A lack of transparency surrounds out-of-pocket costs for surgeries, making it difficult for privately insured customers to shop around to compare costs for operations, according to a survey by the consumer advocacy group Choice.
The consumer group Choice conducted a mystery shop of 60 surgeons' offices around Australia and inquired about a knee replacement, a cataract surgery and a tonsil removal for those with private insurance. It found more than a third of the offices approached—22—refused to provide information about fees
The remaining 38 said there would be a gap or no extra cost for the surgeon. Of this group, eight provided a rough, ballpark figure, and 30 gave more detailed answers.
Choice said that insured patients often only get a clear answer after waiting weeks or months for an appointment. At that point, they might be in too much pain or discomfort to do anything but accept the costs.
"With the average gap payment for knee surgery varying from A$397 (US$299) for South Australian patients to a staggering A$2,600 for ACT patients, consumers deserve to know how much they will have to fork out," Choice's Erin Turner said.
"Gap costs, especially if they're higher than expected or even a surprise, are a common frustration for consumers with the health insurance market. True reform is needed to clear up consumer confusion," she said.