Out-of-pocket costs for medical scans soaring with worse to come, experts warn

Out-of-pocket costs for medical scans have become a significant burden for many Australians, with expenses reaching hundreds of dollars for a single visit. And radiologists are warning the situation is only going to get worse.

A decades-long freeze on Medicare rebate increases has led to out-of-pocket patient expenses for medical scans and images soaring to as much as $120 per visit, prompting many Australians in need to simply walk away from their medical treatment, the ABC is reporting.

Radiologist Dr Stephen Repse, spokesman for the Australian Diagnostic Imaging Association (ADIA), said the situation is only getting worse.

“Every day we see patients walk away because of the cost,” he said.

But he says clinics such as his are forced to charge a gap fee as the Medicare rebate for the procedures had been frozen for two decades, and was only lifted in 2020. Even then, the rebates had been indexed only at 0.9 per cent (in 2021) and 1.6 per cent (in 2022), which is well below what’s needed, Dr Repse said.

“It’s just not profitable,” he said.

“If clinics weren’t charging a gap, they would close their doors.”

It’s true that the federal government lifted the moratorium on Medicare rebate increases in this year’s federal budget, with health minister Mark Butler claiming his government had delivered the biggest increase to the rebate in 30 years.

“The one-off increase that we delivered in the budget to the Medicare rebate, which covers diagnostic imaging, it was bigger in this one year than was delivered by the former government in six or seven years,” he said at the time.

But Dr Repse says the increase is still not enough, despite how it compares to previous increases.

“The rent goes up, the overheads go up, the cost of the actual machinery goes up and already very high staffing costs go up,” he says.

“This money has to come from somewhere. And if the government doesn’t provide it, there’s just no option but to charge gaps.”

What can be done?

The issue is the level of rebate the government is willing to pay clinics, and only politicians have the power to increase the rebate.

For the consumer, the only option to avoid excessive gap fees is to shop around. The ABC report found gap fees can vary wildly for the same procedure between cities, and even between suburbs in the same city.

For example, they found gap fees quoted for a standard pregnancy ultrasound ranged from $170 up to $320, depending on the clinic.

Quotes for a lower-back CT scan ranged from being completely free (bulk-billed) right up to $195. For a basic ankle MRI, patients could pay between $300 and $350.

So, it pays to shop around to make sure you’re getting the best rate.

Have you had any scans recently? How much were you charged? Let us know in the comments section below.

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