nib Agreement Hospitals

If you've just learnt you need to go to hospital one of the first things you need to do is call nib. We can let you know if you're covered and help you understand the best ways to reduce any potential out-of-pocket expenses.

One of the key things we'll recommend is using an nib Agreement Private Hospital, or a public hospital, for your procedure. nib has contracts with many private hospitals and day facilities throughout Australia to ensure nib customers pay as few out-of-pockets as possible. And we'll cover any public hospital in line with the benefits provided by your health cover.

nib doesn't have contracts with every hospital. If you choose to be admitted to a private hospital that is not contracted with nib you'll have significant out-of-pocket expenses to pay. It could cost hundreds or thousands of dollars, so it's important to check before you are admitted. It's also the hospitals responsibility to explain any potential out-of-pockets you may receive before you are admitted. It's called Informed Financial Consent.

Your surgeon's charges for the procedure are different from the hospital costs and you'll also need to discuss fees and potential out-of-pockets with your surgeon (read more).

nib Agreement Private Hospital

If you've already checked with nib that your procedure is fully covered this means you'll be covered in an nib Agreement Private Hospital for:

  • In-patient accommodation fees (i.e. your bed stay, meals, nursing care)
  • Operating theatre
  • Labour ward (if relevant)
  • Intensive and coronary care (if relevant)
  • Surgically implanted prostheses on the Government's 'no-gap' list (if relevant - ask your doctor if you require prosthesis and if it will be 'no-gap')

These are the most expensive part of any hospital admission and represent the bulk of the costs you would expect to receive for your hospital stay.

Some services that you may use during a stay in hospital such as drugs, disposable items, Paramedical services such as physio and occupational therapy, are covered up to nib's contracted rate. However, if you exceed the contracted rate, you may have out-of-pocket expenses.

There are some things that nib won't cover. Excluding these services helps to keep the cost of your health insurance down.

  • Luxury rooms and private room accommodation for same day procedures
  • TV hire, phone calls, newspapers, magazines, beauty salon services
  • Respite care
  • Take home items like crutches and drugs
  • Experimental treatments (and their disposable items) not recognised by Medicare
  • Procedures normally performed in a doctors surgery
  • Private hospital emergency fees
  • Donated blood, blood products, blood collection and storage
  • Donated blood, blood products, blood collection and storage

These are examples only and some other out-of-pockets may apply.

Please contact the hospital and have them explain if any out-of-pocket costs might apply for your specific procedure. (read more).

Don't forget your surgeon's charges for the procedure are different from the hospital costs and you'll also need to discuss fees and potential out-of-pockets with your surgeon (read more).

Public Hospital

If you've already checked with nib that your procedure is fully covered this means you'll be covered in a public hospital for:

  • In-patient accommodation fees (i.e. your bed stay, meals, nursing care)
  • Operating theatre
  • Labour ward (if relevant)
  • Intensive and coronary care (if relevant)
  • Surgically implanted prostheses on the Government's 'no-gap' list (if relevant - ask your doctor if you require prosthesis and if it will be 'no-gap')

These are the most expensive part of any hospital admission and represent the bulk of the costs you would expect to receive for your hospital stay.

Some services that you may use during a stay in hospital such as drugs, disposable items, Paramedical services such as physio and occupational therapy, are covered up to nib's contracted rate. However, if you exceed the contracted rate, you may have out-of-pocket expenses.

There are some things that nib won't cover. Excluding these services helps to keep the cost of your health insurance down.

  • Luxury rooms and private room accommodation for same day procedures
  • TV hire, phone calls, newspapers, magazines, beauty salon services
  • Respite care
  • Take home items like crutches and drugs
  • Experimental treatments (and their disposable items) not recognised by Medicare
  • Procedures normally performed in a doctors surgery
  • Donated blood, blood products, blood collection and storage
  • Private nurses

These are examples only and some other out-of-pockets may apply.

Please contact the hospital and have them explain if any out-of-pocket costs might apply for your specific procedure (read more).

Don't forget your surgeon's charges for the procedure are different from the hospital costs and you'll also need to discuss fees and potential out-of-pockets with your surgeon (read more).

Non-Contract Hospital

If nib does not have a contract with the hospital you would like to attend you will have to pay most, or all, of the cost of your hospital stay if you choose to proceed with your hospitalisation. This may cost you hundreds, or even thousands, of dollars and it can't be claimed back from nib.

Please contact the hospital and have them explain the out-of-pockets that will apply for your specific procedure (read more).

To avoid these expenses we recommend you discuss alternative hospitals with your surgeon. Choosing an nib Agreement Private Hospital means you'll significantly reduce your out-of-pocket expenses.

Don't forget your surgeon's charges for the procedure are different from the hospital costs and you'll also need to discuss fees and potential out-of-pockets with your surgeon (read more).

IMPORTANT: When going to hospital, it's important to understand what you're covered for, if any waiting periods apply and the types of costs involved. You should always check with nib before you go to hospital.