Hospital bills and claiming
Understanding hospital bills
Depending on your situation, you may not receive a bill after going to hospital. If your procedure was included in your cover, you went to a Partner Private Hospital and your medical practitioners participate in GU Health Medical Gap Network, you may not have any extra fees to pay.
If you do receive a bill it’s likely to be from one of three sources:
The hospital
The pathology or radiology labs associated with the hospital
The specialist or anaesthetist
Unrelated healthcare costs
You’ll be responsible for paying for any additional costs if they’re unrelated to your healthcare or not included in your cover, such as telephone, internet and television access. You may also be responsible for paying an excess, if an excess is part of your plan.
Non-partner private hospital
You’ll also need to make sure you’re choosing the right hospital for your treatment by searching our list of partner private hospitals using our Find a provider tool. The agreements we have with partner private hospitals means that you’re fully covered for your accommodation and theatre fees, less any excess that you may be required to pay based on your level of cover.
Fixed daily hospital fees
A small number of hospitals may also charge a fixed daily fee. If this is the case, the hospital should inform you of this fee when you arrange your booking. At hospitals where no agreement exists (non-partner private hospitals), you’ll only receive restricted benefits for the cost of your hospital services. Read our Going to Hospital factsheet, opens in a new tab or refer to your Membership Guidelines, opens in a new tab for more information.
Claiming
If the doctor gives a bill directly to you and they've charged under the Medical Gap Network scheme, it’s important that you send your claim directly to us for processing – don’t send it to Medicare first. If a Medical Gap Network claim is processed by Medicare first, we may not be able to pay above the MBS fee and cover the agreed gap.
Please keep in mind that the GU Health Medical Gap Network scheme will only cover services provided during your hospital stay. Any consultations before and after your hospital stay won’t be covered under the scheme, including any administration and booking fees that may be charged. For our overseas visitors, we cover medical and specialist services, including outpatient. Benefits vary depending on your level of cover.
