Medibank pays $574,710 for a single claim

Posted: 16 May 2018 6:22 am
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Top 10 claims from 2017 highlight the importance of having private health insurance.

A pair of new glasses here, a dental treatment there. That's what most Aussies think about when it comes to claiming on their private health insurance. But what about the real reason you have health insurance? The cover for the big stuff: hospital costs. Well, Medibank have released its list of the top 10 most expensive claims of 2017 and boy howdy there were some big 'uns.

Medibank paid $574,710 for a single claim for a member who was treated for tricuspid insufficiency, a type of heart disease. This was more than $235,000 more than the top claim in 2016, which was for a tracheostomy and cost $339,273.

Continuing down the list a claim for neonatal came in second with a benefit of $445,326, followed by a claim for malignant neoplasm (cancer), rounding out the top three at $373,269. Out of the top 10, neonatal admissions accounted for three claims, which is half as many as it did in 2016.

Primary diagnosisPatient ageStateBenefits paid for single claim
Tricuspid insufficiency (heart related)40NSW$574,710
Malignant Neoplasm (cancer)35VIC$373,269
Intestinal Obstruction (bowel surgery)45QLD$307,619
Gastrojejunal ulcer (stomach ulcer)78QLD$276,367
Disorder of pituitary gland (brain surgery)75NSW$252,903
Rupture of papillary muscle (heart related)63NT$252,490
Acute pancreatitis (Pancreatitis)57NSW$251,276

Compared to 2016, the top claim was substantially more expensive. Overall the average cost of a procedure in the top 10 did not differ all that much, $327,624 in 2016 versus $339,676 in 2017.

These exorbitant costs go to highlight the importance of private health insurance says Medibank chief medical officer Dr Linda Swan.

“No one expects that their healthcare might cost this much. This is why private health insurance is important, it gives customers peace of mind that they will be supported for the unexpected,” said Dr Swan said in a statement.

Make sure you're protected against the high cost of hospital bills. Compare your health insurance options online today by using the comparison tool below or find out how you can benefit from taking out a top hospital policy.

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