Important information for our members
After 12 November 2023, Rosebud Endoscopy is no longer part of our ahm Partner Private hospital network.
Why this change?
ahm has arrangements with most private hospitals and day surgeries in Australia, called Partner Private hospitals, which enable our members to get better value for included treatments at these hospitals. For example, ahm Partner Private hospitals generally won’t charge out-of-pocket costs for hospital accommodation for Included services.
These Partner Private arrangements help us to keep premium increases as low as possible for our members. In putting those arrangements in place, most private hospitals have worked with us on delivering excellent care at an affordable price.
Unfortunately, in recent discussions with Rosebud Endoscopy we’ve been unable to reach an agreement to provide affordable ongoing Partner Private arrangements for our members. We haven’t taken this decision lightly and while it’s not the result we had hoped for, we believe it is important for all our members to keep premiums affordable. We’ll continue to talk with Rosebud Endoscopy to try and reach a new Partner Private agreement that doesn’t put pressure on premiums.
What does this mean for you?
After 12 November 2023, Rosebud Endoscopy is no longer part of our Partner Private hospital network and may now choose to charge you additional out-of-pocket costs for services such as hospital accommodation.
Hospitals are required to give you information about your potential costs, make sure you ask the hospital and your doctor about this before your treatment.
What if I have a pre-booked admission or I am currently receiving treatment?
If you have a pre-booked admission or are currently receiving treatment at Rosebud Endoscopy we will have been provided with the details of your admission and you’ll still receive benefits under our existing Partner Private arrangements for a specific period*. These include, if applicable:
- pre-booked general admissions for six months after 12 November 2023
- pre-booked pregnancy and birth treatment for nine months after 12 November 2023
- hospital treatments that don’t require admission for two months after 12 November 2023
- ongoing treatment of chronic and other conditions for six months after 12 November 2023
- emergency admissions for three months after 12 November 2023
If you require treatment, please message us to find out more about what is and isn’t included in your cover and whether or not the above applies to you.
It’s important to note that after 12 November 2023, Rosebud Endoscopy may now choose to charge you additional out-of-pocket costs for services like your hospital accommodation. Hospitals are required to give you information about your potential costs, make sure you ask the hospital and your doctor about this before your treatment.
If you’d like to understand more about the specific treatments for the above-listed periods, and what’s included in your cover, please message us.
What if I don’t have a pre-booked admission or I’m not currently receiving treatment?
If you’re not currently receiving treatment or don’t have a pre-booking at Rosebud Endoscopy, you may still receive benefits under our existing Partner Private arrangements with Rosebud Endoscopy for a specific period*. These include, if applicable:
- hospital treatments that don’t require admission for two months after 12 November 2023
- ongoing treatment of chronic and other conditions for six months after 12 November 2023
- emergency admissions for three months after 12 November 2023
If you require treatment, please message us to find out more about what is and isn’t included in your cover and whether or not the above applies to you.
It’s important to note that after 12 November 2023, Rosebud Endoscopy may now choose to charge you additional out-of-pocket costs for services like your hospital accommodation. Hospitals are required to give you information about your potential costs, make sure you ask the hospital and your doctor about this before your treatment.
If you’d like to understand more about the specific treatments for the above-listed periods, and what’s included in your cover, please message us.
What happens if the pre-booked admission date needs to change?
Please message us if your pre-booked admission needs to change.
What are your options after 12 November 2023?
- Continue to visit Rosebud Endoscopy, and we’ll continue to pay benefits towards your treatment based on what’s included in your cover. However, Rosebud Endoscopy may now choose to charge you additional out-of-pocket costs for services like your hospital accommodation; OR
- Ask your doctor at Rosebud Endoscopy if they’re able to perform your treatment at a Partner Private hospital to minimise your out-of-pocket costs. Many doctors may have admitting rights at multiple hospitals; OR
- Visit another Partner Private hospital to minimise your out-of-pocket costs.# You can find your nearest Partner Private hospital at ahm.com.au/find-a-provider
It’s always best to message us first before going to hospital so we can let you know what is and isn’t included in your cover and what questions to ask your doctor about potential out-of-pocket costs.
How do I avoid additional hospital costs?
To keep your costs in check, it’s best to message us first before any hospital admission. That way:
- We can take you through what is and isn’t included in your cover; and
- We’ll let you know what questions to ask the hospital and your doctor, so you’re fully aware of any out-of-pocket costs up front.
You can message us between 9am–6pm Monday to Friday (AEDT).
Your hospital should always obtain your Informed Financial Consent before treatment. This means they need to tell you in advance if you might incur any out-of-pocket costs for the treatment you’re about to receive, and the likely amount of those costs. It’s your right to know this, so make sure to ask prior to your treatment.
Why does ahm have special arrangements with some private hospitals?
The arrangements between ahm and private hospitals allow us to negotiate better terms that reflect the value and outcomes that we expect for our members.
These Partner Private arrangements help us to keep health cover costs as low as possible for our members. In putting those arrangements in place, most private hospitals have worked with us on delivering excellent care at an affordable price.
What’s the difference between a Partner Private hospital and a non-Partner Private hospital?
Our extensive network of Partner Private hospitals can provide better value for our members compared to non-Partner Private hospitals.
Non-Partner Private hospitals can choose to charge members additional out-of-pocket costs for services such as hospital accommodation.
Visit ahm.com.au/find-a-provider to find a Partner Private hospital near you.
Will Rosebud Endoscopy become part of our Partner Private hospital network again?
We remain focused on providing better value for our members and are open to working with Rosebud Endoscopy to reach a new agreement that helps us keep premium increases as low as possible.
Got questions? We’ve got answers
Message us between 9am–6pm weekdays (AEDT).
To find a Partner Private hospital visit ahm.com.au/find-a-provider
Disclaimers:
# ahm Partner Private hospitals are not available in all areas. ahm Partner Private hospitals are part of the Medibank Members’ Choice network.
* Subject to meeting all eligibility requirements at the time of service, refer to your Cover Summary and Member Guide for more information. Specified periods listed above meet the requirements of the Private Health Insurance Ombudsman’s Termination and Transition Guidelines.