What are the out-of-pocket costs for a hospital visit?
Informed Financial Consent is your right to know what you’ll need to pay upfront before you receive any hospital treatment as a private patient, and to receive this information in writing. It’s important to ask your treating doctor, the hospital and us about any out-of-pocket expenses you may have to pay.
When you’re admitted to hospital as a member of our health fund, Medicare pays 75% of the MBS fee for eligible inpatient services, and we pay the remaining 25%. If your doctor charges more than the MBS schedule fee, you will be out-of-pocket for this additional amount unless billed under Access Gap Cover.
Ask your treating doctor or specialist
How much is your fee?
Do you participate in the Access Gap scheme under the Australian Health Service Alliance (AHSA)?
If I have to pay a gap, how much will that be?
What are my options if I can’t afford to pay this gap?
Which other doctors and medical staff will be involved in my treatment, e.g. radiologist, anaesthetist, assistant?
How can I get information about assisting doctors’ fees and Access Gap participation?
Will I receive just one bill?
If I am receiving a surgically implanted device or prosthesis, is it a Government approved device (covered by TUH) or will I have to pay a gap?
What are the MBS item numbers for this procedure? (see “Ask us” section below)
Ask your hospital
Does this hospital have any agreement with TUH?
Will I have to pay a gap for my hospital accommodation?
What other out-of-pocket expenses apply during my time in hospital?
Ask us
My doctor gave me these MBS item numbers for my procedure or service. Does my policy cover me for this?
Under my policy, will I have to pay an excess or any other charges? If so, how much?
Will I have to pay extra for my hospital accommodation, my doctor’s fees, and any assisting doctors’ fees, or is it all covered by my policy?
If I have to pay extra, who do I pay, and when?
Find out more about paying your hospital fees.
