nib partners with orthopaedic surgeons on out-of-pocket costs

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nib has announced it will partner with orthopaedic surgeons to guarantee no out-of-pocket costs.

It said its members are also being provided with increased treatment choice, including access to post-surgery rehabilitation at home.

The insurer said its 'Clinical Partners' program involves select orthopaedic surgeons and their entire surgical team. It said they have committed to performing hip and knee joint replacement surgery for nib members with no out-of-pocket expenses above their hospital excess.

With consent from the surgeon, nib members can also choose to recover from the comfort of their home with visits from a dedicated physiotherapist as well as the inclusion of a rehabilitation plan and personalised support from a nib program coordinator.

According to nib managing director, Mark Fitzgibbon, the partnership reflects nib’s ongoing commitment to improving the member experience and reducing the uncertainty around surgery costs that members too often experience.

“We know affordability and out-of-pocket costs are without a doubt the two major pain points for our members.

"Unexpected costs are a major reason why members drop or downgrade their private health cover and the discrepancy in costs for the same surgery can differ by thousands of dollars,” said Mr Fitzgibbon.

“In addition, recent studies suggest patients who go home after a knee replacement surgery do just as well as those who stay in hospital. Through our Clinical Partners program, we’re able to provide our members end-to-end protection, meaning all they need to do is focus on what’s most important, their better health,” he added.

nib said to date, over 280 members have either enrolled, are undergoing or have completed surgery as part of the program. It said it is is looking to expand the program to include additional surgical disciplines and locations across Australia.

"Based on nib claims data for calendar year 2018, medical specialist fees for hip replacements ranged from $1,318 to $10,000. In some cases, this meant members had an out of pocket cost of almost $8,700," it added.