Knowing you need medical help is the first step. Then you need to find a suitable provider to help you.

When facing a procedure, it is always good to discuss your options with your current medical provider. They will know your specific needs and what services are available in your area.

Finding a HCi provider

HCi has agreements in place with over 500 hospitals and day surgeries across Australia. So there’s sure to be one near you!

In the first instance, talk with your GP about possible hospitals, specialists and surgeons in your local area. You can also look at the Government’s Health Direct provider search tool.

Remember that providers, such as a surgeon or specialist, may only operate out of selected hospitals.

Of course, you can also contact us to check your cover and limits.

Understanding hospital inpatient costs

If you are a private patient, HCi pays towards any covered treatment a doctor provides whilst you are in hospital. However, if your provider chooses to charge above the MBS fee, you may have to pay the medical gap. This gap is the difference between the total fee charged by the doctor and the MBS fee. HCi does not pay claims for out of pocket expenses.

It is in your interest to discuss fees with your surgeon and/or specialist and find out if they will use HCi’s Access Gap Cover to minimise or eliminate your medical out-of-pocket costs. You can talk to multiple surgeons/specialists to choose the best one for your situation.

Questions to ask each health provider…

• Do you agree to treat me under HCi’s Access Gap Cover?
• Will I have any out-of-pocket expenses, and if so, can you provide a written estimate of how much?
• Are you prepared to treat me in a different hospital that has an agreement with HCi?
• Will any assisting doctors also use HCi’s Access Gap Cover and if so, how can I obtain a quote for their services?

Your doctor or surgeon needs to give you an informed financial consent letter detailing all anticipated costs. This letter will indicate if the hospital has an agreement with us – if it doesn’t, talk to your surgeon about using an alternative hospital.

For a guide on what the procedure may cost you, the Federal Government’s Medical Costs Finder (MCF) could be a useful tool. It shows what the average price is nationally and per state. You can also see how much Medicare will cover and the likelihood of out-of-pocket expenses.