If you need to go to hospital, you have the option of going to a public hospital or a private hospital. We can pay benefits towards the cost of treatment as a private patient in a public or nib Agreement Private Hospital for services included on your health cover.
If you are an overseas visitor or overseas student from a country without a Reciprocal Health Care Agreement with Australia, you’ll need to rely on private health insurance to help pay for services in a public or private hospital.
When to go to a public hospital
In an emergency, you should go to a public hospital, and if you call an ambulance, you’ll be taken to a public hospital to be treated. Public hospitals are usually equipped to handle more complex cases than a private hospital and may be more appropriate for certain treatments. Your ability to be treated at a public hospital also depends on where your surgeon performs the procedure.
Australian residents who choose to be treated as a private patient in a public hospital will have some hospital costs covered by Medicare, and, depending on your cover, your health insurance will pay some or all the remaining fees for accommodation, theatre, doctors and specialists, although you may also have out of pocket expenses to pay.
International members will always be treated as a private patient, with hospital fees covered by your OSHC or OVHC, although some out of pocket costs may apply.
As a private patient in a public hospital, you may:
Experience wait times to be treated when a spot becomes available for anything that isn’t an emergency
Stay in a private room if available and provided the procedure is included on your cover
Have a limited choice of doctor and hospital
Australian residents can also choose to be treated as a public patient, and Medicare will cover the cost of your hospital stay. However, you could also be faced with:
Being put on the public hospital waiting list for anything that isn’t an emergency
Staying in a shared room with other patients
Limited or no choice of doctor, hospital and when your treatment is performed
Your procedure being postponed for more urgent cases
When to go to a private hospital
Private hospitals are generally for planned and non-emergency services, and give you more choice about your care. Waiting times for planned procedures are usually shorter in private hospitals, and you’ll also benefit from:
Avoiding public hospital waiting lists
Staying in a private room if available
Choosing your doctor, hospital and when your treatment is performed
Talk to us before seeking treatment
Before you go to a hospital or see a medical specialist, talk to us so we can help you find trusted healthcare providers near you that can save you money.
We have agreements with a large network of hospitals and specialists around Australia. If you don’t go to an nib Agreement Hospital or see specialists in our network, you may have significant additional expenses to pay.
Before you’re admitted to hospital, you're entitled to know in writing the potential costs and additional fees you may be charged. This is known as informed financial consent, and includes fees for the hospital, specialists, surgeons, assistant surgeons and anaesthetists involved in your treatment and other associated costs for your procedure. Ask your specialist if they will participate in nib’s MediGap scheme, and if their anaesthetist is part of our GapSure network or also willing to participate in MediGap, to help reduce your out of pocket costs.
