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Tips for using and choosing private hospital cover

When a hospital visit is on the cards, it’s important to know what you’re covered for.

Man laying in hospital bed with a nurse tending to him

None of us plan to be unwell, but having the right level of private hospital cover in place for when you need it can be worth much more than the price of admission. And knowing exactly what treatments and services are included in your cover can not only give you the peace of mind to focus on your return to health, but can also help to minimise a lot of out-of-pocket expenses.

Checking what you’re covered for

When a hospital visit is on the cards, it’s important to know what you’re covered for to ensure there’s no nasty surprises that can delay your journey to better health.

There are many levels of cover that can support you for different in-hospital expenses.

At a basic level, private hospital cover could cover you for things like overnight accommodation in hospital, same-day admission, theatre fees and intensive care.

Depending on the level of hospital cover you choose, you can be covered for a variety of in-hospital treatments from accidents right through to joint replacement surgeries and pregnancy related services.

Although hospital cover helps to reduce the cost of your private hospital visit, depending on who is treating you and where you go for treatment, some specialist fees and other medical expenses may not be included in your cover.

If you’re unsure of what you’re covered for, or if you need to change your cover to match your current circumstances, give us a call on 132 331 or log into www.medibank.com.au/members to view and manage your cover.

Why it’s worth being covered

There’s many reasons why having hospital cover is a good decision for your health, but it can also save you a lot of dollars.

Below is a table of the some common overnight procedures performed in hospital. It shows what the average total cost of procedures alongside the average amount you pay as an out-of-pocket cost if you are a Medibank member with the appropriate level hospital cover.

As a private patient, you can choose the hospital where you would like to be treated and the specialists that will attend to you. Plus you can be treated as soon as you and your specialist are ready – no need to wait weeks, months or even years on the public waiting list.

By choosing a specialist that participates in GapCover and one who will treat you at a Medibank Members’ Choice hospital, your out-of-pocket costs are reduced and sometimes even eliminated.

Waiting periods

It’s important to remember that before you claim a rebate from your health cover provider, a waiting period may need to be served prior to accessing some treatments.

The length of time you must wait depends on the type of treatment and also whether the required treatment is for a pre-existing condition.

For example: if you need a knee reconstruction, you must have held an appropriate level of health cover for at least 2 months prior to undergoing the surgery. However, if you had knee pain prior to taking out your health cover, you may have to wait 12 months before your policy will cover you.

For new members switching to Medibank from another health insurer, you may not have to start your waiting periods from scratch – Medibank will generally recognise the waiting periods that you’ve already served for an equivalent level of cover.

Before you go to hospital, check in with us to find out what you’re covered for and the sort of questions you should be asking specialists before your treatment begins.

With Medibank, you can relax knowing we’re with you every step of the way.

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