Public vs private patient

News • 01 Jun 2020

You can trust us to support your right to have full control over your health and subsequent medical treatment. This includes, but is not limited to, your right to choose whether you are admitted as a private or public patient in a public hospital. TUH is committed to making sure you have all the information you need to make the right choice for you and your family.

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Every Medicare registered Australian has the right to access the public hospital system at no cost. We all pay for this service through our Medicare Levy. Therefore, public hospitals can’t insist on treating you as a private patient and cannot refuse to treat you if you do not agree. If you do choose to enter a public hospital as a private patient, both you and your health insurer are likely to incur additional costs.  

In general, private rooms in public hospitals are allocated to people who medically require them, which may also affect their availability.

If you choose to be treated as a private patient in a public hospital and there is a private room available, we will pay a fixed private room benefit of $70 per day for all eligible admissions.  This is in addition to a standard shared room benefit, guided by the minimum rates set out by the Government. We made this private room benefit standard for all TUH members across Australia from 1 July 2019 to ensure consistency in benefits being paid across different states. 

If the hospital accommodation charges are greater than the TUH benefit, you’ll be required to pay the balance as an out-of-pocket expense. Please note, your policy inclusions and exclusions will apply in the same way they would for admission to a private hospital.

The hospital and your doctor should always provide you with written informed financial consent with emergency admissions being the only exception. If you are unsure about anything please feel free to give us a call on 1300 360 701 so we can talk you through it.

Contracted hospitals

We have contracts with an extensive network of private hospitals which enables us to pay agreed benefits for services included on your cover. Usually, this means you have nothing to pay for a hospital stay unless you have an excess on your cover or there are medical out-of-pocket expenses.

You can also choose treatment as a private patient in a public hospital. However, as we don't have agreed contracts with public hospitals, your treatment may cost you more. If you choose to be treated as a private patient in a public hospital and there is a private room available, you will have to pay a fixed private room fee of $70 per day.  This is in addition to a standard shared room benefit, guided by the minimum rates set out by the Government which we pay as your private health insurer. You can confirm the costs with the hospital prior to admission. Remember, you can be treated as a public patient in a public hospital at no charge, even if you have private health insurance.

Our hospital contracts vary from time to time and you may have additional out-of-pocket costs for stays in non-contracted hospitals, so please check our find a hospital list before each admission.

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