Healthcare costs can be a minefield, especially when it comes to hospital stays. If you’re an Australian citizen or resident, what will you pay for a day in a public hospital? With Medicare in the mix and the various costs for private patients, it’s not always clear-cut. Read on as we uncover the true cost of a public hospital stay per day in Australia, including the role of private insurance, additional fees, and more.
SUMMARY
- For most permanent residents, and those from countries with special agreements, public hospital treatment in Australia is generally free through Medicare.
- However, not all expenses are covered. For example, in some states, ambulance services might not be included in Medicare coverage.
- If you choose private care, Medicare may still play a role. Depending on your treatment, Medicare could cover as much as 75% of your fees.
Healthcare in Australia offers a blend of public and private options, but what happens when you find yourself needing a hospital stay? What will it cost you, and who foots the bill? Navigating the world of Medicare, private insurance, and unexpected fees can be a daunting task.
In this detailed guide, we’ll break down the average cost of staying in a public hospital in Australia, what’s covered, what’s not, and how to prepare for any additional costs. Whether you’re an Australian citizen, permanent resident, or visiting from overseas, understanding these costs is crucial.
How Much Does a Public Hospital Stay Cost Per Day?
The Australian Institute of Health and Welfare (AIHW) reports that a stay in a major public hospital comes with an average price tag of $4,680.
But the good news? For Aussies, Kiwis, and most permanent residents choosing to be public (Medicare) patients, this treatment generally won’t cost a cent. Medicare usually covers all hospital clinical services, doctors’ and specialists’ fees, medication, hospital accommodation and operating theatre fees.
Just remember, if you opt for the public route, prepare for shared accommodation, unless there’s a private room free and you need it. A longer wait time might also be in the cards, compared to private hospital treatment.
Now, if the idea of shorter wait times and more privacy appeals to you, private health cover might be the way to go. Many Australians prefer this route for those very reasons.
And for those visiting Australia on a visa, don’t worry – you can look into Overseas Visitor Health Cover (OVHC) options here.
Does Medicare Cover Ambulance Fees?
Wondering if Medicare covers ambulance fees? Sadly, it doesn’t usually take care of the ambulance ride to the hospital or other emergency services, unless you’re holding a concession card or healthcare card. Those ambulance fees can sneak up on you and be quite costly, so it might be a smart move to look into ambulance cover with most private health insurance plans.
Private Patient in a Public Hospital Costs
When you’re a private patient in a public hospital, Medicare’s still got your back, covering 75% of the medical costs that are part of the Medicare Benefits Schedule (MBS). The remaining 25%? If you have private health insurance, it might step in and cover some or even all of those extra costs, all depending on what plan you’ve got.
CHI EXPLAINS: A private patient is someone who uses private health insurance to fund their treatment. A public patient is someone who goes to a public hospital and relies on Medicare to fund their treatment.
Whatever Medicare doesn’t cover, private health insurance can step in to cover some or all of the balance. That includes:
- Theatre fees
- Accommodation costs and meals
- X-rays and tests
- Allied health services, like physiotherapy and rehabilitation.
But even with private health cover, there might be some sneaky gap fees or other medical costs hiding around the corner. It’s smart to find a private health insurer that fits your needs like a glove, so you can sidestep or at least shrink out-of-pocket expenses.
How Much Does Day Surgery Cost in a Public Hospital?
Whether it’s an overnight stay or just for the day, hospital costs can differ a lot. It all depends on what procedure you’re having and whether you’re being admitted as a public or private patient.
If you’re heading to a public hospital for day surgery, Medicare’s got you covered, as long as you’re a public patient and the surgery’s on their list (that’s the Medicare Benefits Schedule or MBS).
But what if you’re going private for the day? Medicare’s still with you, covering 75% of the MBS fee for the surgery. Your private health insurance will then step in to take care of some or all of the rest.
Does Medicare Cover Emergency Room Visits?
If you find yourself needing emergency care at a public hospital, Medicare’s got you covered. Now, if you end up needing to stay as an inpatient, that’s where things can get a bit more complicated. Costs might vary, and it all depends on a few different factors.
REMEMBER: Medicare doesn’t pick up the tab for an ambulance ride to the hospital (unless you’re living in QLD or Tasmania).
But what about other states and territories? That’s where things get a bit sticky. Costs can vary, and let’s be honest, no one likes surprise bills. That’s where ambulance cover comes in handy! It can help take care of those costs if you ever need to travel in an ambulance.
Why Get Hospital Cover if Medicare Exists?
Australia’s public health system & public health care has a lot going for it, but it’s not perfect. There are plenty of reasons why you might want to take out private hospital insurance, such as:
- Choice of Doctor: With Medicare, if you’re in a public hospital, you usually don’t get to pick your doctor. If you’ve got a preference for someone specific, or just like to have a choice, private hospital cover could be a better option for you.
- Speedier Treatment for Non-Emergency Surgery: Long waiting lists are no fun, especially if it’s for something important like surgery. In the public system, you might find yourself waiting longer for elective surgery. Private hospital cover can help you jump that queue.
- Private Room Comfort: If sharing a room with strangers isn’t your cup of tea, private hospital cover often gives you access to private rooms, depending on availability, of course. A little privacy can make a hospital stay a bit more bearable.
- More Hospital Options: Want a specific hospital? Private cover might let you choose from a wider range of hospitals, making it easier to find one that suits your needs and location.
- Extras: Some hospital cover options also include added bonuses like dental, physiotherapy, or optical cover.
- Peace of Mind: Knowing you’ve got cover if the unexpected happens can be a real stress-reliever.
Sure, hospital care under Medicare is a great safety net, but private hospital cover can add a layer of comfort and control that might just suit your lifestyle better.
What is Hospital Cover?
Hospital cover is a form of private health insurance specifically designed to help with hospital-related expenses. Here’s what it usually includes:
Basic Services:
- Accommodation Fees: Covers the cost of your hospital room.
- Meals: Included as part of your stay.
- Operating Theatre Fees: Helps with surgical costs.
- Medications and Other Costs: This includes the balance after Medicare pays 75% of the MBS fee for doctors, specialist fees, blood tests, x-rays, etc.
Higher Tier Services: If you want more comprehensive coverage, higher levels of hospital cover may include:
- Cancer Treatments: Chemotherapy, radiotherapy, immunotherapy.
- Maternity Care: Pregnancy, birth, and related services.
- Joint Treatments: Reconstructions, replacements.
- Specialised Equipment: Insulin pumps, dialysis for chronic renal failure, etc.
In summary, hospital cover is an insurance product that can reduce the financial burden of hospital stays and treatments. It comes in different tiers, allowing you to choose a plan that best fits your specific health needs.
How to Prepare for the Costs of Staying in Hospital
If you are planning a trip to the hospital, it’s essential to consult with health professionals like your doctor or specialist about the costs involved.
If you have private health insurance, checking with your health insurance fund about your private health cover is also vital to determine your eligibility for various services, whether it’s mental health treatment, intensive care, or other specific hospital services.
It’s also important to consider your status as an admitted patient, whether you need a single room, or a private room.
Is Hospital Cover Worth It?
Taking out a hospital insurance policy can be a valuable asset, especially if you need specialised medical treatment. Here’s why it’s worth it in many cases:
Reduced Costs: Whether you’re treated as a private patient in a public or private hospital, hospital cover can minimise your out-of-pocket expenses.
Avoiding Queues: Skip long public hospital waiting queues, like in the emergency department, or gain quicker access to medical treatment if needed.
Choice of Providers: Choose who’s treating you, and at which hospital.
Avoid the Medicare Levy Surcharge (MLS): If your income is over the Australian government’s threshold, hospital cover can save you from paying the MLS.
FAQs
How do I use my Medicare card to cover hospital expenses, and what might be my out-of-pocket costs?
Your Medicare card can be used to cover a percentage of medical costs in public hospitals as well as some private services. Out-of-pocket costs may vary depending on the treatment, whether you’re an inpatient or outpatient, and the specific hospital or care unit you choose. Always check with the hospital and your insurance provider for detailed information.
What is the difference between inpatient and outpatient care in a hospital setting?
Inpatient care refers to treatment where the patient is admitted to the hospital and typically stays overnight. Outpatient care, on the other hand, involves treatments or procedures where the patient is not required to stay overnight in the hospital. Both types of care can vary in cost, and it’s essential to understand your coverage and potential out-of-pocket expenses.
