Understanding private health insurance and hospital fees

Private health insurance in Australia gives you a wider range of health care options compared to the public health care system.

Your treatment options will depend on your insurance policy and cover you select, please check with your health insurer to be sure of exactly what you are covered for.

You can check your policy directly through your health fund.

For more information about your Australian health fund, visit PrivateHealth.gov.au

Insurance policies often include an excess or deductable, this is usually a fee per transaction/admission to hospital, although sometimes it can be a one-off annual fee. This fee is required to be paid before your insurance will cover any costs for treatment.

Depending on your level of cover this fee may be higher or lower.

If you do not have private health insurance, we can help you to access appropriate treatment at a St John of God Health Care private hospital through our 'self-funded care' option. Self-funded patients are required to pay their estimate account before, or upon, their admission.

Please visit our self-funded care page to learn more.

Before you receive your treatment, you are entitled to ask your doctor or health care provider, your health insurer and chosen hospital about any costs you may have to pay out of your own pocket, commonly known as a ‘gap’ payment.

Non-hospital fees will be billed separately and may include:

• surgeon/specialist physician
• anaesthetist
• pharmacy
• physiotherapy, occupational therapy and dietary services (please check with your health fund if they provide a rebate)
• radiology and pathology
• hire of aids
• clinical care provided at home

Some fees may be covered by Medicare or your health insurance, so please check before treatment.

St John of God Ballarat Hospital

Our Emergency Department is a private emergency facility and an out-of-pocket fee of $305 applies to most visits. We bill Medicare directly for doctors’ procedures and consultations. A $110 fee is charged for any subsequent Emergency Department visits within 7days for the same condition.

St John of God Geelong Hospital

Our Emergency Department is a private emergency facility, and a fixed out-of-pocket fee of $265 applies. We bill Medicare directly for doctors’ procedures and consultations.

St John of God Murdoch Hospital

Our Emergency Department triage fee is $295. This covers your triage assessment, nursing care and medications used during your visit. This fee is not covered by Medicare or private health insurance.

We bill Medicare directly for doctor consultations and procedures provided in the Emergency Department, so there is no additional fee for Medicare-eligible patients.

There are several ways to pay out-of-pocket expenses.

Pay your bill online

You can pay online through our pay my bill webpage.

Pay your bill by phone

Contact our accounts team on 1300 556 089.

Pay your bill in person

You can make payment at the hospital on the day of your admission. Cash and credit card payments are accepted.

You may be able to spread the cost of hospital treatment using the patient funding platform Total Lifestyle Credit (TLC). If you choose this payment option, your plan will need to be in place 5 business days prior to your admission. TLC is a third party that can provide loans for medical fees between $2,000 to $50,000. This can include specialist doctor, anaesthetist, hospital, after-care and pharmaceutical fees. Interest and limits apply. TLC will discuss your eligibility based on employment and Centrelink status. Insured and self-funded patients may apply. For further information, visit the TLC website.