Health fund cover

For patients with private health insurance

At North Shore Specialist Day Hospital we have contracts in place with all the leading private health funds, offering you the convenience of lodging claims on your behalf with little or no upfront costs.

Please provide the correct health fund details in your pre-admission forms. In the days leading up to your admission, we will contact your health fund to establish your level of hospital cover, if the waiting periods have been served, and if there are any out of pocket payments (excess or co-payment).

Some procedures may be restricted or excluded from some levels of hospital cover, such as obesity, and IVF related procedures. After seeing your Specialist please contact your health fund if you’re unsure what you are covered for.

You will need to know the item number corresponding to your proposed procedure(s), if you do not know this please contact our team.

Here are some questions to ask when you contact your health insurance provider

• Am I fully covered for an admission to a private hospital?
• Have I served all current waiting periods?
• Are all my premium payments up to date?
• Does my policy have any restrictions, limitations or minimum benefits that may apply?
• Do I have an excess or any co-payments associated with my policy?

Work Cover or a Third Party Claim

If your procedure is subject to Work Cover or a Third Party Claim, please forward full details of the claim to NSSDH, including a letter from your insurance company accepting liability for the admission.

No health fund cover?

If you don’t have private health insurance, we’ll provide a written quote of all hospital costs. You’ll need to pay all fees on admission.

Medicare rebate

You may be eligible for a Medicare rebate for some or all of your surgical costs. Please talk to our administration team to find out more.

If you have any questions about your health fund cover for your upcoming procedure please contact our team who will be more than happy to assist you.