Should you use your hospital cover in a public hospital?

The short answer is you don’t have to. Read our 2-minute explainer that could save you big dollars.

Having 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.

The thing is, having hospital cover doesn’t mean that you can’t or shouldn’t ever go public. 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 specialist should tell you what your out-of-pocket costs will be before you’re admitted (this is called Informed Financial Consent).

Emergency admission

One way to reduce your out-of-pocket expenses in an emergency admission to hospital is to enter as a public patient.

It’s entirely up to you if you want to use your hospital cover in an emergency. However, we think there are some good reasons to consider your options.

Reasons not to use your hospital cover in emergency

  1. you get the same speed of service as a public patient in an emergency situation
  2. you could risk large out-of-pocket expenses
  3. it does not guarantee you a private room in the hospital

Once you elect to use your hospital cover, you’re locked in to paying all out-of-pocket expenses that are billed to you.

Reasons you may like to use your hospital cover in an emergency

  1. you would like to choose your own doctor at that hospital
  2. they have a private room available for you

Planned surgery

Planned surgery, also called elective surgery, is what private hospital cover does best. You still have a choice to go public, but there may be some compelling reasons not to.

The real advantages of private hospital cover are to use it in a private hospital so that you avoid the long public hospital waiting times and you choose who provides your care.

Reasons to use your hospital cover for planned surgery

  1. use your cover in a private hospital and you might get treated sooner
  2. choose your own the doctor
  3. get your pick of state-of-the-art facilities at public and private hospitals

In the end, the choice is up to you. But at least now you have the basic info to make an informed decision.

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Member give-back

As a not-for-profit and member-owned health fund, we’re committed to giving back claims savings we made due to COVID-19 restrictions. Members will receive their refunds in the same bank account that we pay their claim benefits to. Members don’t need to do anything to receive their refunds.

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