New fees for radiation therapy as of 1/7/21

Maxymoo

Hi everyone, hope your all travelling reasonably well especially those locked down in Sydney.

iha e just finished my TC chemo and am now getting ready to move onto 4 weeks of radiation therapy. I am having treatment at Lighthouse Sydney.  I nearly died when they told me the fees involved . $14,451!,,,, Up front with a rebate of $12,410 from Medicare.  I need to pay approximately $8000 up front then can recycle my refunds from Medicare to cover the the subsequent three payments of $2000 or so. Sorry my chemo brain isn’t up to exact numbers. Apparently these fees are only from 1/7 this year when Federal government changed the Medicare rebates. This is insane!!!!

There is no coverage from health funds( not that I have one) as it is outpatient treatment. Apparently fees apply to low income earners and card holders and financial counselling is available to assist people raise funds/ organise payments.
Whilst I am not super upset about the out of pocket it’s the upfront initial payment. I am lucky and have savings but other people may have to take out loans, when they’re all ready financially stressed being off work etc.

Apparently the co- contribution is up to 50% in some other Area Health Services out west ie Nepean, Westmead, Etc.

This is not on!!!  Cancer patients are being left out to dry. Anyone want to help me that this further?

arpie

Hi @Maxymoo

I've found this link re medicare changes from 1/7 .... can't see radiation mentioned - but I haven't read it all, either
http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/news-210701

Maybe ask for a quote from the Public Hospital Cancer Centres?  If you had it in done in a public hospital, you are saying the cost would have been about 50% 

That's weird - so you are having your treatment at the Lifehouse (Chris O'Brien Centre) - yet their current blurb still says that Medicare will still take care of up to 80% of the costs ..... It sounds like you are being charged the full amount 'up front' then have to claim it back from Medicare, but with other intermediate costs as well?    I wonder why they don't just charge the 'gap'?    I like the term 'patient navigator' - they'd have to be VERY PATIENT with me!  grrr

You don't have a current Concession Card?   They say it is free.


I am guessing Lifehouse would mainly be for private treatment, wouldn't it? 

Take care - so much to assimilate - after all your other treatment too! 

Cath62

Hi @Maxymoo, 

I had private health but for radium there isn't a single private health fund in Australia that covers radium. I had a month of radium and it was $23000.

 It was all upfront but in stages eg $10000 and then Medicare was claimed and paid the same day, then I paid the balance in 3 payments each with Medicare paid the same day. I had to use my credit card and then use Medicare amount to pay the credit card. 

At the time October 2020 my Medicare safety net meant I actually only paid 15% however this is still alot ie approximately $3500. Just insane really. Genesus who did my radium did discuss payment options. I guess if I hadn't had a credit card I may have had to negotiate with them regarding payment. They did offer that to me. 

I haven't worked out the total cost of my treatment but with surgeon out of pocket, general appointments, hospital fees, physio etc it is alot. And on top of that is my private health premiums. 

Australia's health care is great but private health is very expensive. It was like paying private health to pay even more. I guess I could have gone public and get the same treatment but here in Queensland there are queues. My private health meant immediate treatment. It's the only way I can look at it. 

Perhaps BCNA could look to take this issue up so treatment could be less expensive for bc patients. 

Abbydog

I had all of my Surgery and Chemo, privately. BUPA paid up well.
I was advised that I could have Radiotherapy at Public hospitals here in SA, at no cost.
This was no problem, I had 5weeks Radiotherapy Sept and Oct 2020. At our Lyell McEwin Hospital.
They also supplied and applied Mepitel, at no cost to me.
I hope that this has not changed and is still available.
The treatment went well, no complaints.
I was warned that R/T done privately, would cost me a small fortune.

Zoffiel

@Maxymoo Don't assume that the facility you have been referred to is the only one available. Ask if there is one near you that bulk bills (a surprising number do) and don't tolerate any sniffiness about 'preferred' providers.

When it comes to radiation, you will get exactly the same therapy in a public facility as you will in a private. The gowns and waiting rooms might not be as nice and you may not be able to nominate times that suit you, but you need to enquire before you decide what compromises you are willing to make.

I'd love to see a royal commission into the specialist referral process. They do not have to give you options, so they don't. There is a degree of cronyism in that that most folk don't discover until it is too late.

There may not be a cheaper option for you, but you won't know until you ask and they won't tell you unless you do. You may have to be quite insistent and don't just ask the person on the front desk. MXX

Keeping_positive1

It is a rort, isn't it!  You can ask at your local public hospital to see if you can have your radiotherapy there.  My local hospital doesn't have oncology radiotherapy, so I was referred to the closest private oncology radiology clinic and I wasn't out of pocket.  You will find a way around it.  You need to ask at a public hospital how to go about getting your radiotherapy treatement done through the public system, and from what I know the service is just the same.  Perhaps maybe not as fancy gowns to put on, but I wouldn't be paying that much to go private.  Wishing you all the best.

Jwrenn

Did you all get gowns to put on? I had to bring my own, in a private hospital . It was during the first phase of Covid last year and I also had to change in the room in front of the staff, I presume there are change rooms but because of Covid they weren’t able to be used. My very last session another lady came into the waiting area already in her robe, she was smart and changed in the toilet. I didn’t pay a cent for mine as I was referred from the public system and have a health care card. 

arpie

@Jwrenn I went public for my rads & it was a fresh gown every time, in a private booth for getting changed.  Maybe Covid forced the change this time with you having to bring your own?  But I can't really see any reason that you should have to change in front of staff!!  That sounds absurd!   I paid nothing for my rads either - and we stayed at subsidised accommodation on the hospital grounds, as it was a 1.5hr drive each way to get there & home again, so we stayed there to make it easier on me, as I am the driver in the family.

iserbrown

COVID has changed a lot of things.  At my recent mammogram, no gown; the sign if you would like a gown, ask for a gown!  No need really and one less thing to touch.  Yes and got changed in front of staff

Keeping_positive1

I had ulatrsounds a couple of weeks ago, but was not related to my breast oncology appointments.  I was given a gown and was left on my own in the room while I changed.

Jwrenn

@arpie I was not told a reason for having to bring my own gown and changing in the room. I just did what I was asked. Like I said it was in the first wave of Covid, April/May 2020 and  I was lucky to be getting it done at the time. The radiation oncologist asked if I wanted to wait till Covid settled down and as I’m in Melbourne I’m glad I went through with it straight away as we’ve been in and out of lockdowns. They could have had a privacy screen for my modesty, which I had in July when I had the bone density scan at a different place, but they just had a chair for my clothes. I saw where the change rooms were but they weren’t in use. 

Zoffiel

@Jwrenn I think many of us have had that 'We see bodies all the time' moment throughout our treatment. True, they might, but I'd prefer the option of struggling with my clothing, handbag and anxiety in some, even inadequate, version of privacy.

Bizarrely, I find getting dressed under scrutiny even more awkward than stripping off. It's slower for starts and everyone is so impatient while you are trying to turn your clothes the right way out and undo your laces because you'd just ripped everything off when you came in.  I find myself hobbling away trying to do up zippers, apologising for holding up proceedings. That's when I'll drop my handbag then have to scrabble around picking everything (except for my keys) off the floor. Mxx

Emma17

What radiotherapy gowns? I paid $3,000 out-of-pocket for private radiotherapy.  There were no gowns nor a private area to undress and dress.  Instead I entered the bunker, turned my back to the two RTs who were waiting at the treatment board, undressed and then picked up a fresh, folded threadbare towel which was provided to each patient. I unfolded the towel and covered the front of my body as I walked to the board.  The RTs then artfully arranged the threadbare towel around the bare part of my upper body not being zapped.  After each session, an RT would enter the bunker signalling it was over. I would cover my front as I stepped off the board and walked to the plastic chair that held my clothing.  I turned my bare back to the RT as I dressed in front of her/him.

There was no privacy and no dignity extended to patients at what was nothing more than a radiation factory.  My impression was every effort was made to maximise throughput and minimise inputs.  It's called 'profit'.  The claim of providing 'compassionate, person-centred care' was exposed as pure marketing hyperbole.

Abbydog

 I am so surprised at the big variations in patient care and preparation for each R/T treatment. It doesn’t even sound like Private is better. I went Public with no issues. The care was excellent. I had an open locker that was reserved for me for the duration of my treatment. In it went the gown and dressing  gown that I used and reused for each session,  After I checked in I was expected to undress my top half and put the gown on. This was in a private change area, next to the lockers.  I was then ready when called to get straight on the table. 

Ellamary98

My experience both times (2014 and 2020) has been positive. Friendly, respectful staff and no issues with privacy. However, the system really sucks with payments. I had both lots of treatment in a private hospital. The first time, I was completely shocked by the out of pocket costs, and the system of payment (upfront). I wasn ‘t warned and cried silently through my very first session as the receptionist had passed me an invoice for $16000 for the initial week. Last year I was better prepared, but still surprised by their assumption that I could produce $10K upfront . Just because a patient doesn’t have  a healthcare card, doesn’t mean they have access to unlimited funds! In the end, I was $3600 out of pocket.  I really cannot understand why they can’t bill Medicare directly. As though we don’t have enough to deal with.
Looking at my health insurance and Medicare claims on line recently, I realise that the only health provider not making money from my treatment is my oncologist. One specialist charged my insurer $380 for a 3 minute phone call!

Halla

I had my radiation this year at the petermac in melbourne. They were fantastic and it was completely free. No bills at all. Brand new hospital and equipment and 10 minutes from my house.

I had my surgery at a private hospital which cost probably $10k or more out of pocket, the bills kept on coming and I was not warned about them all,  so I insisted on going public for the radiation.