@Joannie
I have high private cover and have had it for about 45 years. I've used it for major things like surgery (mainly minor - and I guess you'd call my BC surgery minor as well on the scale of things.) I am also rural - so we don't have access to as many medical services as those living in the city - and this includes your choice of surgeon.
Sure, the Health Funds pay all the hospital bills - but they don't cover the gaps in anything else - and this includes your surgeon & all the tests/scans/biopsies etc.
There was even a $500 gap in my post op Pathology fee (of all things!) I can't quite work that one out - as I would assume it was a necessary part of deciding whether they'd 'got it all' or not?
If your surgeon charges MORE than what THEY consider to be an acceptable fee for your designated surgery - you will be out of pocket for the difference, as I was to the tune of about $3500.
I also had to pay an additional $400 (on top of my 'excess') as my surgeon's hospital was also not on their list of 'accepted' hospitals! :( It all adds up. So far, $6500+.
Many women choose NOT to have reconstructions entirely due to the Gap/cost. It is considered to be cosmetic surgery.
With this being my first diagnosis with BC (confirmed Jan 5th this year) ..... I wanted it done then & there, and did not want to wait 2-4 weeks or longer, even if my surgeon
was available on the public list - as it was doing my head in.
NOW, in hindsight .... if I need further surgery at any time - I will ask him if he can do me as a public patient instead (as I am so happy with his work) and am prepared to wait 'a while' for that to happen.
People who go public usually have very few out of pocket expenses.
I put a post up earlier, encouraging members who went private to add to the list of those who's surgeon (in particular) have NO gap here:
http://onlinenetwork.bcna.org.au/discussion/18935/no-gap-providers-in-each-state-who-doesnt-charge-out-of-pocket-expenses#latest
