Hospital costs for restricted services

Your out-of-pocket expenses for restricted services will depend on which type of hospital you go to (public or private), and how much that hospital charges private patients for the service.
 

Public hospitals

If your specialist can treat you as a private patient in a public hospital, ask if the hospital charges private patients the government fee for a shared room (for that service).

If the hospital charges more than the government fee, you’ll have to pay the difference. This can vary a lot, so be clear on this before you consent to treatment.

At a glance

We pay – accommodation (up to the government fee for a shared room)
You pay – any excess on your cover and the balance of your accommodation costs.

 

Private hospitals

If you’re treated at a private hospital, you’re likely to have significant out-of-pocket costs.

As with public hospitals, we pay up to the government fee for a shared room (for your hospital accommodation). But a private hospital will probably charge more than that.

At a private hospital you’ll also have to pay for any operating theatre, intensive care or neonatal intensive care costs, as they’re not included in the accommodation cost (which they are at public hospitals).

Again, make sure you understand those costs before you consent to treatment to avoid bill shock later on.


At a glance

We pay – accommodation (up to the government fee for a shared room)
You pay – any excess on your cover, the balance of your accommodation costs, and any other costs involved in your hospital stay.