the costs involved, including a clear statement of any out-of-pocket expenses, and to seek a second opinion if you think you need to. You can also ask your doctor or specialist if they will use HCi’s Access Gap Cover to help reduce, or eliminate, your out-of-pocket expenses.

Have a look at our Member Guide for a checklist of questions you can ask your doctor or specialist to understand their fees and your options. Medical professionals can vary their prices, but our provider search can give you an indication of likely charges.

How to read your informed consent letter

When you see a surgeon ahead of surgery, you can expect a quote or an ‘informed consent letter’.

This letter will give you an estimate of costs from that provider so it may not include extras like the anaesthetist or hospital charges. Ideally, get quotes from all doctors who will be involved in your treatment so you can see the total costs you may face.

The stated cost is what you can expect to be charged for the scheduled procedure, but costs are an estimate only and may increase if additional work is required during the procedure.

The letter will show all elements of the procedure and a total charge. It will also include a rebate – this refers to the amount of costs that will be covered by HCi and Medicare. The difference between the total and the rebate is the gap you will need to pay.

Remember that you are not required to sign it at the consultation so you can think about it and speak to HCi about your health cover entitlements first.

You can read more about informed financial consent or call us for assistance.

HCi used its best endeavours to ensure this information was accurate at the time of publication. From time to time, circumstances relating to the subject matter may change which may impact the accuracy of the information. This information is also general in nature and does not take into account any specific health or financial situation. Before making any decisions in relation to this information, you should consider your own financial and health situation and seek professional advice. Health Care Insurance Ltd ABN 43 009 579 088. A Registered Private Health Insurer.

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