Brief overview of changes to government approved surgically implanted prostheses

Latrobe Health Services currently pays 100% of the charges for prostheses for in-patient hospital related treatment.

As from 31 October 2005, Commonwealth legislative changes will mean a limited number of prostheses will attract a "gap" which members will be required to pay.  

Members can be assured that for all medical procedures listed on the Medicare schedule that require a prosthesis a clinically equivalent no gap prosthesis will available that does not incur a member gap.

The intention of the legislation is to reduce the rate at which the cost of prostheses is growing each year.

Before you undergo any in-patient hospital treatment which will require the use of one or more prostheses, ask your doctor whether the prostheses he/she intends to use will attract a gap. You should also ask your doctor whether there are other prostheses available which do not attract a gap and discuss the reasons for your doctor's choice.

Please contact Latrobe on 1300 362 144 with the prostheses code(s) to confirm whether you will need to pay a gap and to confirm the cost of the gap. For more detailed information please refer to the "Overview Of Prosthesis Changes" section or the "Fact Sheet" on this website