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clock Created with Sketch. 22/02/25
19:13
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Originally posted by UberTrader:
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Look someone in family needed hospital stay for a week and all we paid for the stay was $500 which includes private room plus food. But the problem was the specialist..like an anaesthetic charged out of pocket $1200 for 1 hr (10 minutes for injection and 50 minutes waiting) and specialist for treatment charged I think around $3800..so even though I am on gold hospital and extras we paid around $5000 out of pocket which was shocking as I paid almost close to 50 k before in premium without needing to use it. What I found that specialist charge fees say $1500 then Medicare pays $250 but health insurance only paid $50 so I enquire why do health insurance pay less then even Medicare even though I was on no gap plan. The insurance explanation was eye opener. They said Medicare decided how much particular specialist can charge for particular service so in my case Medicare rate was $300 and Medicare paid $250 so health insurance only $50 to make it no gap. So I need to fork out $1200 on top because specialist invoice was worth $1500 !
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obviously if nothing happens then it will be reflected in price as well but at the moment situation hasn't changed.
(20min delay)