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A health insurance giant has warned that a number of patients are being bled by specialists in out-of-pocket costs, as it introduces a new tool to lessen bill shock.
Medibank revealed that 13% of customer claims collected from 14,000 specialists over the past year had an out-of-pocket cost of less than $500, while 4% had a gap payment of more than $500. The data doesn’t include charges for out-of-hospital care.
“If you listen to the degree of consumer concern in the market, it does feel like there is a lot of out-of-pocket charges at a level that is causing our customers distress,” Linda Swan, Medibank chief medical officer, told The Australian.
Swan said affordability continues to be the upmost concern of Medibank customers, followed closely by out-of-pocket costs.
“It is a very big issue for us as a private industry to work out how we can improve the overall cost of private health insurance and… help minimise any out-of-pocket costs,” Swan told the publication.
To address the concerns, the health insurer is launching a new tool that reveal how often a specialist levies no out-of-pocket charges, an out-of-pocket of up to $500, or an out-of-pocket of more than $500 for a hospital admission. The data will be based on claims received by Medibank and not what is being charged in a doctor’s room, Swan said.
“We are hearing about customers being given two different bills,” Swan said. “One they pay directly to the doctor and one they pay to the health insurer. We are only getting part of the picture about total out-of-pocket costs.”
The Medibank data coincides with a recent quarterly report from the Australian Prudential Regulation Authority (APRA) that revealed a 3.3% increase in out-of-pocket payments for hospital episodes, The Australian reported.
