Out-of-pocket medical costs are ‘stacking one on top of the other’: Is your specialist bill creeping toward $300?
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The rising cost of healthcare is placing increasing pressure on patients across Australia.
A growing gap between government rebates and specialist fees is forcing many to reconsider essential medical appointments.
This widening disparity reveals challenges that go beyond mere numbers, affecting access to crucial care.
The expense of seeing a dermatologist for the first time had nearly reached $300 on average, according to newly released data—a figure revealing a wider issue with Medicare rebates lagging behind rising specialist fees.
Cleanbill, an online healthcare directory originally focused on tracking bulk-billing rates among GPs, expanded its research to examine the out-of-pocket costs for specialist visits, starting with dermatology.
Their report showed that back in March 2017, the Medicare rebate for an initial dermatologist appointment was $72.75, while patients paid on average $148.73 out of pocket. By March 2025, although the rebate had only increased modestly by $11.40 to $84.15, the out-of-pocket cost had soared by $61.45 to $210.18.
Over the past eight years, these upfront costs for initial consultations had jumped more than 40 per cent, with follow-up visits climbing over 55 per cent—while rebates rose by less than 16 per cent.
Patients Bearing the Full Brunt of Costs
Cleanbill’s chief executive, James Gillespie, pointed out that private health insurance offered little relief for these expenses, as it mainly covered private hospital treatment and non-Medicare subsidised services such as physiotherapy or dental work—but not specialist or GP consultations outside hospital settings.
‘These out-of-pocket costs far exceed the increases that we’ve seen to the Medicare rebate,’ Gillespie said. This growing gap had real consequences, with the number of Australians delaying specialist care due to cost swelling from 176,000 in 2016-17 to 900,000 in 2023-24, based on Australian Bureau of Statistics data cited in the report.
While public outpatient clinics offered free specialist services, access was often limited by referrals, waitlists, and clinic-specific procedures. Each specialist appointment required a GP referral to claim Medicare rebates, meaning patients often faced multiple out-of-pocket expenses: ‘stacking one on top of the other,’ Gillespie explained. He also suggested similar price hikes were likely occurring across other specialist areas beyond dermatology.
The Impact on Those with Chronic Conditions and Policy Challenges
A study published in May in Health Policy revealed that about a third of people living with chronic diseases avoided specialist appointments due to cost barriers. Lead author Assoc Prof Jane Desborough said that while GPs were under consistent pressure to bulk-bill, there was ‘no similar conversation about non-GP specialists who are also trained in the public system, who are also remunerated through Medicare…yet from the evidence, it seems quite uncommon for them to bulk-bill’.
Patients juggling multiple chronic conditions often needed to see various specialists, choosing whom to consult based on ‘what’s hurting most at the time’, Desborough noted. Many found themselves sacrificing other parts of life — like social activities and family events — to afford healthcare, a situation ‘not in the spirit of Medicare’, she said.
Health economics expert Prof Yuting Zhang explained that specialist fees had risen sharply while the Medicare schedule fee remained ‘quite flat’ for around 20 years, leaving patients to cover the growing gap. She also highlighted the wide variation in fees within specialties, with some charges reaching about $1,200. ‘More expensive doesn’t really mean better,’ Zhang added.
The health minister, Mark Butler, called on the private health sector, including insurers and specialists, to ‘do more to protect patients for exorbitant bills’. Zhang suggested medical colleges could enforce fee guidelines and increase scrutiny on members charging excessive fees. The government might also consider expanding public clinics to offer free specialist care for those unable to pay gap fees in private settings.
Rising medical bills aren’t just numbers—they affect real lives and real budgets, especially for seniors navigating the healthcare system.
If you want to understand more about how private hospital cover can impact your out-of-pocket costs, this video breaks it down clearly and simply.
Take a moment to watch it—you might find some surprises that could help you plan better for your next medical visit.
Source: Youtube/Sky News Australia
With healthcare costs continuing to rise, how have you managed your specialist appointments lately? Share your experiences in the comments below.
A growing gap between government rebates and specialist fees is forcing many to reconsider essential medical appointments.
This widening disparity reveals challenges that go beyond mere numbers, affecting access to crucial care.
The expense of seeing a dermatologist for the first time had nearly reached $300 on average, according to newly released data—a figure revealing a wider issue with Medicare rebates lagging behind rising specialist fees.
Cleanbill, an online healthcare directory originally focused on tracking bulk-billing rates among GPs, expanded its research to examine the out-of-pocket costs for specialist visits, starting with dermatology.
Their report showed that back in March 2017, the Medicare rebate for an initial dermatologist appointment was $72.75, while patients paid on average $148.73 out of pocket. By March 2025, although the rebate had only increased modestly by $11.40 to $84.15, the out-of-pocket cost had soared by $61.45 to $210.18.
Out-of-pocket dermatologist costs near $300 average. Image source: Pexels/Tima Miroshnichenko
Over the past eight years, these upfront costs for initial consultations had jumped more than 40 per cent, with follow-up visits climbing over 55 per cent—while rebates rose by less than 16 per cent.
Patients Bearing the Full Brunt of Costs
Cleanbill’s chief executive, James Gillespie, pointed out that private health insurance offered little relief for these expenses, as it mainly covered private hospital treatment and non-Medicare subsidised services such as physiotherapy or dental work—but not specialist or GP consultations outside hospital settings.
‘These out-of-pocket costs far exceed the increases that we’ve seen to the Medicare rebate,’ Gillespie said. This growing gap had real consequences, with the number of Australians delaying specialist care due to cost swelling from 176,000 in 2016-17 to 900,000 in 2023-24, based on Australian Bureau of Statistics data cited in the report.
While public outpatient clinics offered free specialist services, access was often limited by referrals, waitlists, and clinic-specific procedures. Each specialist appointment required a GP referral to claim Medicare rebates, meaning patients often faced multiple out-of-pocket expenses: ‘stacking one on top of the other,’ Gillespie explained. He also suggested similar price hikes were likely occurring across other specialist areas beyond dermatology.
The Impact on Those with Chronic Conditions and Policy Challenges
A study published in May in Health Policy revealed that about a third of people living with chronic diseases avoided specialist appointments due to cost barriers. Lead author Assoc Prof Jane Desborough said that while GPs were under consistent pressure to bulk-bill, there was ‘no similar conversation about non-GP specialists who are also trained in the public system, who are also remunerated through Medicare…yet from the evidence, it seems quite uncommon for them to bulk-bill’.
Patients juggling multiple chronic conditions often needed to see various specialists, choosing whom to consult based on ‘what’s hurting most at the time’, Desborough noted. Many found themselves sacrificing other parts of life — like social activities and family events — to afford healthcare, a situation ‘not in the spirit of Medicare’, she said.
Health economics expert Prof Yuting Zhang explained that specialist fees had risen sharply while the Medicare schedule fee remained ‘quite flat’ for around 20 years, leaving patients to cover the growing gap. She also highlighted the wide variation in fees within specialties, with some charges reaching about $1,200. ‘More expensive doesn’t really mean better,’ Zhang added.
The health minister, Mark Butler, called on the private health sector, including insurers and specialists, to ‘do more to protect patients for exorbitant bills’. Zhang suggested medical colleges could enforce fee guidelines and increase scrutiny on members charging excessive fees. The government might also consider expanding public clinics to offer free specialist care for those unable to pay gap fees in private settings.
Rising medical bills aren’t just numbers—they affect real lives and real budgets, especially for seniors navigating the healthcare system.
If you want to understand more about how private hospital cover can impact your out-of-pocket costs, this video breaks it down clearly and simply.
Take a moment to watch it—you might find some surprises that could help you plan better for your next medical visit.
Source: Youtube/Sky News Australia
With healthcare costs continuing to rise, how have you managed your specialist appointments lately? Share your experiences in the comments below.
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