Explainer | What’s the real cost of injury in Australia?

Injuries suck in every way. There’s not just the physical pain, there’s the financial hit and pure frustration of being stuck on the sidelines while you recover. 

But have you ever stopped to think about what injuries you’re most likely to get and how much they’ll cost you? The real cost of injury might be more than you think, let’s take a closer look.

What are the most common sports injuries? 

Fractures are the most common sports injuries, causing just over half of all sports-related hospitalisations. Soft-tissue injuries like torn ligaments come next.

Lots of Aussies love being active and playing sports. It almost goes without saying that there are huge benefits for your physical and mental health, but our adventurous lifestyles in turn increase the risk of injury. Here are a few stats to see where the main risks lie.

If I get hurt, Medicare will cover everything, right? 

Lots of people think Medicare will cover all their costs if they get injured. It’s a common misconception. Let’s set things straight. 

Here are some examples of injury expenses that Medicare often doesn’t cover:

• Most dental services
• Ongoing rehab out of hospital, like physio
• Some scans and tests done out of hospital
• Ambulance costs (unless you live in Qld or Tas where you’ll likely be covered by a state government scheme)
• Stuff that you might need when you’re out of hospital like dressings, crutches and medicine
• Hidden recovery costs like time off work, dog-walkers, food deliveries, taxis and accommodation.

And even for the things Medicare does cover (like going to the bulk-billed GP or some scans), there can be a gap between what you pay and what you get back. This is also called an out-of-pocket cost. Aussies spend around $29.8 billion on out-of-pocket medical expenses each year. Even if you have private health insurance, you might still have quite a few injury expenses that aren’t covered.

The good news is that Flip has launched a new type of on-demand insurance for accidental injuries which you could use on your out-of-pocket expenses. If you’ve turned on your cover before you have the accident and you suffer one of the common injuries we cover, Flip offers a set cash payout that can be used to pay for things that Medicare or private health insurance can’t. 

So, what does an injury cost? 

That’s a tough question to answer. It depends on a whole bunch of things, like what your injury is, whether you need hospital treatment, where you live and if you have private health insurance.

Let’s look at an example to show how it might play out. Say hi to Gus 👋 (we’ve totally made him up but the facts and figures are true).

Gus and his mates took to the slopes on opening weekend. It’d been years since they’d ridden together and they were pumped. Gus was having a blast until he had a nasty run in with a tree when chasing fresh tracks out backcountry. He immediately felt intense pain in his right shoulder. When he got back home, he visited his GP who referred him for an MRI, suspecting a rotator cuff injury. Gus headed off for his scan and then saw his GP during the week to get the results. 

Bad news. The GP confirmed the tear and referred Gus to a shoulder surgeon for an operation. Gus weighed up his options and decided to go through the public system. He waited four months for the surgery, then had ten weeks of rehab with a physiotherapist to get full movement back in his shoulder.

Potential out-of-pocket costs for Gus

$54 for 2 x GP Visits

Bulk billing isn’t available at Gus’ GP, so Gus pays $27 out of pocket for each appointment.

$200 for MRI Scan

Gus pays a $200 gap for his scan, which is about average.

$250 for Private surgical consult

Gus pays $250 to a surgeon for a consult to talk through his procedure. 

$0 for hospital admission

Gus weighs up his choices and chooses to be treated in a public hospital. The waitlist took four months but there were no fees on the day.

$150 for travel

Gus couldn’t drive at first so he caught Ubers to appointments.

$120 for food deliveries

It was pretty hard to cook one-handed. Friends and family dropped off food but Gus ordered more takeaway than usual.

$100 for a sling, anti-inflammatories and pain meds

Gus needed a sling and some medication to help with the pain. He got these from the pharmacy when he got out of hospital.

$800 for rehab physio

Gus had a physio appointment every week for 10 weeks to get the best recovery. Each appointment costs $80. Gus doesn’t have private health insurance so he paid the full amount.

Total estimated out-of-pocket costs for Gus’ skiing injury = $1,674

If Gus had flipped on his Flip insurance that fateful Saturday, things would’ve been different for him and his wallet when he got injured on Sunday arvo. Without Flip, he’s got $1,674 of injury and recovery costs to pay. 

If Gus had turned on his Flip accidental injury cover for the day of his accident, it would’ve cost him just $7 for the day, $25 for a week, or he could’ve covered himself for a whole month for $40. Successful claims for accidental injuries that need surgery in hospital get a $2,000 cash payout. So instead of having a $1,674 bill, he’d have $2,000 in his bank account to play with. Enough to cover all his injury expenses and plenty left over to buy a new set of goggles (and Flip insurance for his next adventure).

Want to see how Flip could cover your injury costs?

As with all insurance, you’ll have to do your research. Big upside, our website is seriously straightforward and you’ll easily find the info you need to help decide if Flip’s right for you.

{{infographics-injuries}}

Note: All dates unless otherwise stated refer to Financial Year 2019-2020

Infographic sources
Australian Institute of Health and Welfare, Sports injury hospitalisations in Australia, 2019–20.

Australian Institute of Health and Welfare, Sports injury hospitalisations in Australia, 2019–20.

Stuart Babbage and Dr. Dana Hutchins for PwC, Australia’s out-of-pocket healthcare problem.