What’s an excess?

An excess is the amount you agree to pay towards inpatient hospital treatment, in exchange for a lower premium. It’s only relevant to hospital cover not extras cover. If you are fit and healthy, with no plans for near-future elective surgery, having an excess on your policy can be a way to save on your health insurance costs day-to-day. However, before choosing your excess, consider whether you could pay the cost if you were admitted to hospital.

Excess options and how often they need to be paid varies between health funds. Some health funds also offer the option of a co-payment, which operate in a similar way.

At Doctors’ Health Fund, we offer three types of excess options: $500, $750 or no excess, depending on the level of cover you choose. Excesses apply to same-day procedures as well as overnight admissions. We don’t offer the option of a co-payment.

If you choose a $500 excess, that is the maximum excess you will pay per person per calendar year to a maximum of $1,000 per family or single parent policy. If you choose a $750 excess, that is the maximum you will pay per person per calendar year to a maximum of $1,500 per family or single parent policy. If you don’t choose an excess, you won’t have an out-of-pocket expense to pay to the hospital at any time if you need to be admitted.

Below is a table outlining the excess options available on each level of Doctors’ Health Fund hospital cover. Until recently, Top Cover Gold was only available without an excess. This is our unique level of hospital cover that pays medical benefits up to the AMA list of services of fees. If you are interested in having this cover, you can now choose to have a $750 excess and you will pay less for the premium.

Do waiting periods apply to excesses?

Waiting periods apply to excesses like any other waiting periods:

• If you downgrade your excess when you transfer, meaning you choose a higher excess amount, no waiting periods will apply, and you will pay the higher excess amount for your first admission. If you paid your excess within the same calendar year with your previous fund, you’ll pay the difference to meet the higher excess amount.
• If you upgrade your excess when you transfer, meaning you choose a lower excess amount, you will pay the excess amount you had with your previous health fund if you have an admission in the first two months of switching. If you have an admission between 2 and twelve months, pre-existing condition rules will apply. If you paid your excess within the same calendar year with your previous fund, then no excess will apply for any additional admissions in that year.
• If you transfer to an equivalent level of cover, you will pay that excess amount if you need to go to hospital. If you paid your excess within the same year with your previous fund, then no excess will apply for any additional admissions in that year.

Interested in a quote?

See how your current cover compares today with an online quote, or contact our expert and friendly team on 1800 226 126 for a tailored and complimentary comparison report further detailing how Doctors’ Health Fund compares.