Endometriosis - Out of pocket Surgeon Fees

Hi

I'm new to the forum and was wondering if people could tell me a bit about their experiences with doctor's fees for endometriosis surgery.

I had surgery earlier this year to remove a very large cyst in one of my ovaries. Its a bit of a long story but to cut it short I think my out-of-pocket expenses for the surgeons/doctors services alone (not including hospital ward and theatre fees, just the doctors fee) with private health insurance, were a lot higher than expected; essentially I feel both my health fund and I payed a significant amount in doctors fees (I can provide more details if anyone is interested).

So I would like to know from as many people as possible, what the typical out-of-pocket expense for JUST the doctor (excluding hospital etc.) performing laparoscopic surgery with a private health insurance has been? I think my procedure was a fairly complicated one (Level 4/5 Endometriosis) and if it is of any relevance, the procedure performed had the Medical Schedule Item Number 35641. It also now appears that I may possibly need additional surgeries because the cysts are still there after the surgery, so it would be really helpful if I could ascertain the costs that I can expect in the future.

Thanks in advance for your input :)

BellyGirl

BG

I had two major ops at the beginning of the year for removal of endo level 4/5 from my bladder, first op and second op right ovary and bowel. I think my surgeon, (head gyno only) charged approx 7000, but he actually gave me 50 percent off as i am a nurse. Then the second op he schedule fee charged me (got all back from medicare and medibank private). The second op i had to pay 3700 to the Colorectal surgeon for surgery on my bowel, and approx 900 to the anaethetist. The reason why these guys charge so much, is due to their insurance. They charge way above the gap, as i think there insurance premiums are up in the 50 000 - 100 000 dollar mark per year. The surgery is so refined and intricate these days, they have to charge these astronumical amounts. This particular surgeon was through 'ECCA' in sydney, and they are renowned for charging like wounded bulls, but have the reputation as some of the best in the country/world for treatment of severe endo. I would of morgaged my house if needed, as the pain relief i now have, and the difference in lifestyle/sick days is unbelieveale. If someone said i would have so much relief i would never of believed them...

Regards

leis x

Thanks for the response firemansgirl, it helps put my costs in better perspective =)

So for your first op you were about 3 grand out-of-pocket for the surgeons fees, health insurance and medicare didn't cover this amount? So your health insurance did not have a 'no-gap' or 'known-gap' agreement with the surgeon you used?

Thanks again for your advice!

Yep i think that is right mate, i think it was about 2500 or 3 grand out of pocket for number one.. alot, but worth every cent... leis

You're definitely right, I agree with you that it'll always be worth paying for when it's your health

I guess with my situation I was also concerned about how it was unclear for awhile how much the surgery would cost? Were the exact costs for the medical services explained and described to you clearly early on?

Yes, my surgeon Michael Cooper, sends a 2 page letter outlining his prices, and why they are so far above the schedule fee/gap. He also mentioned the price when it was decided that i was going to have surgery, then when he asked what my profession was, (for recovery time and return to work) and i told him i was a nurse, then he said, no worries i can give you a 1/2 price LOL!! The other surgeon in the second op, the colo rectal surgeon, i knew he was going to be around 3500 as my friend had the same procedure and she told me he was also $$$.... However, you can always phone and ask their secretaries as they will always explain costs to you.

Leis x

i just rang Dr Cooper's secretary but they won't give you a quote until you've been in to see him.

I had dr cooper and I had leve 4/5 endometriosis it cost me around $8K all up! and with top cover MBF and medicare I only got back around $2K if that.

Thanks for posting that info- that's helped me a lot. I was quoted $7000 for Dr Krishnan. Or, I could wait to have it done elsewhere for less= which is what I'll probably do. I also rang Dr Abbott and left a message but haven't heard back and it's been over a week.