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Excess - image

Having an excess on your Hospital cover is a way of making your health insurance cheaper. Generally, the higher your excess is, the lower your premiums will be.

Just like with your car or home insurance, an excess is a contribution you’re required to pay towards a Hospital claim you make on your policy. It’s paid directly to the hospital when you’re admitted for treatment.

An excess doesn’t apply for Extras or Overseas Students cover.

When do I pay my excess?

You’ll only ever pay your excess if you’re admitted to hospital as a private patient. You’ll need to pay your excess upfront before you receive treatment. The remaining costs will be paid by Medicare (if you’re an Australian resident), and depending on your cover, your hospital insurance - although some out of pocket expenses may apply.

Good news for families

If you're on a selected family cover, you won't need to pay the excess for kids up to 21 years old - call us to find out if this applies to you.

The number of times an excess is payable per calendar year varies depending on your cover. To find out more about your excess, refer to your Policy Booklet or Fund Rules, or call us.

Selecting your excess

Australian residents can select an excess of up to $750 per person. For most family covers, you'll only pay twice the chosen level of excess per calendar year. For Overseas Visitors, you can select a $500 excess or a $0 excess.

You can increase or decrease your Hospital excess by changing your cover in your nib account (for OVHC members, you’ll need to call us).

If you select a higher excess

Your premiums will be lower but you’ll pay more upfront if you’re admitted to hospital.

If you or someone on your policy has already paid an excess for a hospital admission in the current calendar year, you may need to pay the difference between the lower excess paid and your new, higher excess if you’re admitted again in the same year.

While there’s no way of predicting whether you’ll need to go to hospital, you may want to consider a higher excess if you:

  • Are young and healthy

  • Have never been to hospital before

  • Think it’s unlikely that you’ll need to go to hospital

  • Can afford the upfront cost of a higher excess

If you select a lower excess

You’ll pay more for your premiums, but won’t have so much to pay upfront if you’re admitted to hospital.

Because you’re lowering the amount you have to pay if you’re admitted to hospital, reducing your excess is considered an upgrade to your cover. This means that you’ll have to re-serve waiting periods, and your previous higher excess will still apply during this time.

You might want to consider a lower excess if you:

  • Have a history of health concerns

  • Have made multiple hospital claims in the past

  • Think that you may need to go to hospital in the future

  • Can’t afford the upfront cost of a higher excess

Check your excess before you go

Before going to hospital, see if you have an excess for your policy, and make sure you factor it in as an upfront cost that you’ll need to pay before your treatment. Check your excess in your nib account, refer to your Policy Booklet or Fund Rules for more information, or call us.

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