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Out of pocket expenses

No matter what level of cover you have, you may have to pay something towards going to hospital. It’s usually the difference between what nib pays for, and the total cost of your stay in hospital. Not everyone has an out of pocket expense when going to hospital; however it’s common to pay something towards the cost.

In 2016, 74% of nib members who went to an nib Agreement Private Hospital (or public hospital as a private patient) for a procedure included on their health cover had less than $100 in out of pocket expenses for medical services whilst in hospital (excluding any hospital excess).

How can I help reduce my out of pocket expenses?

  • Check you have the right level of cover to suit your needs - you can compare and change your cover in Online Services
  • Always call nib before going to hospital
  • Choose a specialist registered with nib MediGap and ask if they’ll participate for you
  • Attend an nib Agreement Private Hospital
  • Ask for written confirmation of fees from your doctors and the hospital prior to your admission
  • Ask your specialist about all of the potential costs that may be involved in your procedure – including how to understand the fees of other specialists involved
  • Check if there are alternative options which could cost you less

Depending on your level of cover, you might have to pay an excess for your hospital stay when you’re admitted. This is paid directly to the hospital and is separate to your potential out of pocket expenses.

Specialists can decide how much they charge for each patient, and these fees can vary significantly, sometimes by thousands of dollars. Call us and we can discuss your options and ways to reduce your out of pocket expenses.

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