Does Dr Seeto participate in Known Gap?
Yes Dr Seeto participates in the Known Gap scheme if it is offered by your health fund. This, however, is determined by the complexity of your case as well as the complexity of the surgery required.
Fees
What is a “Gap”?
A gap is the difference between what Dr Seeto charges and what you get back from both Medicare and your private health fund if you are privately insured.
What is a
“No Gap” scheme?
What is a “No Gap” scheme?
Where gap costs fall
This page covers the financial side of any consultation or procedure.
Some private health insurance funds offer a no Gap scheme for surgical treatments. This is where the private health fund sets the fee for the particular surgery and there is no out of pocket cost to the patient.
Informed consent not only includes discussion about your orthopaedic condition, the treatment options available and the risks and benefits of these options. It also includes financial consent, which are the costs associated with different treatments available.
What is Dr Seeto’s Normal Consultation Fee with a Gap?
| Initial charge | Medicare refund | Out of pocket costs | ||
|---|---|---|---|---|
| Initial consultation | Other type of patient | $300 | approx. $80 | approx. $220 |
| Disability pension/aged pension cardlholder | $240 | - | $240 | |
| Subsequent consultations | Other type of patient | $180 | approx. $40 | approx. $140 |
| Disability pension/aged pension cardlholder | $150 | - | $150 | |
What is “known Gap”?
Known Gap is where the surgeon charges a known fee above the level that is set by the private health fund. This is the fee which the patient will pay. Depending the health insurance company, the gap is usually $400 to $500 for Dr Seeto’s fee.
Not all insurance companies offer the “known Gap” scheme.
Does Dr Seeto participate in No Gap?
Unless there are extenuating circumstances, Dr Seeto does not participate in the No Gap scheme.
Is the “known Gap” different for different operations?
No, the known Gap is the same for different operations.
The known Gap however is different between different insurance companies.
What if I do not have private health insurance?
Dr Seeto looks after all patients irrespective of health insurance. The options available to you if you have no private health insurance are:
Surgery in the public hospital
There is no cost- There is a waiting list which can be 6-9 months
- Dr. Seeto trainees may assist or perform parts of your surgery under his supervision
- Your after surgery care will be in the public hospital clinic
Surgery in the private hospital
- Surgery costs vary based on the procedure, equipment/implants needed, and hospital stay duration
- The waiting time is usually weeks as opposed to months
- Dr Seeto performs all the surgery himself
- Your after surgery care is in Dr Seeto’s office
Do you need a
Knee replacement?
Dr Seeto in affiliation with Medibank Private and East Sydney Private hospital, offers a program for eligible Medibank Private Members, to eliminate medical out of pocket costs for your Knee Replacement.
The program includes a pre-surgery preparation program, spending the minimal time necessary in hospital, as well as home rehabilitation if necessary.
Book a consultation
today
Patient Info
Practice Opening Hours
Monday to Friday
9:00 am - 4:30 pm
9:00 am - 4:30 pm
Address
Suite 209, 203-233 New South Head Road Edgecliff NSW 2027