FREQUENTLY ASKED QUESTION

What isn't covered by hospital insurance?

Your hospital insurance cannot cover ‘outpatient’ services—these are treatments you receive when you haven’t been formally admitted to hospital, for example, tests and examinations (like x-rays and blood tests). In most cases, Medicare will help cover these services.

If you visit your doctor or specialist at a hospital, without being admitted, this is classed as outpatient hospital treatment, for which your private health insurance cannot pay a benefit. Please call us to get a quote if you’re unsure.

Depending on your level of cover, you may also have exclusions and/or restrictions. If a service is excluded, it’s not covered at all. Restricted services receive the minimum default benefit, which generally means a large out-of-pocket.