New data has revealed Medibank paid $574,710 on a single claim last year with heart-related procedures accounting for two of its costliest claims in 2016-17.
The health fund paid out $3.4 million for its top 10 hospital claims, with the patients requiring more than 1,200 days in a hospital, or just under three and a half years.
Neonatal admissions accounted for three claims in the top 10. A neonatal procedure refers to the admission of a child within the first 28 days of their life.
The average cost of having a baby has increased from $6,738 to $7,969 over the past five years. Yet the most expensive neonatal claim for the year was $445,000.
The three top neonatal claims saw a benefit of over $1.1 million paid on behalf of customers.
Medibank chief medical officer Dr Linda Swan said while these procedures were Medibank’s most costly for the year they are examples of why insurance is important.
“The top 10 claims that Medibank paid for customers represent complex treatment. We were able to support these patients during a very stressful time in their lives, to get the care they needed,” said Dr Swan.
“These patients would generally have complicated conditions keeping them in hospital and many would have required time in an intensive care unit as part of their treatment.
“We want our customers to understand their health insurance, make the most of it and have a great experience with us. We want them to be able to make informed choices about their healthcare.”
“No one expects that their healthcare might cost this much. This is why private health insurance is important, it gives customers peace of mind that they will be supported for the unexpected,” added Dr Swan.