The cost of pacemakers and other cardiac devices

Written by Joshua Malin
Reviewed by Lana Hambilton
Last updated 21/11/2023

Costs and cover

What is the cost of pacemaker surgery?

Most healthcare providers consider pacemaker implantation to be a relatively minor surgery, and it’s usually priced as such. For patients privately insured for this procedure who were treated in a private hospital, around 50% had no out-of-pocket doctors fees for their pacemaker surgery.⁵ The typical out-of-pocket cost for the other 50% was only $50. While this doesn’t include hospital fees, which average around $17,000, most or all of your hospital costs can be covered by your health fund.

While the procedure cost is quite reasonable, there may be other costs that you need to consider, which will vary based on your circumstances and policy. For example:

• Excess. An excess is only paid when you claim on your private hospital insurance. You decide what amount this excess will be (or whether you’ll pay it at all) based on the options available when choosing your hospital insurance. For example, you might choose a $250 excess, which you will be required to pay if you make a claim. The higher your excess, the lower your premiums will usually be for the same policy, and vice versa.
• Co-payment. A co-payment is a charge you may have to pay every day of your stay in the hospital to your insurer, often up to a capped amount. For example, you may pay $50 each day you’re admitted as a private hospital patient.
• Miscellaneous costs. While we can’t predict what these might be, it’s important to consider the ancillary costs of undergoing such a procedure; e.g. parking, babysitting or loss of income if you need to take a few weeks off work.

Procedure and insurance costs only apply if you’re being treated as a private inpatient. If you’re treated as a public patient, Medicare will cover the total cost of your surgery. However, this will also mean:

• You must enter the public waiting list for this procedure, which is typically longer than the private system
• You cannot choose your doctors (e.g. cardiologist, anaesthetist)
• You would be unlikely to have a private room during your hospital stay

Should I take out private hospital insurance for pacemaker procedures?

The typical cost paid towards private patient pacemaker insertion surgery (which is typically paid by private health insurers, provided the patient has an appropriate level of cover) for accommodation, theatre and medical device fees is $17,000.⁵ Pacemaker costs for private patients may exceed what the fund pays and you may need to pay any gap and excess costs as well as incidentals (e.g. WiFi, Foxtel etc.), but that’s where those costs end.

Ultimately, it’s up to you whether you want to go public or private. However, it might be worth it if you’d like to choose your own doctor, recover in a private room (if available) and avoid the public system’s waiting lists. In short, with private health insurance, you can undertake the procedure on your terms.

If you’re trying to figure out which policies might suit your particular health needs, read our explanation of the different private hospital insurance categories. It will explain which tiers cover which services and can help you decide whether this purchase suits your needs.

Meet our health insurance expert, Steven Spicer

As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.

Steven has 20 years of experience as a people-first business leader, with a focus on creating services that put customers first.

Want to know more about health insurance?

• Private health insurance
• Hospital cover
• Hospital insurance tiers
• Extras cover
• Gap payments