Hospital cover helps pay for your treatment as a private patient in an Australian hospital, for treatments listed as included cover on your policy.

With this kind of health insurance, you can:

  • skip public waiting lists for procedures,
  • stay in a private hospital, in a private room, and
  • receive treatment from a doctor or specialist you choose.

Depending on the treatment you require, you may need to sit through waiting periods before you can begin claiming, unless you’ve sat through them before. Waiting periods differ depending on the treatment you need.

What’s covered under your hospital insurance policy?

It depends on your level of cover. Let’s take a look.

  • Basic hospital cover. Enjoy admittance to private hospitals, and avoid public waiting lists!
  • Medium hospital cover. You get all the benefits of basic cover, with added policy features.
  • Top level hospital cover. This covers any service Medicare pays a benefit to.
Included treatment Public hospital treatment only
Waiting periods Public
Included treatment Private hospital treatment
Choice of doctor
Excluded or restricted treatments Heart surgery (bypasses, angiograms)
Non-cosmetic plastic surgery (e.g. skin grafts)
Palliative care (limited to 2 months)
Psychiatric services
Rehabilitation
Waiting periods Private
Included treatment Heart surgery (bypasses, angiograms)
Choice of doctor
Non-cosmetic plastic surgery (e.g. skin grafts)
Palliative care
Private hospital treatment
Psychiatric services
Rehabilitation
Excluded or restricted treatments Assisted reproductive services (e.g. IVF)
Major eye surgery (e.g. cataract procedures)
Dialysis (e.g. kidney failure)
Joint and hip replacements
Obstetrics (pregnancy services)
Sterilisation (e.g. vasectomies, tubal ligation)
Waiting periods Private
Included treatment Assisted reproductive services (e.g. IVF)
Heart surgery (bypasses, angiograms)
Major eye surgery (e.g. cataract procedures)
Choice of doctor
Dialysis (e.g. kidney failure)
Joint and hip replacements
Non-cosmetic plastic surgery (e.g. skin grafts)
Obstetrics (pregnancy services)
Palliative care
Private hospital treatment
Psychiatric services
Rehabilitation
Sterilisation (e.g. vasectomies, tubal ligation)
Waiting periods Private

Please note, you will need to sit through waiting periods before being able to claim on certain treatments (e.g. two months for palliative care).

You can also get ‘Limited Hospital Cover’, which excludes most private hospital treatment, but can cover you as a private patient in a private hospital if you’re in an accident.

Excluded cover may vary from policy to policy.

What’s covered under ‘private hospital treatment’?

You should know that something as simple as ‘private hospital treatment’ actually covers more than 5,000 different treatments! Think appendectomies, ear nose and throat procedures, splinting up broken bones, chemotherapy, treatment for viruses, and much more. Basic treatment is covered, even if certain others (listed in the above table) are limited or excluded – depending on your level of cover, your insurer, and your policy.

What isn’t covered under this kind of policy?

It’s simple really: your hospital cover generally doesn’t include treatment that occurs outside a hospital. For example, it will not cover things like,

  • dental checkups,
  • physiotherapy sessions,
  • chiropractic work, or
  • optometry.

The above treatments are subsidised by extras policies, which are sometimes called an ancillary policy.

Why you should consider hospital cover

You could be eligible for a rebate

Depending on your age and income, you could receive a rebate up to 40% on the cost of your hospital cover. You will then receive this back through your tax return or as a discounted premium throughout the year – depending on what you opt for. This acts as a the Federal Government’s ‘carrot’ to get Aussies everywhere to take out private health cover. As for the ‘stick’…

Avoid extra tax

The Medicare Levy Surcharge is a tax levied on higher income earners ($90,001+, if you’re a single) who do not have hospital cover. If you want to avoid it, get covered – simple as that!

Lock in a low rate with Lifetime Health Cover

By taking out hospital cover before the 1st of July following your 31st birthday, you can lock in the lowest base rate premium for as long as you hold cover, even if you switch between health funds. Joining after this age may subject you to a loading as part of the Government’s Lifetime Health Cover regulations.

Excess or co-payment options lower your premium

Choosing an excess or co-payment is a great way to reduce your monthly premium. Also referred to as an ‘up-front deductible’, it is the amount you agree to pay if you are admitted into hospital. The excess is payable as a lump sum, while the co-payment is calculated based on how many days you’re admitted for. Keep in mind though that you’ll still have to pay the Medical Gap, depending on where you go.

Peace of mind

Above all, hospital cover gives you the confidence of knowing that when a medical event arises, you and your family will be covered with high quality private care. The most important thing in life is your health. And regardless of what stage of life you are in, everyone can benefit from private hospital cover.

If you would like to look at your options why not try our health insurance comparison tool. If you would like some expert advice call us on 13 32 32.

So, what are you waiting for?

Call us on1800 304 709   or Compare Now