When you are admitted to any hospital as a private patient, there are three different costs associated with your treatment - hospital services, medical services and other professional services.
Hospital Services
Manchester Unity has agreements with an extensive network of participating private hospitals and day hospitals throughout Australia.
If you are admitted to a participating private hospital, you will pay nothing for your overnight private room accommodation, theatre fees, intensive care, labour ward (if cover includes Obstetrics) and Government approved prosthesis (for example, artificial hips and knees or heart pacemakers). You will only need to pay an excess, if applicable. Please note however if your doctor chooses a prosthesis which is not on the Government approved schedule, you will have to pay some of the cost. Your doctor is required to advise you of this beforehand, wherever it is possible to do so.
The account for the services provided in hospital is usually sent directly to Manchester Unity after your stay, once you have confirmed the services received.
If you choose a luxury private room with ensuite you may be required to pay extra. Luxury private rooms are only available at a small number of hospitals and you will only pay the difference between the cost of a normal private room and the cost of luxury room accommodation.
For those hospitals where we do not have agreements to cover all hospital services, you may be required to pay a portion of the in-patient charges depending on your level of cover. For this reason, it pays to check that you are being treated at a Manchester Unity participating private hospital.
Know your rights and responsibilities as a private patient in hospital. Download the Private Patients' Hospital Charter or call us for a copy of the brochure on 13 13 72.
Medical Services
Your hospital plan covers the difference between the Medicare schedule fee and the Medicare benefit (75% of the schedule fee) for medical services received as a private patient in hospital. You will be fully covered if the providers of these services - such as surgeons, anaesthetists, pathologists - charge the schedule fee.
You may also be fully covered even if your doctor charges above the schedule fee, if he/she has agreed to participate in our Medicover scheme. Under this scheme, doctors Australia-wide are being invited to enter into an arrangement to eliminate or reduce the amount payable by the patient, known as the "gap" payment.
Other Professional Services
Accounts for other professional services received in hospital - such as physiotherapy and pharmacy items - may be billed separately by the provider of the services or by the hospital. Many of Manchester Unity's hospital agreements include benefits for these services depending on the level of cover selected.
Emergency Ambulance
Members of all Manchester Unity hospital covers are entitled to emergency ambulance transport, anywhere in Australia.
Treatment in a public hospital
If you choose to be treated in a public hospital as a private patient, you are fully covered for all hospital charges, excluding any excess. Your Manchester Unity membership will also cover additional costs for doctors or specialists, depending on your level of cover. As soon as possible after admission, the hospital is required to inform you of your right to be treated as either a Medicare (public) patient or as a privately insured patient.
Please note that private health insurance does not cover everything. There are some situations where you are not covered.
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