Medibank and MUH No-Gap Joint Replacement Program

Medibank and MUH have launched a No-Gap Joint Replacement Program providing eligible members with no out-of-pocket costs for hip and knee replacement surgery (an excess may apply depending on your level of cover and if you are claiming for the first time in a calendar year).

The program includes the following:

• Post-surgery consultations with your surgeon after your hip or knee replacement surgery during the program.
• Assessment at our Pre-admission Clinic and Optimised Recovery Clinic.
• Joint replacement surgery with a participating surgeon, including your Medicare listed prosthesis (artificial joint).
• Anaesthetist costs.
• Assistant surgeon costs.
• Hospital accommodation and theatre costs (including Medicare listed prostheses only).
• Diagnostic tests (scans and blood tests) whilst admitted and for pre-admission bloods taken at Douglass Hanly Moir Pathology at Macquarie University Clinic or scans conducted at Macquarie Medical Imaging located within Macquarie University Hospital. The diagnostic tests must be on a referral from a participating surgeon and you must be participating in the No-Gap Joint Replacement Program.
• Your participating surgeon will work with you to decide if you need rehabilitation and if so what rehabilitation is right for you.

The No-Gap Joint Replacement Program is available to members who have held residents hospital cover, including hip and knee replacements for 12 months and once the participating orthopaedic surgeon and the hospital accepts the member into the program. The program is available for hip and knee replacements only.

Eligible members must be accepted into the program in line with clinical criteria by a participating orthopaedic surgeon and Macquarie University Hospital. Availability is subject to the individual participating surgeon's capacity and early bookings are encouraged.

If you are a Medibank member, find out if you are eligible for the program by calling 1300 733 338 or email health.programs@medibank.com.au

Please note AHM members are not eligible for the program.  If you are an AHM member, please call Medibank to find out more. Conditions apply.

Some of the common hip and knee procedures include:

• Total Knee Replacement (49518)
• Total Hip Replacement (49318)
• Revision Knee Replacement (49533)
• Revision Hip Replacement (49380)
• ACL Reconstruction (49542).

There are other procedures available in this program. Call us on +61 (2) 9812 3333 to find out more.

Yes, you can choose one of our participating surgeons. The participating surgeons in the program are:

• Professor Munjed Al Muderis
• Dr Razvan Stoita
• Dr Tim O’Carrigan
• Dr Mustafa Alttahir
• Associate Professor Sam Adie
• Dr Michael Dan
• Dr Nick Hartnell
• Dr Bernard Zicat
• Dr Sunny Randhawa
• Dr Rishi Narasimhan
• Dr Min-Jae Lee
• Dr Ruy da Assunção
• Associate Professor Sameer Viswanathan

The Medibank and MUH No-Gap Joint Replacement Program covers hip and knee replacements only. You will need to be eligible for the No-Gap Joint Replacement Program and obtain a referral from your GP to a participating orthopaedic surgeon. You will need to contact the surgeon's rooms to book an appointment.

The consultations with your participating orthopaedic surgeon prior to admission are not included. Your post surgical consultations with your surgeon during the program are included, however, associated costs are not.

Costs associated with your hip or knee replacement surgery with a participating surgeon during your admission (including Medicare listed prostheses only) and post-surgery rehabilitation are included in this program.

Medical costs and other costs for unrelated conditions/procedures (for example, diabetes and cardiac conditions) are not covered by the No-Gap Joint Replacement Program and additional costs may apply. You may need to pay your Medibank private health insurance excess (depending on your level of cover
and if you are claiming for the first time in a calendar year).

If there are complications during your hospital admission that require additional care or services beyond what is included in the  No-Gap Joint Replacement Program there may be additional costs.

Please speak to your participating orthopaedic surgeon about the risks that may be associated with your chosen surgery.

Your participating orthopaedic surgeon should also make you aware of and obtain your Informed Financial Consent for any additional costs.

Assessment at Macquarie University Hospital's Pre-admission Clinic and our Optimised Recovery Clinic are included. Rehabilitative services are included under the program.

• Outpatient diagnostic costs (such as scans and blood tests) are not covered.
• Your participating surgeon will work with you to decide if you need rehabilitation after your surgery and if so, what type of rehabilitation is right for you.
• If clinically appropriate, your surgeon may refer you to Medibank@Home who can deliver rehabilitation in the comfort of your home.
• If rehabilitation care in an in-patient setting is required, your hospital accommodation at a Members Choice Hospital will be covered with no out of-pocket costs. There may be costs associated if you are treated by a Rehabilitation Physician or require diagnostic tests, however the doctor will need to provide you with Informed Financial Consent.
• If you elect to receive rehabilitation services other than Medibank@Home or a Members Choice hospital, out-patient costs may apply.