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GESA Supporting Patients’ Visibility of Out-of-Pocket Costs Through the DOH Medical Costs Finder

Thursday 10, Feb 2022

The Medical Costs Finder is an online tool designed to reduce ‘bill-shock’ for consumers from unexpected out-of-pocket medical expenses. The website (originally launched in 2019) provides typical out-of-pocket costs based on historic aggregated information for over 1,300 common in-hospital and out-of-hospital services. 

Over the last 12 months the Department of Health has worked to enhance the website to allow individual medical specialists to publish their practicing locations, estimate fees and private health insurer arrangements for a select number of the specialists’ high-volume services. This information will be accessible by consumers and GPs. 

The Medical Costs Finder is not a quoting tool. Consumers will gain a better understanding of what contributes to out of-pocket costs earlier in their healthcare journey as they will have information on insurer gap arrangements, Medicare contributions, specialist fees and resulting out-of-pocket costs.

A demonstration of the website is available here. Information about the tool at a glance is provided in the Medical Specialist FAQ's.

To ensure the website design is fit-for-purpose and appropriate medical services are included, the DOH consulted with representative medical specialists from the GESA. 
Through this collaboration, a total of seven services have been agreed for inclusion in the initial release of the website:

1.    110: Initial Consultant Physician Appointment
2.    116: Follow Up Consultant Physician Appointment
3.    132: Initial Appointment for Complex disorder
4.    133: Follow Up Appointment for complex disorder
5.    32222 – 32226, 32228, 32229: Colonoscopy
6.    32222 – 32226, 32228, 32229 + 30473: Colonoscopy and Gastroscopy
7.    30473: Gastroscopy

Your feedback opportunity:
If you provide any of the above services in a private setting, you are invited to participate in the Medical Costs Finder. A private beta will commence in March 2022, this is where the website will be open to only a small selection of participants to test and provide feedback on the website. The DOH is seeking participation from a range of specialties and is already taking registrations. The website is anticipated to go-live in the second quarter of 2022.  To participate in private beta, sign-up for the initial launch, or if you would like to know more about the website, please contact OOPTransparency@health.gov.au.