The cost of doctors' visits, tests and treatments can be confusing, and some costs can be high. Together with things like parking, these expenses can add up.
Make sure you ask what you will have to pay. You may be able to get help with some costs.
What you need to know
Medical service costs
There are a number of medical services you may have to pay for, such as doctors' visits, tests and treatments.
Costs can vary depending on:
- whether you are seen as a public or private patient
- which doctors or other health professionals you see
- where you have tests or are treated
- whether you are an inpatient or an outpatient.
The amount you pay for medications (drugs) can vary a lot. The main reason is whether or not the drug is covered by the Pharmaceutical Benefits Scheme (PBS).
- When a drug is covered by the PBS, The government pays most of the cost. The person having the drug pays a small amount called a co-payment,
- When a drug is not covered by the PBS, the person having it pays the whole cost. This is why the cost of some drugs can be very high.
Other reasons for cost differences include:
- whether you are being treated as an inpatient or outpatient
- the pharmacy your drug comes from (including hospital or private pharmacies)
- whether the drug is given as part of a clinical trial, or has been specially requested from the drug company by your doctor (compassionate access).
Hidden costs of cancer
Apart from medical expenses there are other costs that can add up when you have cancer. These are sometimes called the hidden costs of cancer.
Non-medical costs may include:
- transport to and from the hospital
- parking costs
- accommodation if you need to travel away from home for treatment
- having less income due to taking time off work
- other people taking time off work to help you
- childcare and house keeping costs
- health aids, such as specialised clothing, mobility devices or diet supplements
- other health services like physiotherapy, counselling, etc.
- complementary therapies
- home modifications, community care or support program costs.
What to ask or talk about
Asking about costs
Before you have any doctors' visits, tests or treatments, it is important to ask about the costs
Ask what the fees will be and how much you will get back from Medicare or your private health fund. You will have to pay any remaining costs (the gap payment).
When you talk to your doctor about treatment options, ask what each option will cost and the total amount you will need to pay.
Most treatments are available in both the public and private systems but the costs can be very different. Ask what your treatment will cost in each system.
Help with medical costs
The government has a number of schemes that can help people with medical costs.
This is when your doctor accepts the amount Medicare pays as full payment for your visit, and you do not have to pay anything. Not all doctors offer bulk billing. Some tests can also be bulk billed, so ask your doctor about this when they are ordering tests.
Medicare Safety Net
This helps people or families who have a lot of medical expenses. Medicare keeps track of the amounts you have paid for services, e.g. doctors' visits or tests.When these out-of-pocket costs reach a certain amount, Medicare pays a higher benefit for any more services you have that year.
PBS Safety Net
This helps people or families who pay a lot for prescription drugs (medications). Once you have spent a certain amount on your medications in a year, you can get your prescriptions at a lower cost for the rest of the year.
The PBS does not keep track of your expenses unless you go to the same pharmacy for the whole year. If you go to different pharmacies, you need to keep track of your own prescription expenses. Pharmacies can help you with this by giving you a Safety Net sticker or a computer print-out. Ask your pharmacist what to do.
Help with other costs
For general advice:
- Ask to see a social worker at the hospital or treatment centre.
- Contact Centrelink
- you may be entitled to sickness benefits or other payments like Mobility Allowance
- your carer may be entitled to Carer’s Allowance.
- Talk to the Cancer Council about assistance with financial hardship due to cancer.
For help with transport and parking:
- You may be entitled to a Mobility Parking Scheme permit, which allows you to get some parking free or at a reduced cost.
- There are some charities that provide volunteer transport. Ask your social worker or contact the Cancer Council.
- If you live in a rural or remote area you may be entitled to financial help from the NSW Government Isolated Patients Travel and Accommodation Assistance Scheme (IPTAAS).
- Some hospitals have special parking arrangements for people who need regular treatment, such as radiotherapy.