Hospital emergency departments: What are your options?

Posted: Jun 06 2022

There is never a good time for an injury, accident or unexpected medical emergency, but should you or a loved one find yourselves in this situation, the following information is intended to assist you during what can be a very stressful time.

Most likely when seeking urgent medical care, you will be headed to a hospital Emergency Department by ambulance or your own transport and in some circumstances, you will have the opportunity to choose which hospital you would like to attend.

If you are experiencing a life-threatening emergency, call 000

Public v Private (Emergency Departments)

Public Hospital Emergency Departments

All Australian citizens and residents are entitled to use public hospital emergency Departments free-of-charge as a public patient.

These services are available 24/7 for unplanned, urgent and severe injuries and illnesses, with patients seen on a priority basis, meaning those needing critical care will be treated first before other medical cases are attended to.

Demand can be high, with longer times, depending on the severity of your illness or injury.

Private Hospital Emergency Departments

Some private hospitals offer Emergency Department services, which you may choose to access for reasons of convenience relating to the location, access to a particular specialist or for access to their facilities should you need to be admitted.

As with public hospitals you’ll be attended to on a medical needs basis, but you can commonly expect a shorter waiting time compared to a public hospital emergency department.

However, there are out-of-pocket costs you need to be aware of. Most private hospitals charge an upfront, out-of-pocket fee. There may also be an out-of-pocket gap if you require investigative tests such as blood tests, X-rays, or scans.

Public hospital emergency departments

Private hospital emergency departments
  • open 24/7
  • busier
  • larger emergency department that deals with many serious accidents and emergencies
  • have longer waiting times
  • free to attend (costs are covered by Medicare)
  • usually only open during prescribed hours
  • can sometimes be less busy or quieter
  • often have shorter waiting times
  • more expensive (medical consultancy or facility fees often charged, plus gaps for investigative tests such as x-rays, blood tests)
  • hospitals themselves may be more specialised in certain areas
  • may have more control over treating specialist or surgeon if required to be admitted

What will I pay?

Care provided in a public or private Emergency Department is considered an outpatient service. Whether you attend a public or private Emergency Department, this outpatient service is covered by Medicare. You are considered not in hospital at this point in time.

However, in the case of a private hospital, the hospital will commonly charge additional out-of-pocket fees. This is in addition to any doctors out-of-pocket fees.

Under Australian law these outpatient services are unable to be covered by private health insurance.

Public emergency departmentPrivate emergency department
Does Medicare cover claims?Yes – all costs covered by MedicareSome costs covered by Medicare, but you may be charged additional fees.
Out of pocket costsNoneMost private hospitals in Adelaide have a fixed out of pocket fee around $400 such as:

Ashford Hospital

Calvary Adelaide

Plus gaps for investigations such as xrays and blood tests

When can I use my private health insurance?

If you are admitted into either a public or private hospital for further medical care then you become an inpatient. This is when you are eligible to use your private health insurance hospital cover.

However, if you are admitted in a public hospital, just because you have private health insurance doesn’t mean you have to be admitted as a private patient, this is your choice.

ScenarioCan I use my private health insurance?
1. You present at a private hospital emergency department with a broken arm. You require an x-ray and plaster cast and are treated in the emergency department.No - these are considered outpatient services and are covered by Medicare only.
2. You present to a private hospital emergency department, and your broken arm requires surgery. You are formally admitted to the hospital, given an identification bracelet and taken to the ward.Yes – once you are admitted you are considered an inpatient, and this is where your private health insurance hospital cover can kick in. You are still required to pay the emergency department fees before you are admitted.

General tips when visiting an emergency department

So you’ve chosen which hospital you’re going to attend, here are some tips to keep in mind. Remember, it is important to use good judgement when seeking care from an emergency department and only visit if it is an emergency.

Getting there

No matter whether you choose a public or private hospital, you have a few options when it comes to getting to the emergency department. Depending on your condition, you may be able to ask a friend or family member to drive you, or take a taxi.

If you’re wanting to visit a private hospital emergency department, and are in a position to do so, it’s a good idea to call ahead to ensure that the facility can take you before you make the journey. Many private hospitals will also detail the types of emergencies they will take on their website, with an estimated wait time able to be found online for most private hospitals.

If you require an ambulance, being driven by ambulance to the emergency department is not a free service. If you have ambulance cover, either as part of your private health insurance or an SA Ambulance Cover membership, then you will be covered for this cost, but limits may apply. It is also important to note that SA Ambulance Service have some policies on particular conditions that mean they need to take you to the nearest hospital, but for less urgent care, you can request them to take you somewhere in particular.

If you are experiencing a life-threatening emergency, call 000

What to bring

  • Medicare card
  • Regular medications, if you can
  • Doctor’s details
  • If visiting a private hospital, your Health Partners Card in case you need to be admitted

Note: If you have an Emergency Medical Information Book, make sure it’s located in an easy to find spot (e.g. your fridge) and up to date in case of emergency.

What to expect

On arrival you will be assessed by a nurse who will triage your condition based on the information you provide. You will be seen as soon as possible according to the severity of your illness or the urgency of your requirements based on this triaging by nurses, and not in order of attendance. If another patient comes to the emergency department with a more serious condition while you are there, you may be required to wait.

Before you leave

Make sure you fully understand the treatment you have had and know when to take any prescribed medication. Confirm if and when you need to have a follow up appointment with your GP and ask about a medical certificate if you need one.

Other services

The decision to attend an emergency department comes with stress and uncertainty, it often happens when you least expect it. Give yourself a head-start by being aware of the options around you and knowing what services are available for you and your family.

If you are unsure about whether to visit an emergency department, or need further advice, there are also virtual clinics and services like Healthdirect and the Women’s and Children’s Hospital Child and Adolescent Virtual Urgent Care Service that can help. These services can connect you with a registered nurse or doctor virtually, who can provide further guidance.

Remember if you or a loved one are experiencing a life-threatening emergency, call 000

For more information on navigating the hospital journey, you can access Health Partners Hospital Support or call us.

Posted: Jun 06 2022


The information contained here is of a general nature and does not take into account your personal medical situation. The information is not a substitute for independent professional medical advice and is not intended to diagnose, treat, cure or prevent any disease or used for therapeutic purposes. Should you require specific medical information, please seek advice from your healthcare practitioner. Health Partners does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information provided. While we have prepared the information carefully, we can’t guarantee that it is accurate, complete or up-to-date. And while we may mention goods or services provided by others, we aren’t specifically endorsing them and can’t accept responsibility for them.

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