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Compare the Top Hospital Cover Plans in 2024

Hospital cover is a type of health insurance policy that covers medical treatments and services performed within a hospital setting. It typically includes expenses such as accommodation, surgeries, specialist consultations, and diagnostic tests.
Fact Checked

Updated: 22 May 2024

Hospital cover is ideal for individuals and families who value the peace of mind that comes with knowing they have financial protection in the event of hospitalisation or major medical procedures. It can be particularly appealing to those who prefer to have more control over their healthcare choices, including choosing their doctor or specialist.

Key facts

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What is Hospital Cover?

Hospital cover is a type of health insurance generally covering the costs of in-hospital treatments, including accommodation. Depending on the level of coverage you choose, it can provide benefits for basic services like lodging or extensive procedures like surgeryIt’s important to note that hospital coverage does not include coverage for services outside of a hospital, such as general practitioner visits.

How does Hospital cover work?

Hospital coverage works by providing coverage for treatments and services within a hospital. Private hospital policies can cover expenses such as doctor fees, operating theatre fees, pathology services, and accommodation in private hospitals. However, it’s essential to understand the specific coverage offered by your plan before signing up, as it may not always be fully comprehensive.

Hospital Product tiers and what they cover

Private health insurance hospital cover and the Medicare Levy Surcharge

In Australia, as a taxpayer, paying a Medicare Levy of 2% on your taxable income is generally required. However, if you do not have appropriate private health insurance, you may also be subject to an additional charge known as the Medicare Levy Surcharge (MLS). The MLS is calculated as a percentage ranging from 1% to 1.5% of your income and is paid in addition to the Medicare Levy.

The percentage of the surcharge you are liable for depends on your income threshold, whether you are a single individual or part of a family unit. This includes couples, single parents, and de facto couples. To determine the amount of Medicare Levy and MLS you must pay, it is important to understand your income level and consult the relevant income thresholds.

Lifetime Health Cover Loading and Hospital cover

Lifetime Health Cover (LHC) Loading incentivises individuals in Australia to obtain private health insurance before the age of 31. Complying with LHC Loading rules offers benefits such as access to high-quality healthcare from a young age and avoiding financial penalties. Individuals can lock in lower premium rates by securing private health insurance early, proactively managing their health, and addressing existing conditions. It is a proactive step towards ensuring comprehensive health coverage, better health outcomes, and long-term financial security.

Pros and Cons of Hospital cover

  • Access to free or subsidised medical services in public hospitals as a public patient.
  • Reimburse up to 100% of Medicare
  • Benefits Scheme (MBS) fees for general practitioner visits.
  • Reimbursement of 85% of the MBS fee for specialist visits.
  • Option to choose public hospitals in case of medical emergencies, where extensive equipment and specialists are available.
  • Avoidance of Lifetime Health Cover Loading and savings on the Medicare Levy Surcharge.
  • Reduced waiting lists for elective procedures.
Couples Life Cover
  • Limited choice of doctors or specialists within private hospital networks.
  • Lack of control over the timing of procedures.
  • Exclusion of treatments done overseas.
  • Ambulance cover is not included.
  • Cosmetic surgeries are not covered.

What Isn’t Covered by Private Hospital Cover

While health insurance covers most healthcare expenses, most plans may not cover certain services. This includes treatments, services, sessions, or procedures conducted outside a hospital setting. Other exclusions may include cosmetic procedures, fertility treatments, and certain prescription medications. However, you’ll typically be able to purchase an Extras policy which could help you cover these costs.

Compare and Review Hospital Policies

The table below shows the monthly costs of various hospital cover policies provided by different health insurance brands: