Hospital Cover

If you simply want the peace of mind of having access to a hospital bed when you need it, then Hospital Only Cover may be the answer.

Some people choose Hospital Only Cover to meet the Medicare surcharge requirement for high income earners for tax reduction purposes. If this is the case, it’s still important to understand which fund offers great benefits and aligns to your needs.

Hospital cover will often come with cost reduction options ranging from co-payment, excess and per night capping, right through to premium packages that cover most hospital costs.

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An important issue in choosing hospital insurance is the actual private hospitals you can go to with each particular health fund. Funds are now commonly striking agreements with selected hospitals. These agreements may limit your choice of hospital in a particular area.

If you have a full cover option in a fund that covers your choice of hospital then you are covered for the full cost of staying in these hospitals (aside from any excess or co-payment arrangements). Cover for non-agreement hospitals depends on the fund’s particular policy. Some funds may only pay a basic rate set by the government, and other may pay slightly more.

When choosing hospital cover, it’s important to get a copy of each fund’s hospital list (showing those hospitals with which they have an agreement). Some intermediaries such as iSelect provide a fund summary list that includes all hospital agreements across its participating funds. This can save you considerable time and energy in selecting hospital cover for your needs in your particular area.

In regional and rural areas selecting a fund that has a local hospital agreement is vital, as you may incur significant incidental costs and/or inconvenience should you have to travel to an alternative hospital. It is imperative that your choice of fund provides access to a suitable and convenient hospital.

It’s also important to check for any other restrictions that may apply to your choice of hospital cover. For instance, some funds may exclude specific treatments or place restrictions on certain treatments meaning that they may only cover part of the total cost.

Some treatments that are commonly excluded include:

  • Coronary bypass and/or major heart surgery
  • Assisted Reproductive
  • Cosmetic and Plastic surgery Hip, knee and other joint replacement
  • Rehabilitation Cataract eye surgery
  • Obstetrics and birth related care
  • If you are considering these or other specific treatments make sure you choose a fund that does not exclude or limit these areas in any way.