What is hospital cover?

Quality health care when you need it

Hospital cover is an affordable way to access private health care, which gives you the power to choose your own hospital, use your preferred doctor or specialist, and nominate when you are treated.

What you get with hospital cover

Our Participating and Members First hospital networks include most private and all public hospitals throughout Australia. With our hospital cover, you're covered for the following in-hospital expenses for as long as medically necessary:

Overnight and same day accommodation
Operating theatre, intensive care and labour ward fees
Supplied pharmaceuticals covered by the Pharmaceutical Benefit Scheme and provided as part of your in-hospital treatment
Allied services such as physiotherapy, occupational therapy and dietetics
Surgically implanted No Gap Government recognised prostheses

And on top of most Mutual Community hospital covers, you receive cover for capped recognised emergency-only ambulance transport services or on-the-spot treatment.*

Gap cover that works

Mutual Community hospital cover pays 25% of the Government Schedule Fee for medical treatment you receive from surgeons, anaesthetists and any other doctors or specialists during your hospital stay. Medicare pays the other 75%. Where a doctor or specialist charges more than the schedule fee, it's usually up to you to pay the 'Gap'.

However, if you have hosptital cover with us, through our Ezyclaim system your specialist can agree the fees charged with us and bill us directly, so in most cases you won't even see a bill.

What isn't covered

To keep premiums affordable, some Mutual Community hospital covers include 'Waiting Periods' and 'exclusions'.

For example:

If your private health insurance cover option has a one year Waiting Period on pre-existing ailments then you can't claim for any hospital stay relating to that ailment during your first year of Mutual Community membership
If your private health insurance cover option has an exclusion on some services, you won't be able to claim for them for the duration of your cover

Check out the great range of Mutual Community hospital covers - you're sure to find one that's right for you:

Show me all Mutual Community hospital covers

What have others like me chosen?

What is the Medicare Levy Surcharge?

* The level of ambulance cover you receive is dependent on your level of hospital cover, membership type and the provisions of your state of residence. Please refer to the full policy details to determine what is covered.