You might have heard of the Medicare Benefit Schedule (MBS). This is a list of the medical
procedures Medicare covers, as well as what they’ll pay towards treatment.
When you are admitted to hospital as a private patient, your specialist’s bills will be covered
up to the MBS fee. Medicare will cover 75% of the MBS fee, while we will cover the remaining
25%. An out-of-pocket expense occurs when there is a difference between your specialist’s fees
and the combined benefit provided from Medicare and HBF.
We have a number of arrangements in place with specialists that can help eliminate or reduce
these out-of-pocket expenses for you: