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Articles Insurance Most commonly asked questions about Hospital cover
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5 of the most commonly asked questions

most commonly asked questions about hospital cover

Private health insurance can be pretty confusing – especially if you’re buying it for the first time. To help, we’ve answered some of the most commonly asked questions.

1. Do I have waiting periods and can they be removed?

The Australian Government sets the maximum waiting periods that health funds can enforce for hospital treatment. They are:

  • 12 months for pre-existing conditions
  • 12 months for pregnancy
  • Two months for psychiatric care, rehabilitation or palliative care, even for pre-existing conditions
  • Two months in all other circumstances

There’s usually no waiting period if you need hospital or medical treatment because of an accident that happens after you’ve joined a health fund.

If you have cover with another fund and are transferring, your waiting periods will be honoured as long as you’re switching to a comparable or equivalent level of cover. If you’re taking a higher level of cover than before, waiting periods will only apply to the new services you didn’t previously have cover for or any higher benefits that are available when upgrading.

2. If I need to go to hospital, will I have any out-of-pocket expenses or gaps?

Depending on your level of cover, you might need to pay a hospital excess and/or co-payment when you’re admitted to hospital.

Before going to hospital, make sure you ask your specialist and/or surgeon to give you a written copy of all costs associated with your procedure. Then call us and we’ll be able to tell you what your out-of-pocket-costs will be.

3. Why do I need private cover when I can go to a public hospital?

Australia is lucky to have such a great public health system, but the length of time you could wait for a procedure could be up to or more than 12 months. Depending on the nature of your procedure, the time you’re on the waiting list could also increase if other more urgent or emergency cases present. By having private hospital cover you can:

  • Choose your hospital, surgeon and specialist
  • Choose when to have your procedure
  • Skip the lengthy public waiting list
  • Be comfortable in your own private room (where a private room is available at your hospital)

4. What discounts are on offer?

Health Insurance is legislated by the government which means the government sets a maximum amount of discount that can be offered by health funds, making Health Insurance fair for all Australians. We understand that health insurance can be expensive, but by paying your premium by direct debit you’ll receive a 3% discount.

Get a premium discount on Hospital Cover for 18 – 29 year olds and keep it till you’re 41. The younger you are when you take out hospital cover, the higher your discount. Once you have your age-based discount, it will stay in place until you turn 41 years old.

5. Can I transfer my cover from an existing fund with no delays?

When joining us, we’ll contact your insurer and cancel your cover the day you join, making sure you have no break in cover.

We're always here to help

If you have any questions about your cover please call our Member Care team on 1300 113 113.

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