Hospital fees and claiming

Based on your level of cover, different health funds and policies vary in what components of your hospital stay will be covered.

What's included

Your hospital stay includes your room, theatre costs, intensive care (ICU) (if needed), inpatient medication and meals. These costs are generally covered by your private health insurance.

What's not included

Extra services such as the below are not included and may be billed separately by the relevant provider after your stay:

• treating doctors and surgeons
• anaesthetists
• other medical practitioners, consultants or surgical assistants
• medical and allied health services (eg physiotherapy)
• pharmacy (eg non-admission related, non-PBS and discharge medications)
• radiology services (eg X-rays, MRIs, CTs )
• pathology services (eg Blood tests etc).

Find out more about out-of-pocket expenses.

Ensure you ask your treating doctor, anaesthetist and surgical assistants to explain their charges, and to give you an indication of how much you will get back from Medicare.

Health fund checklist

Contact your health fund to help you work out what is or isn’t covered and how much you will have to pay.

Ask these five questions:

1. Am I fully covered for an admission to a private hospital and the procedure/s I am having? (Your doctor should provide you with the MBS item number(s) for your procedure).
2. Do I have an excess or any co-payments associated with my policy? If so, what are they?
3. Does my policy have any restrictions, limitations or minimum benefits that may apply to my planned admission? If so, what are they?
4. Have I served all current waiting periods?
5. Am I currently financial, with all premiums payments up to date?

Reminder:

• If you have recently changed funds or changed your level of cover within the same fund, confirm with your health fund that this doesn't effect cover for this admission.
• If your admission is related to an accident, inform your health fund as it may be covered by another insurer such as WorkCover.

If you do not have private health insurance please email: estimates@muh.org.au for a cost estimation of your hospital fees. This amount will need to be paid prior to or on admission to hospital.

If you are being admitted as a result of WorkCover or third-party liability, you require written approval from the relevant insurance company prior to admission.

If your claim has not been approved by the insurance company, you will need to pay the hospital’s estimated fee prior to or on admission.

If you are an overseas visitor, you will need to pay the hospital estimated fee prior to or on admission. If you have appropriate overseas health insurance, you can seek reimbursement from your insurer.

For further information, please contact our admissions team on +61 (2) 9812 3000.