Understanding financial terms

Everyone deserves the opportunity to make informed decisions about their care.

This is why it’s important that you understand the key financial terms relating to your cancer treatment. Here’s a guide to some of the terms you may come across before and during your treatment:

Gap fee – Also known as an out-of-pocket expense. This refers to the amount of money that is owing between the cost of your cancer care and what Medicare and your private health insurance covers

Out-of-pocket costs – Expenses that are not covered by Medicare or your private health insurance

Self-funded treatment – The payment of treatment where private health insurance is required (e.g. chemotherapy treatment in a day hospital), without private health insurance coverage

Co-payment – If your private health insurance cover has a co-payment, this is the amount you agree to pay each day towards the cost of your hospital stay

Medicare Safety Net – The Medicare Safety Net is a threshold designed to help those who have incurred high medical costs, providing you a higher Medicare benefit back for out-of-hospital costs

Pharmaceutical Benefits Scheme (PBS) – The Pharmaceutical Benefits Scheme (PBS) subsidises the cost of medicine for most medical conditions, including certain chemotherapy drugs. The Scheme is available to all Australian residents who hold a current Medicare card

Medicare Benefits Schedule (MBS) – Medicare allows Australians to access an extensive range of health services at little or no cost. The Medicare Benefits Schedule (MBS) outlines the benefit amounts you are eligible to receive from Medicare

Pharmaceutical Safety Net – The Pharmaceutical Safety Net protects patients and their families who require a large amount of PBS or RPBS (Repatriation Pharmaceutical Benefits Schedule) items. If you ask your pharmacist, they will record your supply of PBS and RPBS items on prescription record forms. When you reach the Safety Net threshold within a calendar year, you will be eligible to receive free or discounted PBS or RPBS medications for the rest of that year

The content found on the Icon Cancer Centre website is intended solely for informational purposes and should not be considered as medical advice. It is not a substitute for consulting with a qualified medical professional. Our website is designed to provide information and support to the general public. Please be mindful that we do not dispense medical advice, and for personalised medical guidance, we strongly advise you to consult with a qualified medical professional or doctor.

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