You can choose where you’re treated and 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 include an agreement on how much they can charge.
Non-agreement hospitals and day surgeries
In some instances, we haven’t reached an agreement with a private hospital or day surgery. These are referred to as non-agreement hospitals.
If you receive treatment for a service that’s included or Restricted on your cover at a non-agreement hospital we’ll only pay a limited benefit and you’ll be significantly out-of-pocket. If you receive treatment for an excluded service no benefits will be paid.
We recommend you contact us before being treated to clarify your benefit entitlements.
The hospital and doctors treating you should tell you about their costs before you go to hospital, so it’s important to ask.
If you’re treated as a private patient in a public hospital for included services, you’ll be covered 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 to pay yourself. 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 you’re covered for.
We can help out by confirming:
- Whether any Waiting Periods still apply
- If you’re covered for the procedure
- 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 hospital
Contact us so we can help to answer this question.