Care for Newborns Leads List of Most Expensive Claims

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Medibank Private has released the amounts of its ten most expensive hospital claims last year, with a combined cost of $2.76 million.

A single health insurance claim of almost half a million dollars for the care of a newborn baby leads the list. At $439,626 for the surgery and the long-term hospital accommodation required, the benefit paid for the procedure is 20% above Medibank Private’s previous highest claim.

In total, five of the ten largest health care benefit payments listed in the latest report are for neonatal care, including care for three extremely premature babies born between 24 and 28 weeks. According to Medibank Private Chief Executive Officer, Bruce Levy, this is unexpected but highlights the unpredictable nature of health.

“We all know health funds are expensive and, while this lists our greatest claims, it is indicative of the growing cost and just how expensive it can be.

“The individuals appearing on the list, or the parents in the case of the infants, probably never thought they would require hospital services to the extent these claims indicate. Fortunately Medibank is here to help them cover these alarming costs.

“While the top ten claims represent only a tiny proportion of the over $2 billion in benefit payments we pay each year, the number of high cost claims valued over $10,000 are growing rapidly.

“In 2009 we paid 44,164 claims over $10,000, an increase in 23 percent from 2008, a dramatic increase that is emblematic of growing costs in all areas of the Australian health system.

"These figures also illustrate the limits to self-insurance. With costs of $10,000 and above increasingly common, and health costs growing as fast as they are, people relying on self insurance are risking their financial and their physical health,” he said.

In financial year 2008-09 Medibank Private paid a total of $2.36 billion in hospital and medical benefits, an increase of 10% from the previous year. Medibank Private members were admitted 862,748 hospital admissions in the period.

National Chart Toppers 2010 - Procedure & Total Benefit List

1    Neonatal surgery and post-operative care:    $439,626
2    Neonatal surgery and post-operative care:    $350,420
3    Neonatal surgery and post-operative care:    $281,669
4    Neonatal surgery and post-operative care:    $277,289
5    Acute respiratory failure:    $269,972
6    Coronary artery bypass:     $246,869
7    Bowel surgery – rectal resection:     $241,052
8    Oesophagectomy with gastric reconstruction:    $240,500
9    Neonatal surgery and post-operative care:    $214,102
10    Bowel surgery - hemicolectomy:    $203,672

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James Connors
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