What is Hospital Cover?

Hospital cover is the component of health insurance coverage that looks after the cost of treatment when you are admitted to hospital.

How does hospital cover work?

Health funds generally allow you to select your level of hospital cover, with the premium rising according to the number of features and level of cover offered by the plan that you select. For example, younger, fitter people may choose a package that excludes or only partially covers hip or shoulder joint replacement and cataract surgery to reduce the cost of their health plan. However, someone with more health concerns may choose a more comprehensive plan which could include everything from dialysis through to palliative care.

Hospital cover plans vary between health funds, so you should read the information brochure for the health plan you're interested in and be aware of waiting periods and other conditions.

What does hospital cover include?

Hospital cover provides access to treatment as a private patient in the hospital selected by you (this could be from a list of approved hospitals) and by the doctor of your choosing.

Your health fund will cover your costs including:

  • accommodation and/or theatre costs, and
  • doctors', surgeons' and anaesthetists' fees.

With private health care, you can enjoy shorter waiting times and greater flexibility in scheduling elective surgery.

Is hospital cover affordable?

You can choose the level of hospital cover that suits your lifestyle and budget. To make it even more affordable, most health funds give you the option of choosing an excess or co-payment to help reduce the cost of your hospital cover premium.

An excess is the amount you agree to pay up-front to the hospital if and when you are admitted, while a co-payment is an amount you agree to pay per day, depending upon the length of your stay in hospital (usually co-payments are capped at a certain amount of days).

In addition, the Australian Government currently offers a rebate which can be applied to your premium, so hospital cover is now more affordable than ever.

These articles are provided as reference material to allow more informed decision making, but are not intended as being a complete source of information on any topic. All readers should make their own independent analysis on the topic to make sure they have considered the aspects that are important to them.