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Hospital cover helps cover your costs when you are treated as a private patient in hospital. It also gives you options – like being treated by your own doctor, shorter waiting times for elective surgery and the timing of your treatment.  With Health Partners, you have the option of taking out standalone hospital cover or a package cover which combines hospital and extras in the one package for you. 

 

What’s covered?

Hospital cover helps pay for Medicare-recognised procedures when you are admitted to hospital. With all hospital cover options, you are eligible to receive benefits at your choice of participating hospitals (private or public), Australia-wide. If the procedure or service you require is included in your cover, Health Partners will:

Pay for:

  • Your accommodation in hospital (including registered day facilities)
  • Your theatre, labour ward and intensive care fees
  • All PBS prescriptions relating to your admission, while you’re in hospital
  • An extensive range of government-recognised surgically implanted prostheses
  • Access to a range of health management and support programs.

Pay towards:

  • In-patient medical expenses. 
  • A range of additional services depending on your level of cover.

To compare hospital cover, view the summary of services table.

 

What’s not covered

There are some situations where your Health Partners hospital cover will not cover you:

  • Outpatient services
  • Services at unregistered day facilities
  • Emergency department facility fees (unless otherwise specified)
  • Excluded services (see individual cover options for details).

 

Limited benefits

Limited benefits apply for admissions where a Medicare rebate does not apply to the treatment procedures. Benefits paid are in accordance with the Federal Government default payment schedule. This may result in large out-of-pocket expenses.

For more information, please refer to what's covered or contact us.
 

Excess and co-payment

With Health Partners you can select from various excess and co-payment options when deciding on your hospital cover.

Excess and co-payment tables

Hospital excess

An excess is the amount you agree to pay towards your hospital accommodation, should you need to go to hospital. This is payable on admission, once only per person, to a maximum of twice per membership per rolling year (that is, you will never pay more than the yearly excess limit in a 12-month period). It is in addition to any out-of-pocket expenses (also known as ‘gaps’) incurred for in-hospital medical treatment.
 

Your chosen cover may have an excess only, an excess and a co-payment or no excess at all.

Excess is capped
This table only includes covers that have an excess.
 

Cover  Type of membership  Yearly excess limit (the maximum you may pay if admitted to hospital) 
Gold Value
Hospital 
Single or Sole Parent  $500
Couple or Family  $500 per person; $1000 per membership 
Silver Hospital   Single or Sole Parent  $500 
Couple or Family  $500 per person; $1,000 per membership 
Bronze Hospital   Single $500 
Couple, Family or Sole Parent  $500 per person; $1,000 per membership 
Family Essentials   Sole Parent  $300 
Family  $300 per person; $600 per membership 
Couples Choice 
Couple   $300 per person; $600 per membership 
Singles Starter Single  $500 

 

Hospital co-payment

A co-payment is the daily amount you agree to pay (in addition to any applicable excess) towards your hospital accommodation. It is capped so that you know the maximum that may apply in a rolling year (that is,
you will never pay more than the yearly co-payment limit in a 12-month period). It is in addition to any out-of pocket expenses (also known as ‘gaps’) incurred for in-hospital medical treatment.

Your chosen cover may have a co-payment only, an excess and a co-payment or no co-payment at all.

Co-payment is capped

This table only includes covers that have a co-payment.

Cover  Type of membership  Yearly co-payment limit (the maximum you may pay if admitted to hospital) 
Gold Hospital 50  Single or Sole Parent  Maximum of 5 days ($250)
Couple or Family  Maximum of 5 days ($250) per person, to a
maximum of 10 days ($500) per membership 
Silver Hospital 250 Single or Sole Parent  Maximum of 5 days ($250) 
Couple or Family  Maximum of 5 days ($250) per person, to a
maximum of 10 days ($500) per membership
Silver Hospital 500  Single or Sole Parent  Maximum of 5 days ($250)
Couple or Family  Maximum of 5 days ($250) per person, to a
maximum of 10 days ($500) per membership
Bronze Hospital 500  Single Maximum of 5 days ($250)
Couple, Family or Sole Parent  Maximum of 5 days ($250) per person, to a
maximum of 10 days ($500) per membership
Bronze Plus Single or Sole Parent  Maximum of 2 days ($100) 
Couple or Family  Maximum of 2 days ($100) per person, to a
maximum of 4 days ($200) per membership

 

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Excess and co-payments are only payable if you are admitted to hospital and are in addition to any out-of-pocket expenses (also known as ‘gaps’) incurred for in-hospital medical treatment.

 

Waiting periods

Waiting periods are the initial periods after joining or upgrading your private hospital cover during which you cannot claim hospital benefits.

If you haven't already served waiting periods, after two months you can claim benefits for hospital services available on your level of cover, except for the following where 12-month waiting periods apply:

  • Pregnancy and birth-related services, including IVF
  • Pre-existing conditions (excluding psychiatric conditions, palliative care and rehabilitation)
  • Home nursing
  • Home sleep studies.

Waiting periods do not apply for:

  • Newborn babies added to a family hospital cover within 60 days after their birth
  • Treatment required immediately following an accidental injury sustained after you’ve joined.

You may be able to obtain immediate benefits if you are transferring from another health fund with an equivalent level of cover. 

Waiting periods when you transfer from another fund

If you transfer from another fund with an equivalent level of cover, and have served the relevant waiting periods, you can obtain immediate access to all services on your selected level of cover. 

If you transfer to a higher level of cover, waiting periods apply to the additional benefits available on the higher level of cover. During this time you will receive the same benefits and pay the same excess and co-payment as the Health Partners equivalent of your previous level of cover.

Where your previous cover had excluded benefits, waiting periods will apply for these specific services.

If you have only partially served waiting periods with your previous fund, the remainder of the waiting period will be served with Health Partners.

Any loyalty bonuses or accrued entitlements with your former fund are not transferable to Health Partners.

When you transfer, we will explain to you which benefits you can claim immediately and the waiting periods that apply (if any).
 

Waiting periods when you change your cover

For current members changing their level of cover, waiting periods only need to be served for the additional benefits on the new level of cover. During this period you will receive the same benefits as your previous level of cover.

When you change your cover, we will explain to you which benefits you can claim immediately and the waiting periods that apply (if any).

 

Pre-existing conditions

A pre-existing condition is one where signs or symptoms of an ailment, illness or condition, in the opinion of a medical practitioner appointed by the Fund, existed at any time during the six months preceding the date on which you purchased or upgraded your hospital cover.

A 12-month waiting period applies for pre-existing conditions. This does not apply to psychiatric conditions, palliative care and rehabilitation.

For more information download the Product Disclosure Statement.

 

Quote

Get a quote

Call Health Partners on 1300 113 113 1300 113 113 or get a quote online

(or 1800 182 322 1800182 322 if you are outside the Adelaide metropolitan area or interstate)