You can choose whether you’re treated in a private hospital, or as a private patient in a public hospital — in conjunction with your doctor or specialist.
Partner private hospitals and day surgeries
To help you know your costs and benefits up front we’ve contracted with most private hospitals, which includes an agreement on how much they can charge. This makes it simpler and clearer for you.
Non-partner hospitals and day surgeries
In some cases, we haven’t reached an agreement with a private hospital or day surgery.
These are referred to as non-partner hospitals.
If you receive treatment for a service that’s Included or Restricted on your cover at a non-partner hospital, we’ll only pay a limited benefit and you may be significantly out of pocket. If you receive treatment for an Excluded service, no benefits will be paid.
We always recommend you complete a hospital cover check for summary of your cover and the level of benefits you will receive from us, before you go to hospital.
To get the right information to make a hospital claim, before you go, give your specialist our
7 Questions for your specialist before going to hospital
Public hospitals
If you’re treated as a private patient in a public hospital for Included services, you can receive benefits for same-day admissions and overnight accommodation in a shared room. If you choose a private room in a public hospital, you may have an out-of-pocket expense. This depends on your cover and what you’re going to hospital for. You can refer to your product guide to see at a glance what's Included on your cover.
By completing a hospital cover check before you go to hospital, we can confirm:
- If the procedure is Included on your cover
- Whether any waiting periods still apply on your cover
- If your condition could be considered pre-existing
- If you need to pay an excess or daily charge
- If the hospital you will be treated at is an ahm partner private hospital