Who pays?

The health system can be confusing so it’s hard to be sure who pays for what. Let’s try to clear up those murky money waters.

Between Medicare, private health insurance and out-of-pockets, figuring out who pays what can be tricky. Lucky for you, we’ve come up with this handy guide. Please remember that this is only an overview - check out Benefits depend on your level of cover and any restrictions, exclusions or waiting periods you have.

View your full cover description for more detailed info.

  Medicare Peoplecare You
Hospital Extras
Ambulance (state-based providers only) No Yes Yes No

Outside of hospital (outpatient)

Things like specialist fees, radiology, pathology.

 Yes No  No  Yes 
Private Hospital (inpatient)

Remember that your waiting periods need to be served before you go into hospital and we can only pay for the services you’re covered for. If you have an excess, or use the TV or newspapers while you’re in, that’ll be at your own cost.

Medical

Things like specialist fees, radiology, pathology.

 Yes  Yes  No  Yes

Hospital

Things like accommodation fees, theatre fees, protheses.

 No  Yes  No  No

Public Hospital (inpatient)

as a Private patient If you have an excess, or use the TV or newspapers while you’re in, that’ll be at your own cost. Your hospital might ask you to pay additional charges for your admission.

Medical

Things like specialist fees, radiology, pathology.

Yes

Yes

No

Yes

Hospital

Things like accommodation fees, theatre fees, protheses.

Yes

Yes

No

No

Public Hospital (inpatient)

as a Public patient You may have out of pocket costs from your doctor or specialist even if you’re a public patient in a public hospital. If you use the TV or newspapers while you’re in, that’ll be at your own cost.

Medical

Things like specialist fees, radiology, pathology.

Yes

No

No

Yes

Hospital

Things like accommodation fees, theatre fees, protheses.

Yes

No

No

Yes

Other services

Things like dental, optical & physio.

(There are some interesting freebies on Medicare like dental for kids and some free consults for chronic conditions you could get after seeing your GP that are worth looking at.)

Yes

No

Yes

Yes

You can check what you’re covered for and your waiting periods using our Online Member Services, or by giving us a buzz on 1800 808 690.