Who pays for what when it comes to your medical bills?
A simple guide on who's responsible for healthcare costs
Australia is known as ‘the lucky country’ – and it’s no different when it comes to our healthcare. Through Medicare, we can be treated in a public hospital as a public patient for no charge and receive subsidised prescription medicines and GP appointments.
However, Medicare doesn’t cover the costs of everything you might need to continue to be as healthy as possible. For example, if you require an emergency ambulance, glasses, braces on your teeth, or hearing aids, or you want to visit a chiropractor, physiotherapist or podiatrist, you’ll be left to foot the bill.
And, if you find yourself in need of non-emergency surgery, you’ll probably face a long waiting list in a public hospital to get the treatment you need.
That’s where private health insurance comes in; it aims to fill in the gaps that Medicare leaves and helps you fund your healthcare needs.
Medicare doesn’t cover the costs of everything you might need to be as healthy as possible
Hospital Cover provides benefits for your hospital stay as an inpatient, covering accommodation and patient meals, surgery fees, prostheses, nursing care, medical supplies and prescription medication. With nib, you can tailor your health insurance policy to meet your needs, that way you don’t have to pay for things you won’t use – like pregnancy cover. If you’re already an nib customer, it’s important to check your policy to make sure it meets your current health needs, especially as your life stages change; you can do this via Online Services or by calling us on 13 16 42.
Most people assume that if they need an ambulance, it will be covered by the Government or Medicare, but for many Aussies this isn’t true. So, as part of all our hospital covers, we also include nib Emergency Ambulance Cover which means you’ll be covered for emergency ambulance transportation in most circumstances.
The nib Accidental Injury Benefit provides cover for you if you need in-hospital treatment as the result of an accident. It’s offered with every level of Hospital Cover, and includes cover for any follow-up admissions for up to 90 days following your injury. Check your policy in Online Services to see if you’re covered.
Regardless of the type of cover you have, you may have out-of-pocket expenses when visiting hospital. An out-of-pocket is the difference between what nib contributes to your treatment and what your healthcare providers charge. However, you can reduce – or even eliminate – any out of pocket expenses by checking if your doctor or specialist will participate in nib MediGap. nib MediGap is a network of health professionals who receive a higher payment from nib and, in return, they agree not to charge our customers any out-of-pocket expenses. Check out our guide of handy tips on reducing your out-of-pockets. You can also manage your hospital excess by electing to pay a higher premium.
Taking out Hospital Cover helps you avoid the long waiting lists you might experience in a public hospital. Data released by the Australian Institute of Health and Welfare has shown that public patients in 2015-16 had a median wait time of 42 days for elective surgery, while patients who used their private health insurance waited just 20 days – that’s a big difference when you’re in pain!
With private hospital cover, you’ll also be able to choose when you receive your treatment, meaning you can get back to health quicker, and you can book your appointments around your work/family schedule. You’ll also be able to choose your preferred doctor and specialist and have a say in the hospital that you’re treated in.
At nib, we believe that the path to becoming healthy begins long before you visit hospital. That’s why we offer a range of Extras Covers that provide you benefits for the things that help keep you feeling your best, whatever your stage of life. So, if you’re looking to get cover for services like dental, optical, occupational therapy, physio, chiro or osteo, having Extras Cover might be the way to go.
We like to keep things simple at nib. That’s why we offer our Extras Covers with either 60% or 75% back. Depending on what cover you decide is best, you’ll receive 60% or 75% of the total cost of your treatment – every time you visit1.
You never know what’s around the corner. Hear how Josh’s spinal surgery has helped him get back on his feet and back to doing what he loves.
Keen to get a quote? With nib, you can get a quote online in just minutes.
1Subject to waiting periods and up to your annual limits.