If you need to visit a hospital for treatment, we have agreements with most of the participating private hospitals and day surgery hospital facilities Australia-wide.
In most cases, once you’ve paid your agreed excess, your approved hospital accommodation charges will be covered in full. This means that you’ll benefit from capped fees we’ve negotiated and convenient billing as your invoice will be sent directly to Territory Health Fund.
Private hospitals and day hospital facilities that have not signed an agreement with us attract reduced benefits which will mean you may have out-of-pocket medical expenses for in-hospital treatment.
PLEASE NOTE: Hospital services are paid based on the contract that exists between the Fund and the hospital provider. Default benefits will apply to services not included or if the contracted number of services is exceeded which includes hospital substitute treatment*.
* Hospital substitute treatment allows patients the option subject to a doctor’s approval, to complete their hospital recovery in the comfort of their own home or in community healthcare clinics e.g. wound care and IV therapy.