In-patients and out-patients

In general, private heath funds do not cover out-patient treatment unless it's specified on your level of cover, and we have a specific agreement with the provider for a service. nib will not cover you where Medicare covers the fee or for emergency department fees.

In-Patients: A patient receiving treatment that requires a stay in hospital, admitted for the day or overnight. Treatment received in an emergency ward of a hospital without a formal admission does not qualify the patient as an in-patient.

Out-Patients: A patient who receives treatment outside of an admission to a hospital. Treatment may be provided at the hospital premises, in medical practitioner's consulting rooms or at another designated health facility such as community health centre or polyclinic.