Our top tips on being a private patient in a public hospital

Unlike planned elective surgery, unexpected health emergencies can leave you with limited time to make decisions about your healthcare.

One of these decisions - if you need to be admitted to hospital after a visit to the emergency department - is whether you will be admitted as a public or private patient.

What does it mean to be a private patient in a public hospital?

To be privately covered in a public hospital means your health insurance policy is covering your admission, rather than Medicare.

There are genuine and appropriate reasons to receive treatment as a private patient in a public hospital – you might live in a rural or remote area, or a service you require is better accessed in a public hospital facility. However, especially after the event of an unexpected admission, this decision should always be yours as the patient.

While in the emergency department, you might be approached by hospital staff who will discuss this topic with you. So, here’s our top 3 things to consider when making this decision:

You are not obliged to use private health insurance for a public hospital stay

If you are eligible for Medicare benefits, you can choose to be covered as a public patient and all medically necessary inpatient costs will be covered by Medicare. You have a right to be a public patient, even if you have private health insurance, and this should not affect the level of clinical care you receive.

It is entirely your choice as to whether you elect to use your private health insurance, and if you do, you must be provided with informed financial consent before being treated as a private patient, or within a reasonable timeframe after admission.

Ensure you are receiving the right benefits by using your private health insurance

If you do choose to be a private patient, it is important to check that you are receiving the right benefits such as choice of doctor, accommodation options, and other equivalent private hospital options. Public hospitals are known to offer benefits to patients who choose to use their private health insurance, including free Wi-Fi, food vouchers or parking discounts. It’s important that these benefits don’t replace the more important benefits you are eligible for as a private patient.

Be prepared for possible out-of-pocket costs if you use your private health insurance

Even though you’re in a public hospital, the conditions of your health insurance policy will apply to your admission if you choose to be a private patient. This means, you may be required to pay any excess, and the doctor who treats you may charge a gap for their services, above what Medicare and your health fund will cover. It is important to remember that if you are covered by a policy that has exclusions or restrictions, you may not be covered privately for the services you require.

It is important to remember you have a choice when deciding how you will be covered for services in any private or public hospital. Be informed, be equipped with the right questions, and know your rights as a patient.

At Doctors’ Health Fund we advocate for informed financial consent and patient choice. Contact us today on 1800 226 126.