How much does foot and ankle surgery cost in Melbourne?
If you have hospital cover with most major health funds, such as Bupa and HCF, your out-of-pocket fee for Dr Janan Chandrananth's surgery is approximately $500. That's because he participates in the known gap scheme with these funds for most operations. The anaesthetist, surgical assistant and hospital bill separately, and those costs are set out below.
What is a known gap?
Medicare sets a schedule fee for each operation, and your health fund pays a benefit on top of it. The schedule fee has not kept pace with the cost of providing surgery, so many surgeons charge more than the two rebates combined. The difference is your gap.
Under a known gap arrangement, the surgeon agrees with your fund to keep that gap to a set amount. You know the figure before surgery, and the account goes straight to your fund. However, in these situations, Dr Chandrananth's total fee is under the Australian Medical Association (AMA) recommended fee.
What you'll pay, bill by bill
Surgeon: approximately $500 with HCF, Bupa and Medibank Private. For other funds, such as GMHBA and Latrobe Health, the fee is calculated individually to match the major funds. Accounts go directly to your insurer, and you pay the gap 7 days before surgery.
Anaesthetist: a separate account. Anaesthetists usually charge a small gap and tell you the amount in advance.
Surgical assistant: most operations need one. They usually charge a small fee and tell you in advance.
Hospital: most hospital costs are covered by your hospital cover. You may pay an excess, depending on your policy.
Does my health insurance cover foot and ankle surgery?
Foot and ankle operations fall under the "Bone, joint and muscle" category of hospital cover. Gold and Silver policies include it. Bronze and Basic policies only include it if they are a "plus" product that adds it.
If you have recently taken out or upgraded your cover, a 12-month waiting period applies to pre-existing conditions. Ask your fund to confirm your policy covers the operation and what excess applies. We can give you the Medicare item numbers to quote.
What does a consultation cost?
Initial consultation: $300 ($230 for aged pensioners)
Review consultation: $210 ($150 for aged pensioners)
Medicare pays a rebate on part of this if you have a current referral from your GP. Private health insurance does not cover consultations in the rooms. Payment is due at the appointment by credit card, EFTPOS or cash; American Express and Diners Club are not accepted.
There is no out-of-pocket cost for DVA Gold Card holders or patients with a valid WorkCover or TAC claim.
What if I don't have private health insurance?
You can still see Dr Chandrananth in the rooms, with the Medicare rebate on the consultation. If surgery is recommended, you have two options:
Self-fund your surgery as a private patient, with a written quote covering the surgeon, anaesthetist, assistant, implants and hospital.
Ask your GP to refer you to a public hospital orthopaedic clinic. Public surgery has no charge, but waiting times are usually longer.
When will I know my exact costs?
If you're with one of the major funds in the known gap scheme, such as Bupa or HCF, you'll receive a written financial consent at your appointment if surgery is recommended. It sets out Dr Chandrananth's fee and your gap before you commit to anything. The anaesthetist and assistant confirm their own fees in advance.
A full quote takes longer if you're self-funding, or if your fund isn't part of that arrangement, such as GMHBA or Latrobe Health. We collect quotes from everyone involved in your surgery, then give you the total cost in writing before surgery is booked.
Our full fee schedule is on our patient fees page.
FAQs
Does private health insurance pay for the consultation?
No. Health funds can't pay for specialist consultations outside hospital. Medicare pays a rebate if you have a current GP referral.
Is there a gap for WorkCover, TAC or DVA patients?
No. Dr Chandrananth doesn't charge an out-of-pocket fee for DVA Gold Card holders or patients with a valid WorkCover or TAC claim.
When do I pay the surgical gap?
Seven days before your surgery. Consultation fees are paid on the day.
Is the $500 gap the same with every health fund?
It applies with most major health funds, including Bupa, HCF and Medibank Private. For GMHBA, Latrobe Health and some other funds, the fee is worked out individually to match.
Ready to discuss your treatment options?
Book a consultation and we'll go through your treatment options, then give you your costs in writing before any surgery.
