Fees

Once we receive your procedure details from your surgeon’s rooms, we’ll automatically send you a text or email with:

• An introduction to your anaesthetist.
• An estimate of your anaesthetic fee.
• Information on rebates and payment options.

Our anaesthetists set their own fees independently. These fees reflect their commitment to a sustainable private healthcare system and are based on several factors including:

• The complexity and duration of your procedure.
• Your general health.
• The type of anaesthetic required.

Anaesthetic fees are separate from your surgeon’s and hospital’s fees. The final amount may vary from the estimate depending on the duration of surgery and any additional care required during your anaesthetic.

Your fee may be fully covered by your fund, or you may be responsible for a portion of your fee, known as a “gap” or an “out-of-pocket”. You remain liable for the full anaesthetic fee, even if you fund is expected to cover the full amount.

If you do not have health insurance and are self-funding, you must pre-pay the full anaesthetic fee as a deposit prior to the procedure. Your final fee may be more or less, and we will contact you after your surgery if this is the case.

We make the claiming process simple.

• If you have private health insurance, we will claim your rebate on your behalf.
• You’ll only need to pay the gap(if there is one).
• In some cases, payment is not required until afteryour procedure.

If you are self-funding (uninsured), a deposit equal to your fee estimate must be paid before your procedure. After the surgery, we will finalise your account and:

• Submit a Medicare claim for adult patients (you’ll receive the rebate directly).
• Provide a receipt for you to claim from Medicare (for children).

If a rebate is delayed or rejected, we’ll assist you by providing all required documentation for your health fund or Medicare.

The gap exists because rebates from Medicare and private health funds have not kept pace with the rising cost of delivering high-quality anaesthetic care.

• Medicare rebates were frozen from 2014 to 2019, which also limited increases from many private health funds.
• Over the past 35 years, rebate increases have fallen well below inflation, reducing their real value.
• Some health funds cap rebatesand reduce them further if the “known gap” threshold is exceeded.

Unfortunately, this information is often not well explained by insurers. To assist, we’ll provide a tailored anaesthetic fee estimate specific to your procedure and health fund. There’s no need to call us to arrange this—it will be sent automatically via text or email.

If you are dissatisfied with the amount your fund contributes for your care, we strongly encourage you to contact your fund.

We’ve compiled examples of typical rebates for common procedures to help you understand what to expect.

Download our Fee Examples PDF

Please refer to your personalised fee estimate for the most accurate information.

We recommend the following resources to help you better understand how anaesthetic billing works:

• Australian Society of Anaesthetists:

Billing information sheet

Download PDF

• Australian Medical Association(AMA):

Private Health Insurance Report Card – 2024
See page 20 for a visual comparison of fund rebates

View Report Card

Yes, and it’s simple.

• Call your new fund—they’ll handle the switch, including contacting your current fund.
• Any prepaid premiums will be refunded by your old insurer.
• You usually won’t need to re-serve waiting periodsif you maintain the same level of cover—check with your new fund to be sure.

Changing funds can be worthwhile if your current one doesn’t provide strong rebates for anaesthesia.

Not necessarily.

“Gold”, “Silver”, “Bronze” and “Basic” tiers refer to which procedures are covered—not how much your insurer will pay. Even with Gold cover, you may still need to pay a gap depending on:

• Your fund’s rebate policy for anaesthetics.
• The complexity of your procedure
• The anaesthetist’s fee.

Your estimate will clearly outline any expected gap.

Hospitals and health funds often refer only to hospital fees when they say “no out-of-pocket cost.”

However, doctor’s fees—including those from your anaesthetist—are set independently of both the hospital and the insurer. Your anaesthetic fee may involve a gap that’s not visible to the hospital or your fund.

Any fee or invoice you receive from Pacific Anaesthesia reflects:

• Our anaesthetist’s billing policy.
• The level of rebate provided by your insurer.
• The nature of your procedure.