What happens if I need to go to hospital?

If you need hospital treatment, you have two options:

You can go through the public system. You will get a shared room in a public hospital, have a doctor allocated to you, and potentially wait on the public waiting lists for your treatment. All of this is covered by Medicare.

OR

You can elect to be admitted as a private patient. You will have the choice of where, and when you're treated, whether you have a private room, and which doctor performs the treatment. This isn't covered by Medicare, and is generally very expensive.

What is Hospital Cover?

Hospital cover is exactly what it sounds like: insurance that helps to cover your costs in hospital. With hospital cover you’re covered for things like treatment, accommodation and nursing care.

How much of your expenses are paid depends on your level of cover, the procedure or care given, and the hospital you choose to stay in.

Hospital cover doesn't cover you for services received outside of a hospital like a visit to your GP, dentist, new glasses. Things like x-rays, where you aren't admitted as an inpatient to hospital (even if they're done in a hospital building) also aren’t covered.

What is the difference between levels of cover?

All health funds offer different levels of hospital cover that govern which hospital you can go to, the amount that you pay when you are admitted into hospital and which services are covered.

This means it's important to find this information out when choosing your hospital cover.

To learn about the differences in our levels of hospital covers check out our Hospital Cover page.

How do you claim hospital expenses?

There are usually two types of accounts that need to be paid: the hospital accounts (for accommodation, all that yummy food, etc.), and the doctor’s accounts. Each of these are claimed slightly differently. Check out our How to claim page for the full run down.

Will I have to wait before I claim?

Yes, particularly if you’re new to health insurance. With our covers (and most other health insurers) you have to wait a specific amount of time between signing up and making your first claim. This is called a waiting period.

On some procedures, there is a timeframe after the waiting period during which insurers will pay benefits at a lower rate in a public hospital only. This is called a benefit limitation period.

For more detail, check out our waiting periods and benefit limitation period page or view the products page for the specific waiting periods that apply to your level of cover.

What if I have a pre-existing condition?

You’ll still be covered, but there are special waiting periods for pre-existing conditions.

For services that relate to your condition the waiting periods will be extended, generally to 12 months.

Do I have to pay an excess?

Yes. If you are admitted to hospital, you will have to pay an excess directly to the hospital upon admission. An excess helps with the cost of your admission and by having an excess, the amount you pay for your cover is lower.

The most you will have to pay in excess per year is $500 for a single policy and $500 per person up to a maximum of $1,000 for a couple or family policy per year. For example if you are admitted to hospital and pay the $500 excess and are re-admitted later in the year, you won’t need to pay it again.

What are co-payments?

Co-payments are part of some hospital covers (on top of the excess) to help keep the cost of the cover down. Co-payments are usually charged per day that you’re in hospital and apply in certain situations, for example when you stay in a private room.

Which hospitals are on Frank's ‘participating hospital list’?

View our list of participating private hospitals. This can change, so if you need to be 100% sure, either ask the hospital, or contact us.

Are there services Frank won’t pay on?

Yes there are. It might make us sound mean, but if you have a read, you'll see they're fair. Read the full list of things Frank won’t pay on.