Hospital cover

Hospital cover is for things like accommodation, theatre and doctors’ fees in hospital. We love keeping our hospital cover simple with five types of private hospital cover to best suit your needs. All our covers come with an exceptional level of ambulance cover.

Ambulance cover included

One thing that Peoplecare includes as a bonus is 100% land, air and sea ambulance cover with no annual limits with every Peoplecare cover.* A short trip in an ambulance can be expensive. To view what you get, read here. 

*State-recognised ambulance providers only. 

 

2023 CSIA highly commended and Peoplecare results in IPSOS Health Care and Insurance Australia survey.svg

Australian Service Excellence Awards CSIA 2023 Highly Commended
* IPSOS 2021 survey results for open private health insurance funds.

How does hospital cover work?

Holding hospital cover allows you to go to hospital as a private patient for the services you are covered for.

All our hospital covers help you:

  • Avoid Lifetime Health Cover loading
  • Receive a government rebate to reduce your premiums (see the income tiers for eligibility)
  • Suit your budget and needs
  • Choose your own doctor
  • Avoid paying Medicare Levy Surcharge
  • Access Australia-wide coverage at more than 540 hospitals with 37,000 medical specialists

Expenses hospital cover can pay: 

  • Hospital accommodation (100% if the treatment is included on your cover) 
  • Theatre fees (100% if the treatment is included on your cover) 
  • In-hospital medicine (100% of PBS listed medications if the treatment is included on your cover) 
  • Doctor’s fees. Peoplecare pays a minimum of 25% on each Medicare Benefit Schedule fee if the treatment is included on your cover (we pay more if your doctor uses our Access Gap scheme) and Medicare pays 75%. Learn more about Access Gap. 

How much can a hospital stay cost?

Hospital claims paid in the 2023 financial year
Admission reason Total benefit paid
Heart and Vascular $419,582.63
Heart and Vascular $139,688.70
Back, Neck and Spine $128,778.00
Back, Neck and Spine $120,322.65
Heart and Vascular $111,819.00

 

 

Are you under 30?

Take out our Basic Plus Hospital or Bronze Plus Hospital cover before you turn 30 to lock in the age-based discount. The discount ranges from 2% to 10%, depending on your age.

Read more

 

 

Two important things to be aware of — these apply to all health funds

  1. Waiting periods (including those for pre-existing conditions), excesses, restrictions & exclusions might apply. Read more
  2. Going to public hospital as a private patient? Public hospital waiting lists apply, so check with your doctor and the hospital.

 

 

Coming to us from another health fund? Switching is easy

Switching is simpler than you think. It takes around five minutes and you can switch online or over the phone.

Don’t worry, if you’re transferring from another health fund we’ll make sure we recognise any waiting periods you’ve already served if you switch within 30 days.

To switch, just join Peoplecare and we can cancel your existing cover for you. You won’t spend any time without cover that way. We send them a request for details of your cover with them (this is called a Transfer Certificate) and then we’ll recognise the waiting periods you’ve already served.

Sometimes if you’ve used all of your annual limit with your old fund, you’ll have to wait for the new financial year to renew your limits.

Read more

 

 

Are you new to hospital cover?

There are waiting periods involved and a blanket 12-month waiting period for pre-existing conditions (except for rehabilitation, psychiatric services and palliative care) when you first join.

 

Ready to join?
Get cover for a
Family
in
NSW

How does joining work?

Step 1

Choose your Hospital cover

  • Silver Plus Hospital:
    $500 excess; or
    $750 excess
  • Silver Plus Grow:
    $500 excess; or
    $750 excess
  • Silver Hospital:
    $500 excess; or
    $750 excess
  • Bronze Plus Hospital:*
    $500 excess; or
    $750 excess
  • Basic Plus Hospital:*
    $500 excess; or
    $750 excess

*The age-based discount is available on this cover

You can take hospital cover on its own (except Silver Plus Grow which must be purchased with an Extras product as combination cover), most people add extras cover to give them broader coverage.

Step 2

Choose your Extras cover

Extras cover gives you benefits for items and services that aren’t covered by Medicare. Such as your teeth, glasses, chiro, physio and more.

  • Premium Extras
  • High Extras
  • Mid Extras
  • Simple Extras

You can take extras cover on its own, but most people add hospital cover for their hospital & medical costs.

Step 3

Take 10% off your extras

When you combine Hospital and Extras covers, we take 10% off your extras premiums as an ongoing discount.

Hospital cover - what's covered

(depending on your level of cover):

  • Public or private hospital bed - shared or a private room (if available)
  • Same-day surgery
  • Theatre fees
  • Special unit accommodation
  • In-hospital psychiatric treatment
  • In-hospital rehabilitation treatment
  • In-hospital pharmacy
  • Surgical prostheses, up to the benefit listed on the Government Prostheses List (a prosthesis is an artificial substitute for a body part)
  • Ambulance services Australia wide
  • Hospital substitution options
  • Health programs

Hospital cover - what's not covered

There are a few things that aren't covered by your hospital cover. They include treatments & services that

  • are received within your waiting periods
  • Medicare doesn't cover (like cosmetic surgery)
  • are received outside Australia
  • are covered by a compensation or another type of insurance (like third party or sports club insurance)
  • were received more than 2 years ago
  • Outpatient treatment & services 

and:

  • Some high cost (non PBS/TGA approved) drugs
  • Pharmacy - most pharmacy items that you're given while you're in hospital are covered by your hospital bill. The hospital may charge you extra for pharmacy items that you take home with you and this isn't covered by your hospital cover. 
  • Prostheses that aren't listed on the Government Prostheses List. (A prosthesis is an artificial substitute for a body part.)
  • Ambulance subscriptions or state-based levies
  • Ambulance services paid for by the Government, compensation or another type of insurance
  • Ambulance services that aren't medically necessary
  • Some medical devices and consumables
  • Experimental treatments