If you're referred for surgery or treatment, you may like to learn about Access Gap Cover to help minimise or, in some cases, eliminate out-of-pocket expenses when you go to hospital.
We have agreements with most of the participating private hospitals and day surgery facilities Australia-wide. In most cases, once you’ve paid your agreed excess and copayment (where applicable), 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 us.
Private hospitals and day hospital facilities that have no signed agreement with us attract reduced benefits which will mean you may have out-of-pocket medical expenses for in-hospital treatment.
Use the above to find a hospital most convenient to you.
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.
We have agreements in place with certain optical providers under our Premier Provider Network to provide you with great discounts, so you get even more value for money.