For all appointments and enquiries (02) 9587 4720
PATIENT INFORMATION
CONDITIONS TREATED AND SURGICAL PROCEDURES
HCF No-Gap Hip & Knee Surgery with Prof Sam Adie
If you're an Medibank member considering hip or knee replacement surgery, understanding your cover is a key step. Prof Sam Adie is a participating provider with Medibank, offering no-gap arrangements for eligible patients through a No-Gap Joint Replacement Program. This can help significantly reduce or eliminate your out-of-pocket surgical fees.
What Does Medibank No-Gap Mean for You?
For eligible Medibank members accepted into the program, the no-gap arrangement can cover the following costs associated with any hip or knee replacement procedure, including primary and revision procedures:
- Surgery with Prof Sam Adie, including your prosthesis (artificial joint)
- Anaesthetist costs
- Assistant surgeon costs
- Hospital accommodation and theatre costs
- Pre-admission clinic and optimised recovery clinic assessments
- Diagnostic tests (scans and blood tests) taken during your admission or as pre-admission tests at approved pathology and imaging providers
- Post-surgery physiotherapy services, either in your home or at an outpatient clinic
- Post-surgery consultations with Prof Adie during the program
Key Benefits for HCF Members
- No Extra Bills
- Dedicated Support: Our experienced administrative team will verify your cover, handle paperwork, and guide you through the process.
- Multiple Locations: Consultations available at St George Private Hospital (Kogarah), Vitalis Medical Practice (Kirrawee), and North Ryde Medical Centre.
A no-gap arrangement means that Prof Adie and other members of his care team agree to accept the benefit paid by Medibank as full payment for surgical services, provided you have the appropriate level of cover. This can give you peace of mind about your costs before you proceed with surgery.
Am I Eligible for HCF No-Gap Surgery?
Eligibility for this program depends on several factors. To be considered, you generally need:
- To be accepted into the program by Prof Adie and the hospital based on clinical criteria – do you actually need to have surgery, or are other options more suitable for you?
- To have served all applicable waiting periods on your policy.
- The program covers most hip and knee replacement procedures, including primary and revision surgery.
Next Steps
- Call Prof Adie's rooms on (02) 9587 4720.
- Book a consultation with Prof Adie to discuss your condition and management options.
Frequently Asked Questions
Does Medibank cover hip and knee replacement surgery?
Yes, Medibank generally covers hip and knee replacement surgery under hospital and ancillary cover, provided the procedure is clinically necessary and you have the appropriate level of cover. Medibank can verify your specific policy details if you contact them.
What costs might I still need to pay?
While the no-gap program aims to cover the surgical fees and related services, you may still be responsible for your Medibank hospital excess (depending on your level of cover and if it's your first hospital stay in the calendar year). Medical costs for unrelated conditions or any complications requiring additional services beyond the program's scope may also incur extra charges. Informed Financial Consent will be provided for any additional costs.
Are there waiting periods for Medibank cover for hip and knee replacement surgery?
Yes. Waiting periods apply if you have recently taken out or upgraded your hospital cover. You generally need to have held joint replacement cover for 12 months. Contact your insurer to confirm whether you are currently eligible for hip or knee replacement surgery.
Can I use my Medibank cover at all of Prof Adie's consulting locations?
Yes. Consultations are available at our rooms in Kogarah, Kirrawee, and North Ryde. However, your surgery will be performed at an approved hospital where Prof Adie has operating privileges, as part of this specific no-gap program. Our team can confirm all details during your booking.
How do I find out if I'm eligible for the Medibank No-Gap Joint Replacement Program?
You can log into the Medibank app, call Medibank on 1300 509 576, or visit your local Medibank branch to confirm your cover details. If you need further help, our rooms staff can help check your eligibility.
For all appointments and enquiries please phone (02) 9587 4720 or email admin@drsamadie.com.au
Monday to Friday
9 am to 5 pm
FAX (02) 9587 6927
St George Private Hospital
Specialist Consulting Suites
Suite 201
Level 2, 131 Princes Hwy
(Entry from South St)
Kogarah NSW 2217
