How to have a gender-affirming hysterectomy in melbourne part 4: money
This is what my hysto cost without private health insurance, in rough order of payment. I’ll update this as Medicate rebates come in.
Initial consultation with surgeon: $200
Medicare rebate for initial consultation: $76.80
Anaesthetist: $990
Medicare rebate for anaesthetist: $250
Dr Cilly’s fee: $1600
Medicare rebate for Dr Cilly’s fee: $850
Hospital fee for the surgery: $2916
Hospital fee for the overnight stay: $1322
Post-operative drugs: $21 (with a healthcare card — $50 otherwise)
A mystery invoice from the hospital one month later: $680
Another mystery invoice 6 weeks later: $420 (this one was apparently a mistake, and I didn’t have to pay it!)
Total: $6552.20
Oh no! I was a big idiot! I was very naive about how private health worked. I didn’t have the right kind of private health insurance. I really didn’t understand the process correctly and didn’t know what questions to ask. If I’d had the right private health insurance plan and had gone to one of the insurance’s approved hospitals, I would have had to wait a year for my surgery, but saved about $5600. Do this if you can! It’s hard to be exact about numbers, because as far as I can tell surgeons and hospitals charge entirely based on whim, so what was true for me might not be true for you. Absolutely definitely go to the Medical Costs Finder and read through it thoroughly, it’s written very clearly there.
I decided to get privately surged without insurance for a few bad reasons:
1) The waiting list for public hystos is years long, especially for non-urgent cases
2) Past GPs refused to refer me to the public waiting list for a gender-affirming hysterectomy anyway
3) It was the height of the Covid Delta outbreak. News reports were saying that hospitals were going to be overwhelmed any second, and doctors on the radio were saying that healthcare would be hard to get for years to come
4) Since having organs is a pre-existing condition I would have had to serve a year’s waiting period for any private health insurance to kick in, and a year is a pretty long time
5) I was sick of waiting, sick of this tiny horny alien trying to claw its way of my body every month
6) I had the money in my savings
7) I’d been wanting to get it done for 15 years and was just so overjoyed it was finally a possibility
8) Finding the right insurance plan was really, really confusing (and I was already in a very confused headspace, doing a PhD during a pandemic)
9) I thought the money I paid before the surgery was the only money I’d have to pay
So, understandable, but also, quite dumb.
One thing I didn’t expect was how fragmented all the fees were. In the week leading up to the surgery, a whole bunch of nice but insistent randos called me up and demanded coin. The hospital, the anaesthetist’s office, the surgeon’s office, all shook me down. And then afterwards, the hospital and the surgeon sent me even more invoices. I paid for my surgery in little chunks of hundreds of dollars. One of these invoices was even sent out by mistake, and I’m glad I asked the surgeon about it. If you’re an evil person, find someone who’s about to have surgery, call them up on the phone, and tell them to give you a thousand dollars, they’ll probably do it.
Before this surgery I hadn’t had any experience with the health system besides getting my wisdom teeth removed as a gawky teen, going to the GP as a gawky adult, and enrolling in medical trials as a paid guinea pig. I was completely in the dark about how the private health system worked, and when people tried to explain it to me, I didn’t understand the jargon. Since then I’ve learnt quite a bit about PHI (as we experts call it), and I’m looking forward to helping others avoid the mess I found myself in.
