OSHCstudents – If you choose to use private health insurance to pay for your hospital treatment, it’s important to understand what’s generally included so you can get the most out of your cover.
By law, private hospital cover can only pay towards the cost of ‘in-patient’ hospital treatment. Medicare may cover some or all of the cost of outpatient medical treatments.
Before you choose to be treated as a private patient using your private hospital cover, there’s a few questions to ask:
- Is the treatment I need covered under my policy?
Your health insurer should give you paperwork that will confirm what types of treatments are and are not, included in your policy. They may group treatments into ‘groups of services’ so it’s not always clear. If you’re not sure, it’s best to check directly with your insurer to confirm you’re covered.You may also find that you are given a ‘Medicare item number’ which is a specific number assigned to each procedure. This is used by Medicare and insurers to work out what they need to pay, based on the type of service you need. You can also use this number to check if you’re covered with your insurer. - What does it mean if my treatment is ‘covered’?
For each of the types of costs you may face in hospital, your insurer might cover them slightly differently.
Generally, private hospital cover will:- Pay towards the ‘hospital costs’ you have in hospital
- Together with Medicare, pay 100% of the MBS for the ‘medical costs’ (doctors’ fees) for your treatment in hospital. Your insurer may have a ‘medical gap scheme’ that helps cover any medical costs above this amount
- Pay toward the cost of prostheses up to the approved amount on the Australian Government Prostheses List
- Pay toward the cost of medications, if the medication is:
- On the Government’s Pharmaceutical Benefits Scheme (PBS)
- Approved by the Therapeutic Goods Administration (TGA) as a treatment for your condition
- Taken in hospital, and
- Required to treat the condition you’re in hospital for
It’s best to check the details of the above with your insurer, as it will vary.
You are international students or foreigners arrive to Australia, or Australian citizens traveling abroad who are looking for OSHC, OVHC, travel insurance, please contact OSHCstudents Team at email: info@oshcstudents.com and our partners for further information and assistance.
OSHCstudents (source: Bupa)
