Female patient is charged $16,000 for life-saving surgery despite having private health insurance

A breast cancer patient has been forced to pay $16,000 for life-saving surgery, despite having private health insurance.

Madonna Buiter and her husband lost their home deposit savings after being slugged with repeated unexpected fees and charges throughout her treatment.

Ms Buiter and thousands of others are being hit with hefty medical bills due to laws which prevent private health insurance paying for costs incurred outside hospital.

Madonna Buiter (pictured) and her husband lost their home deposit savings after being slugged with repeated unexpected fees and charges throughout her treatment

The issue is known as bill creep, and occurs when patients are forced to undergo multiple consultations, accruing costs not covered by insurance.

‘They say, “Oh well, you should shop around and find a cheaper surgeon”,’ Ms Buiter told an investigation by Four Corners.

‘Well, that sounds great in theory, but on this side of my journey I can say now, when you’re given that diagnosis, you have breast cancer, you need surgery. I don’t know that that’s realistic or reasonable at that time.’

The mother-of-two said it was hard enough to keep up with the process seeing doctors and booking surgeries let along find out what the charges would be.  

Ms Buiter and thousands of others are being slugged with hefty medical bills due to laws preventing private health insurance from applying to out of hospital costs (stock image)

Ms Buiter and thousands of others are being slugged with hefty medical bills due to laws preventing private health insurance from applying to out of hospital costs (stock image)

Other patients told of paying illegal booking and administration fees, with one one needing to pay $6000. 

How to avoid out-of-pocket costs 

– Ask your GP about specialists’ fees

– Find a surgeon in a no gap scheme

– Question tests not covered by Medicare

– Query everything you don’t undestand

– Be honest about what you can’t afford

– Refuse to pay booking fees, administration fees or nursing fees

– Report such fees to your health fund

– Get a second opinion 

Surgeons can get higher insurance rebates for not charging gap fees, and some then charge ‘booking fees’ instead.

Stephen Duckett, director of health with the Gratton Institute blamed doctors for charging ‘outrageous’ amounts.

Doctors are able to charge what they like, Mr Duckett said, making it hard for health funds to set premiums.

The Four Corners investigation, which looked at the bills of 700 patients, found most did not blame surgeons.

Policy consultant Terry Barnes said private health insurers are often unfairly assumed to be to blame for out-of-pocket costs, even when the fault lies with surgeons.

In order to avoid out-of-pocket costs, patients should query any fees they don’t understand and be honest with surgeons about what they can afford. 

After talking about specialists’ fees with their GP, patients should then find a surgeon in a no gap scheme and refuse to pay any booking or administration fees. 

One  issue is known as bill creep, which occurs when patients are forced to undergo multiple consultations, accruing costs not covered by insurance(stock image)

One  issue is known as bill creep, which occurs when patients are forced to undergo multiple consultations, accruing costs not covered by insurance(stock image)



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