Australians paying more for hospital fees despite fewer visits
Gap payments are highest in the ACT.
The nationwide proportion of in-hospital medical services with no gap payments has dropped 3.5% over the last year.
According to the latest data from the Australian Prudential Regulation Authority (APRA), the proportion of services with no gap decreased from 88.4% in March 2015 to 85.9% in March 2016.
A medical gap is the out of pocket cost you pay for medical charges over what Medicare and your private health insurance cover.
Despite there being less gap-free services, average gap payments increased slightly.
The average gap payment across all services rose from $18.59 in March 2015 to $19.23 in March 2016.
|State||Services with no gap||Average gap|
across all services
when gap was paid
Average gap payments across all services was highest for those in the Australian Capital Territory, with patients approximately $60 out of pocket, more than 200% higher than the national figure.
Patients in the Northern Territory forked out an average of $34.72, followed by New South Wales at $25.96.
For non-GP services Medicare covers 85% of the Medicare Benefits Schedule (MBS) fee, the baseline price for medical services, as a rebate.
If you have private hospital cover and are admitted to hospital for a procedure, your doctor can choose to bill more than the Federal Government scheduled fee. This can result in out of pocket expenses not covered by Medicare or health insurers.