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When you take out private hospital cover with a health fund, you’ll be covered for admission to any of their agreement private hospitals (provided your cover isn’t limited to public hospitals only). These are private hospitals that have agreements in place with your health fund to reduce or eliminate any out-of-pocket expenses you might otherwise have had to pay.

All major health funds have agreements with a large number of private hospitals, but it is recommended that you check before deciding which hospital to be treated in. This is important especially if you have a hospital in mind prior to treatment, or if you live in a rural area where the nearest agreement private hospital may be a distance away.

What can I expect at an agreement private hospital?

Not only can you choose the agreement private hospital you wish to be admitted to, you can also choose your doctor within that hospital and enjoy greater flexibility regarding the timing of your treatment. Depending on the level of your cover and room availability, you may also receive your own private room.

Once you are admitted into an agreement private hospital for a procedure covered by your policy, some or all of the costs associated with your treatment will be covered by your health fund, including:

  • intensive care
  • accommodation and theatre costs
  • doctors’ fees
  • coronary care
  • labour ward costs

What if I choose to go to a non-agreement private hospital?

If you choose to be treated at a private hospital that doesn’t have an agreement with your health fund, the extent of cover you receive will depend on your policy. Keep in mind that you will most likely incur out-of-pocket costs during your treatment.

How do I know which hospitals have agreements with my health fund?

To find out which private hospitals in your area have agreements with your health fund, use this online tool.

To find private hospital cover to suit your needs, try our easy-to-use comparison tool today.

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