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How much does specialist charge?

OSHCstudents – Find out what costs might be involved in a specialist appointment, who will pay, and how much is covered by your private insurance.

While there are guidelines that give recommendations on how much a doctor could charge, such as the MBS and through the Australian Medical Association (AMA) , specialists can set the fee that they feel is reasonable for their services.

Depending on whether the service is provided before, during, or after a hospital admission, the service may be paid for by:

  • Private Health Insurance
  • Medicare
  • You
  • A mix of the above

When choosing your specialist, always remember to ask if they bulk bill or will participate in any medical gap scheme your insurer may have in place, as this may reduce the cost to you.

It’s important to try and ask any doctors and specialists involved in your treatment about any costs you may have to pay, and get it in writing where possible. This is called Informed Financial Consent and will help you avoid any unexpected costs.

The AMA have developed some handy resources on Informed Financial Consent, including downloadable templates that you can give to your specialists to fill out, and a list of questions you might want to ask, which you can access here.

Costs before your hospital treatment

Some of the costs you might encounter in lead up to a hospital admission could include:

  • The cost of your specialist consultation
  • Costs for tests before your admission. Your specialist may also order a range of different tests in diagnosing your condition, or in the lead up to a hospital admission

By law, private health insurance is only able to pay towards the costs of medical treatment during a hospital admission (also called ‘in-patient’ services). Medicare may cover some, or all, of the costs for treatment and tests outside of hospital (also called ‘outpatient’ services).

Costs of your in-hospital treatment

If you’re a public patient in a public hospital, then your costs will be covered by Medicare.

If you’re a private patient in public hospital, or a private patient in a private hospital, then you may have some portion of your costs covered by Medicare, some by your private health insurer and there may also be a gap that you need to pay.

Don’t forget to ask your specialist about this before you have your treatment, so you know what to expect.

How do I know what my private health insurance will cover?

Many health insurance funds have agreements with specialists that outline the maximum amount to charge for each treatment, which limits the amount you’re likely to be out of pocket. This is often called a Medical Gap Scheme.

When choosing your specialist, you can contact your health fund to check if that particular specialist has an arrangement, and if not, it might be worth finding out which specialists they do have arrangements with. You could then ask your GP to refer you to one of these specialists.

It’s important to remember that your specialist can choose whether to use a medical gap scheme on a case by case basis. Check with your specialist if they will for your treatment.

You are international students or foreigners arrive to Australia, or Australian citizens traveling abroad who are looking for OSHC, OVHC, travel insurance, please contact OSHCstudents Team at email: info@oshcstudents.com and our partners for further information and assistance.

OSHCstudents (source: Bupa)

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Baek Ah Yeon

I trust Allianz Care since it is one of the largest insurance companies in Australia, with the medical centres where I only have to pay for what is left from insurance support. (no need to claim later). Besides, those centres are located at the centre of the city, close to schools. Very convenient, right? Credits to Allianz Care for providing reliable medical centres for health check and treatments.

Baek Ah Yeon | University of Queensland

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I’ve been living with homestay family for 2 years. I’m now 19, I can move out but I don’t want to leave my host, who has become my family. It feels like I’ve met my second family. Thanks OSHCstudents for sending me to this homestay!

Ariella Pei | University of Canberra

Chatchawat Paton

I realised how important insurance was when I started living in Australia. There I switched to using Allianz Care instead of the previous service. Allianz Care is extraordinarily good in its consulting service and customer care. I’ve learned a lot about Australian health care, also I was consulted with mental issues and how to live a healthy lifestyle. I am very happy now.

Chatchawat Paton | Torrent University

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Having lived in Australia for 2 years, I’ve been reliant on AHM OSHC to pay for my health care, which supports me for other expenses. Last year, I sent my claim requests for several times and always received the claims within two days. Everything is easy, fast and simple.

Phuong Anh | Victoria University

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Thanks to Allianz Care, every time I claimed my medical receipts it processed much more quickly and easily than I expected. I was initially a bit concerned since Allianz Care is more expensive than other insurance companies, but now I can ensure that it is totally worth the money.

Xiaoyu Cheng | Monash University


My homestay was very comfortable and convenient. My host was really kind. He showed me where to shop, which buses to catch, where the nearest train station is, to get off at which station so that I wouldn’t be taken to another suburb. Travelling was easy since the place was close to public transports. It only took 30 minutes to get to my college, actually I could go anywhere easily!

Emma | Macquarie University

Jing Zhang

When told that I was going to live with an Italian family, I was pretty nervous and doubted whether or not they could speak English well as the local people? Yet it was no longer a problem when I saw them. They knew the problems of people who first came to Australia and always tried to help me. I learned so many things about both Australian and Italian culture and enjoyed tasty Italian meals every time. Awesome!

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