Combined private and public

Poek78 Member Posts: 5
Diagnosed a couple of weeks ago with grade 2 breast cancer and have met with surgeon privately and getting an MRI done this week.  Have not discussed out of pocket costs but wanted to know if anyone has combined private with public care and how I organise this? 


  • June1952
    June1952 Member Posts: 1,858
    @Poek78 - many people do the surgery privately then ongoing treatment via the public system so no doubt they will come on to advise you.  Your surgeon's or oncologist's office or your BC nurse will assist with all that.  Some surgeons have a tiny sign in their room advising they will negotiate on fees so be brave and ask !
  • arpie
    arpie Member Posts: 7,667
    Welcome to BCNA, @Poek78 - you are in the best place to get honest answers from those who've 'been there, done that' .... and there are no silly questions, so ask away.

    I went private for surgery & public for radiation @Poek78 - and my surgeon was upfront about out of pocket costs for the surgery.   Sometimes they work in both private and public arenas - tho if you go with them in the public section - there may be a bit of a wait ..... 

    Sometimes there are  unforeseen gaps in other areas too - tho my public radiation (Mon-Fri for 4 weeks) cost nothing other than accommodation.  I even had a $500 bill for part of my biopsy results, that for some reason, Medicare wouldn't cover! .... 

    Absolutely, you must ask about the Gap BEFORE you have your surgery - and as @June1952 says, have a go at negotiating with the surgeon! ;) 

    Feel free to jump onto this thread for info on other topics on the Forum - there is a link to what to take to hospital as well as tick sheets for 'self assessing' following your surgery.  Take them with you to your team meetings after your surgery.

    We also have some 'off topic' threads, where you can show us your pets, garden, art & crafts & more .... and also some Funny posts as well - as we all need a laugh now & then!

    If you add your general location on your profile - members may also be able to advise you of other services that may be available to you in your area.

    Make sure you take a buddy with you to your meetings - even record them on your phone so that you can listen to them again later on. It is easy to miss bits in the emotions of the moment ... and 2 sets of ears are definitely better than one.

    Take care & all the best for your upcoming appointments xx
  • Poek78
    Poek78 Member Posts: 5
    Thank you!  Good to know.  Another question.  When and how do I get allocated a Breast Care Nurse & is there cost associated with that? 
  • June1952
    June1952 Member Posts: 1,858
    edited May 2023
    @Poek78 - if you have not been allocated a BC nurse, check out the McGrath Foundation website to find the details of the one in your area and make contact yourself.  There is no charge for her services.
    If you add your general location to your profile other members near you will be able to provide lots of info for you.
    Here you go:
  • jennyss
    jennyss Member Posts: 1,970
    Dear @Poek78,
    Five years ago I had private surgery and public chemo and radiotherapy, and a wonderful breast care nurse. There was no cost associated then. I think location has quite a bit to do with service availability.

    from jennyss in Western NSW
  • Halla
    Halla Member Posts: 185
    edited May 2023
    Hi, I had surgery privately and radiation in the public system. The cost of surgery was a bit of a shock given I had private health, I probably spent about $15k all told, but I was operated on quickly and successfully, and all the medics that see the scars say what a great job the surgeon did. I had a lumpectomy but apparently there were quite a lot of tumours so it was pushing the boundaries of that kind of surgery. Anyway she got clear margins and 2 years down the track my scans are all good. At the time I didn’t care whether I had a mastectomy or not, but now I’m quite glad I got to keep my boobs. So I’m glad a paid for a good surgeon . Then the radiation at peter mac was absolutely fine - totally free and top notch brand new facilities and equipment. 
  • Abbydog
    Abbydog Member Posts: 482
    I was first referred to a Breast Surgeon, He charged a $500 gap for surgery. I did Chemo Privately. I think I had small medicare gap with Oncologist consults. I know BUPA paid out well. The Oncologist told me that Radiotherapy could be done in the Public sector, with no cost to me. I'm in SA, I don't know how this works in other states. My Onc made the referral to Public R/T, and it all flowed very well. Private R/T can cost something like $2000-$4000 gap. I've heard of a friend negotiating the R/T gap successfully.
    I did pay gaps with Radiology types of tests. In hind sight I should have asked each time test was ordered if it could be bulk billed. Since I have been asking, I have often been bulk billed. 
    My care has been excellent and prompt. Hopefully the Public sector would have been too.
    You may not feel this appropriate now, but if you have Income protection you should start your paper work now, if you want to claim. There is often a waiting period. If you have a regular job and superannuation, you probably have IP within in it.
    If you update your profile, we can answer some questions more specifically. Eg location.
    You won't know how all of this affects you until it all starts happening.
    I was very lucky. No nausea with Chemo. Didn't lose my hair (used Cold Cap)
    I did have side effects, but none serious. You can't predict. Keep an open mind.
    I was also lucky with R/T, no burning. I used Mepitel. You can ask about these things as you go.
    There is so much to take in, but you can do it.
    I always keep a question list on the go, for each next visit.
    Take someone with you, for second pair of ears. Husband, friend or sister etc
    All the very best with your treatments.
  • cranky_granny
    cranky_granny Member Posts: 758
    @Poek78 i saw my breast surgeon in her rooms. Paid the fee and they sorted medicare refund. Surgery was done publicly with her. 2 weeks from stopping chemo to going into surgery. Though the margins were insufficient and the nodes weren’t clear that can’t be blamed on her. As the more detailed biopsy results came i later. The ones while in theatre didn’t show enough detail and obviously the dye stuff didn’t either. But that was me we are all different. I just had the rad cycle increased to hope kill off any strays. 
    Best wishes for your treatment plan. Ask Questions. I was in such a whirlwind that I didn’t and now regret that i didn’t even  remember what grade or type though i know they told me. Thats why its always good to have a 2nd set of ears and the tick sheet is valuable. Keep away from Dr google it’s usually crappy unless you have a degree in such stuff. Make sure they explain it in layman’s terms. No mumbo jumbo medical terminology. I have also learnt to get copies of my reports. My folder is getting quite fat now. 
    Again best wishes for your treatment ahead stay in touch on here. And ask anything nothing is dumb or  silly  and if we don’t know theres always a reference somewhere in the network.