Private hospital stays offer choice and comfort, but they also come with their price tag. In this article, we’ll unravel the complex world of private healthcare and hospital costs, from Medicare benefits to health insurance options, intensive care fees, and specialists’ fees. Let’s make sense of the cost of a private hospital stay in Australia together.
- With private health insurance, you get the choice to be treated in a private or public hospital, along with the ability to choose your doctor.
- Public hospital healthcare is free for all Australian citizens and most permanent residents.
- Treatment costs are often covered by a combination of Medicare, private health insurance, and personal payments.
- Medicare does not cover ambulance services and certain emergency treatments.
Navigating the healthcare system in Australia can be tricky, especially when it comes to understanding the costs involved with private hospital stays. Whether you’re looking for a little extra comfort, specialist care, or just curious about your Australian health services options, it’s vital to understand the factors that can affect the price.
From Medicare and the Medicare Benefits Schedule (MBS) and private health insurance coverage, to specific hospital fees and doctor’s charges, let’s dive into what you need to know to prepare for the costs of hospital admission and hospital care in a private hospital in Australia.
What is the Cost of a Private Hospital Stay Per Day in Australia?
The Different Private Options
Private Patient in a Private Hospital, Without Private Health Insurance
- Costs: These can be substantial, including fees for:
- Hospital accommodation.
- Surgeon and specialists.
- Operating theatre.
- Intensive care.
- Medications, tests, and more.
- Choice of hospital, surgeon, and specialists.
- Shorter waiting times for elective procedures.
- High out-of-pocket costs.
- Medicare may only cover a portion of the medical fees, leaving you to cover the rest.
Private Patient in a Private Hospital, With Private Health Insurance
- Costs: Varies with the level of coverage and excess you choose, but insurance can cover a significant portion of the costs for:
- Hospital accommodation.
- Surgeon and specialist fees.
- Medications, tests, and other services.
- Choice of hospital, surgeon, and specialists.
- More control over when you are admitted.
- Possibility of private room (depending on coverage).
- Insurance can greatly reduce out-of-pocket expenses.
Staying in a private hospital in Australia? It’s good to know the out-of-pocket costs of hospital services in a private setting, and it can depend on a lot of things like the hospital’s specific fees and charges from doctors and specialists.
CHI TIP: Even if you are a private patient with health insurance, you can also tap into Medicare benefits, which can cover 75% of your hospital and medical treatment fees.
Typically, the remaining 25% will be covered by your private health insurance fund, depending on your level of cover. Check with your insurer to see what you can claim back for your hospital stay and treatments.
Just remember, the amount you can claim might change based on your level of cover and any excess – that’s the amount you pay when making a claim.
In a private hospital, you might also have to pay for:
- Intensive care (if needed)
- A private room
- Operating theatre fees
- Everyday items like dressings and bandages
- Tests, like blood tests, x-rays, or CT scans
- Specialists’ fees
And here’s a little heads-up: If you wind up in an emergency department in a private hospital, you might face extra fees for services Medicare doesn’t cover.
One more tip – if you’ve got private health cover, it’s smart to call up your insurer and check your policy to see what hospital treatments you’re covered for. For example, tonsil surgery is usually covered if you’ve got at least the Bronze tier of cover, but you might still have to pay something extra or wait a bit before you can claim. But if your policy doesn’t cover this, you might have to dig deep into your pocket for the difference between the listed price and what the hospital charges.
Why Take Out Private Health Insurance?
1. Access to Private Hospitals
With private health insurance, you’re not restricted to public hospitals. Choose the facility that best fits your needs.
Arrange treatments to align with your life, picking dates that suit you.
If you desire more privacy during recovery, options for a private room are often available.
2. Flexible Coverage Options
- Private health insurance plans often come in various shapes and sizes, including hospital stays, medical services, and extras like dental or physiotherapy.
- You can mix and match to create a plan that perfectly aligns with your individual health concerns and budget.
3. Choose Your Doctor
- If you have a preference for a particular specialist or surgeon, private health insurance enables you to make that choice.
- This control can be crucial for ongoing treatments or specific medical conditions.
4. Potential Shorter Waiting Times
- Private health insurance may allow quicker access to elective surgeries and treatments that might have extensive waiting periods in public hospitals.
- This speed could mean getting back to normal life faster and potentially less pain and discomfort while waiting.
5. Tax Benefits
Depending on your income level, private hospital cover can help you avoid paying the Medicare Levy Surcharge.
It’s a financial incentive that makes private health insurance an attractive option for many.
6. Peace of Mind
- Knowing that you have coverage tailored to your needs offers peace of mind.
- Whether it’s an unexpected illness or a planned procedure, having insurance provides reassurance that you’ll receive the care you need without undue financial strain.
In essence, taking out insurance with a private health service provider is about choice, control, and confidence in your healthcare. It’s not just about the immediate needs but taking a more comprehensive approach to your health and wellbeing. By aligning your coverage with your lifestyle and health goals, you create a personalised safety net that’s there for you when you need it.
Avoiding Unexpected Hospital Fees
If you find yourself admitted to a hospital, either for same-day procedures or longer stays, here are some questions you can ask to avoid unexpected fees:
- Am I covered for my treatment? Understanding your coverage, whether through Medicare or private health insurance, is crucial.
- Does my private health insurance policy have any waiting periods, exclusions, or minimum benefits? Knowing these details can prevent surprises.
- Do I need to pay any excess or co-payments? These additional costs can add up.
- What are the accommodation fees if I want a single room? If you prefer privacy, this is essential to know.
What’s the difference between an inpatient and an outpatient?
An inpatient is someone who stays in the hospital for one or more nights, usually for more intensive or complex treatments. An outpatient, on the other hand, visits the hospital for treatment but does not stay overnight. Outpatient care often includes procedures like consultations, diagnostic tests, or same-day surgeries.
What is a waiting list, and how does it work in a hospital setting?
A waiting list is a list of patients waiting for a specific medical treatment or surgery, especially in public hospitals. The waiting time can vary depending on the urgency of the treatment, available resources, and the number of patients in line. Health professionals usually assess and prioritise patients based on need.
What does it mean to be an admitted patient in the hospital?
An admitted patient is someone who has been formally admitted to a hospital for treatment and usually stays overnight. This can be for surgical procedures, intensive care, or ongoing monitoring and treatment.
Who is eligible for treatment as a public patient in a public hospital?
Eligibility for public patient treatment in a public hospital usually depends on being an Australian citizen or permanent resident and holding a valid Medicare card.