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同问,
我的医生在bupa网站上查出来是:
No Gap may apply. Over 90% of claims。 这样报销比较多吗?
打算去私立生,我买的是最基本的保险,bupa的回复很官方:
When you are admitted to hospital or day surgery, your costs are split into two separate parts: your hospital costs and your medical costs. It's important to understand the difference between the two, as they are billed separately.
Hospital Costs
If you choose to be treated in a private hospital as a private patient, Bupa will pay minimum shared room benefits as defined by the Australian Government, and you will have your choice of doctor. These benefits will not be adequate to cover all of the hospital expenses, and this will likely result in large out-of-pocket expenses.
Alternatively, if you are treated in a public hospital as a private patient, we will still pay minimum shared room benefits. If these benefits are less than the public hospital charges, you will have out-of-pocket expenses to pay. However, these are likely to be significantly less than what you would need to pay if you visit a private hospital.
I recommend asking your chosen hospital for Informed Financial Consent so you will know what your out-of-pocket expenses will be.
Medical Costs
We recommend asking the doctors involved in your procedure, such as your treating specialist and anaesthetist, for Informed Financial Consent prior to your procedure. We cover 100% of the Medicare Benefit Schedule (MBS) set by the Australian Government for all inpatient doctors' bills. If your doctor charges more than the MBS fee, there will be an out-of-pocket expense (also known as a 'gap amount' or 'medical gap'), which you'll have to pay. Your Informed Financial Consent will outline any gap amounts.
Your doctor may choose to participate in our Medical Gap Scheme. This is a network of doctors who may choose to charge No Gap, or a Known Gap not exceeding $500. Doctors participating in this scheme will bill us directly. You can access a list of these doctors on our Find a Healthcare Provider tool.
请问有经验的各位,现在有必要把保险升级吗?
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