What's the real cost of going private in a public hospital?

Posted: Sep 19 2019

Health Partners CEO Byron Gregory shares his thoughts on going private in a public hospital, and explains how it will benefit you and at what cost.

Public in private hospital

Updated 21/04/2021

If you have ever been admitted into a public hospital unexpectedly, it’s likely that one of the first questions you were asked is if you want to use your private health insurance. As a health fund member, you have the right to use your health insurance however you see fit. Your cover, your choice.

The reality however, is that public hospital staff are increasingly pressuring their patients to use their hospital cover. Effectively, they want to bill your health fund for treatment that you’re entitled to receive free of charge through Medicare.

Will it benefit you?

The hospital may offer ‘bonuses’ if you agree to go private. This usually includes free TV access and the daily newspaper. It may include a single room (though they are reserved for those who medically need them the most).

Is there a cost?

This inappropriate practice of ‘cost shifting’ is purely a revenue-raising strategy for the public system that puts pressure on private health insurance premiums.

To paint a picture, last financial year Health Partners paid out $8.7 million to public hospitals, accounting for about 10% of hospital benefits paid. This figure is at an all-time high.

As your health insurance partner, we want to support you in making informed decisions that will get you the outcome you’re looking for.

If you’re asked to use your health insurance in a public hospital, you’re entitled to take your time and discuss this question with those you trust.

It’s also your right to ask questions. Ask if using your health insurance will entitle you to the doctor of your choice, what happens when the doctor of your choice isn’t available and what your gap fees will be. You should also clarify your accommodation options (private or shared room), as only part (or all) of the cost may be covered under your health insurance policy.

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Posted: Sep 19 2019


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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