Hospital Only Cover
Hospital only cover is designed to pay benefits toward the cost of your treatment in hospital. By law, there are only 3 levels of hospital cover available to Australians: top, medium, and basic.
There are plenty of ads on TV and the web that might use names like ‘gold’, ‘silver’ or ‘saver’. These are just different names for those 3 levels.
In short, the higher the level of cover you get as a couple, the more procedures you will both be covered for.
Hospital cover also means you can avoid long public hospital waiting lists by being treated in a private hospital. That way you have the freedom to decide:
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Who you are treated by:
some couples may want a surgeon recommended by their doctor, family or friend
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Where you are treated:
access to a private hospital close to home and a more comfortable environment can reduce worry
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When you are treated:
on average, waiting times are usually shorter in the private system so you don’t have to live with discomfort for as long.
When a procedure is “covered”, that means 100% of the cost (minus any excess) of your hospital visit is paid by your health fund. This includes everything from accommodation, food, theatre fees, medication, and general services.
And just in case you were wondering, having hospital cover before you turn 31 means you won’t pay the annual Lifetime Health Cover Loading.
Hospital waiting periods might come into play when taking out couples health insurance
Waiting periods are designed to prevent Australians from claiming immediately after joining a health insurer and then cancelling their policy once they’ve received treatment.
This kind of “hit-and-run” behaviour would very quickly drive up health premiums and negatively affect the world class health services our country has.
It’s critical to understand “pre-existing conditions” with hospital cover as well. This way you won’t waste time and money taking out a new policy, only to find you won’t be covered for a current condition.
A pre-existing condition is classified as any ailment, illness, or condition that you had signs or symptoms of during the 6 months before you begin a health insurance policy with hospital cover.
If you decide to take out health insurance, your new fund will need time to advise you if your condition is pre-existing. Always check well before you go into hospital to ensure you’re covered.
Pre-existing conditions have a 12 month waiting period for health insurers. The Australian Government has published an overview of this which you can download here.
