Using Your Cover

Tips for using and choosing private hospital cover

When a hospital visit is on the cards, it’s important to know what's included in your cover

Written by Medibank

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’s in your cover

When a hospital admission is on the cards, it’s important to know what’s included in your cover to ensure there’s no nasty surprises that can hamper your journey to better health.

There are many levels of cover that can support you depending on your needs.

At a basic level, private hospital cover could pay benefits towards things like overnight accommodation in hospital, same-day admission, theatre fees and intensive care for a limited number of services.

Depending on the level of hospital cover you choose, your cover could pay benefits towards a variety of in-hospital treatments from joint replacement surgeries right through to pregnancy related services.

Although hospital cover helps to reduce the cost of your private hospital admission, 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’s included in your cover, or if you need to change your cover to match your current circumstances, give us a call on 132 331 or log into to view and manage your cover.

Why it’s worth being covered

There are many reasons why having hospital cover is a good decision for your health, but it could also help reduce the costs of private hospital treatment.

Try our interactive tool to find out common hospital procedures for someone like you, and how health cover could help with the costs.

As a private patient, hospital cover lets you enjoy generally shorter wait times for a range of in-hospital elective procedures, plus flexibility over where, when and by whom you get treated.

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 could be significantly reduced.

Waiting periods

It’s important to remember that a waiting period may need to be served prior to accessing treatments or procedures included in your health cover.

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

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 benefits may be paid under your policy.

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 and equivalent services.

Before you go to hospital, check in with us to find out what’s included in your cover 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.

Written by Medibank

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