Private patients

When admitted to Alfred Health, holders of Medicare cards have a choice to be treated as either a public or private patient. This is called your financial election. An election choice can be made before, at the time of, or as soon as practical after you are admitted.

You can choose to be admitted as either a public or private patient at our hospital. By using your private health insurance, you are helping The Alfred meet the costs of its services and purchase and upgrade equipment. This is entirely up to you and you will receive the same treatment whether you are a public or private patient. Contact the Finance Patient Liaison Team for further information.

As a private patient you will be provided with an Informed Financial Consent form as part of your election process

Public hospitals are required to provide a clear explanation of the financial responsibilities of a private patient election. This includes notification of likely out of pocket expenses (gaps), by all relevant service providers, prior to admission to hospital or as soon as circumstances reasonably permit. We will perform a membership eligibility check to ensure you have appropriate cover for your admission.

What to expect

When you tell us you have private health insurance, a Finance Patient Liaison Officer will meet with you to ensure you are fully covered for your admission, answer any questions and ensure that all documentation related to your stay is complete.

What are the benefits to me as a private patient in a public hospital?

We are committed to providing a high standard of care and treatment to every patient. Patients with private health insurance have the choice to be treated as either a public or private patient.

Your decision to be admitted as a private patient allows us to bill your health fund. We appreciate and welcome you using your private health insurance at Alfred Health, as we strive to work hard to deliver quality health services to meet the increasing demands of a growing community and implement a range of programs designed to improve access to quality care.

Regardless of financial status, all patients receive the same quality of treatment and range of services. For patients who choose to use their private health insurance we can provide the following:

• Health Fund Excesses: An excess or co-payment is an amount you pay towards the cost of your hospital treatment. Your excess amount will depend on your Heath Fund policy type. If admitted to one of Alfred Health’s facilities, we will waive the excess or co-payment to ensure you are not out of pocket for your hospital stay.
• Specialist Care: you may be treated by a Specialist of your choice or a nominated Specialist providing you with the benefit of having one dedicated professional managing your care. Your specialist will oversee your treatment and any follow-up care.
• Access to a single room: You will have access to a single room in our hospital at no additional cost if one is available. Based on clinical need patients who are very ill will be given priority for a single room regardless of election status.
• Access to the Finance Patient Liaison team: who will assist with any concerns you may have relating to your hospital stay and liaise directly with your health fund on your behalf.

When to tell us you want to use private health insurance

You can make a decision to be treated as a private patient before, or at any time during your stay. To be admitted as a private patient or if you require any further information about using your Insurance, you can request to see a Finance Patient Liaison Officer.

What does my private health insurance cover?

Your private health insurance covers:

• Your hospital accommodation
• Prosthetics
• Specialist and surgical costs
• Anaesthetic costs
• Pathology and medical imaging costs

You will not have any out of pocket expenses for the following hospital generated accounts:

• Accommodation and Medical/Surgical Implanted Devices (Prosthesis): Includes the bed fees, meals, nursing and allied health care. Invoices will be submitted to your private health insurance on your behalf.
• Diagnostics (Pathology and Radiology) and Staff Specialists (Doctors employed by the hospital):  All accounts will be submitted to Medicare and your private health insurance on your behalf. There will be no ‘gap’ (out of pocket expense).

If you are unsure about your level of cover or whether you are fully covered, a Finance Patient Liaison Officer can clarify this with you before any decisions made.

What is not covered by my private health insurance?

You do not need to pay for medicines given to you to take while in hospital. All patients will be charged for medications provided on discharge and any equipment (aids and appliances) issued as part of the discharge arrangements.

These charges are applicable to all public and/or private patients.

Changing election due to unforeseen circumstances

Once an election is made, it can only be changed in the event of unforeseen circumstances, such as:

• you are admitted for a particular procedure and develop complications which need additional procedures
• your hospital stay is substantially longer than originally planned by the clinical staff treating you
• your social circumstances change while you are in hospital, for example, job loss

Where a valid election is changed, this will be effective from the day the change is made.