Having private hospital cover means you can choose whether you want to be treated as a private or public patient. If you go to a public hospital, you’ll be asked to sign a ‘patient election form’, which tells the hospital whether you want to be admitted as a private or public patient.
But, having private hospital cover doesn’t mean that you can’t or shouldn’t ever go publicly. You have the right to be fully covered by Medicare as a public patient if that’s what you choose. Whatever you choose, the hospital and your doctor should tell you what your out-of-pocket costs will be before you’re admitted (this is called informed financial consent).
Going private
If you’re going to hospital for something that isn’t an emergency, going to a private hospital means getting to choose your doctor and avoid long public hospital waiting lists. You’re also more likely to score yourself a private room (since there are more of them available).
If you choose to be treated as a private patient and you’re moved by ambulance to another hospital, the cost is usually covered by your hospital cover.
Going to public hospital as a private patient? Public hospital waiting lists apply, so check with your doctor and the hospital.
Why would I go public?
There are a few reasons that you might go to a public hospital.
For example, if it’s an emergency (you’ll
usually be taken straight to a public hospital in this case) or they might have the best facilities for your condition. Another key reason to go public is that it’s free (there may be some minor charges). We’re pretty lucky in Australia that we’ve got a world-class public hospital system. You might have to wait a fair while to get your elective (planned) surgery, but if you have a life-threatening or urgent condition, the public system will get you sorted quickly.
While private hospital cover does cover you for a private room, there’s no guarantee one will be available. Private rooms in public hospitals are given to patients based on their medical needs, not their health cover.
The same goes for choosing your own doctor - private hospital cover does give you the option, but it all depends on whether your doctor is available and works at your local public hospital. Depending on your condition, the doctor who treats you at a public hospital might even be the same one you’d have chosen as a private patient. In these cases, it’s often just as easy to be admitted as a public patient.
It’s important to keep in mind that any restrictions or exclusions on your cover still apply if you’re admitted as a private patient in a public hospital.
| Private patient in a private hospital | Private patient in a public hospital | Public patient in a public hospital | |
|---|---|---|---|
| How quickly will I be treated? | As soon as you and your doctors are ready (as long as you've served your waiting periods) | As soon as there's a spot available on the public hospital waiting list (as long as you've served your waiting periods) | Unless it's an emergency, you'll have to wait until there's a spot available on the public waiting list. This could be weeks (or even months) depending on the treatment you need |
| Can I choose my own doctor? | Yes (unless it's an emergency, when a choice of doctor isn't always possible) | Yes, as long as it's not an emergency and your doctor works in a public hospital. | No |
| Can I choose which hospital I go to? | Yes, as long as your doctor works there | Yes, as long as your doctor works there | Yes, depending on your condition and what services are available |
| Can I get a private room? | Yes, if one is available | Yes, if one is available or it's medically necessary | If one's available and it's medically necessary |
| Will I have to pay for my hospital accommodation? | You'll only have to pay your excess (if you've chosen one on your cover) and any extras you use (like TV or getting the newspaper) as long as you're at a hospital that has an agreement with Peoplecare (and most of them do) | You'll need to pay your excess (if you've chosen one on your cover). The good news is that it's halved when you're admitted to a public hospital | No |
What if I change my mind?
You’ll only be able to change how you’re admitted if something unexpected comes up, so it’s important to have all the information you need before you make your choice.
At the end of the day it’s entirely up to you and what you’re comfortable with – having private hospital cover just gives you more options. If you’re planning a hospital stay, or have any questions about private vs public admissions, give us a call and our Peoplecarers will talk you through it.
