Patients with private health insurance
We recommend patients with private health cover contact your fund prior to admission to confirm your level of cover. As part of your admission process, you will be asked to complete a health fund claim form. This form allows the hospital to send your account direct to your health fund following your discharge. You will not receive an account from the hospital unless there are costs not covered by your fund.
Account enquiries before your stay
If you have a question about the potential cost associated with your hospital stay please contact our Patient Services team as follows:
Malvern - (03) 9508 1789
Brighton - (03) 9508 5888
Account enquiries after your stay
If you have a question regarding your account after your discharge from our hospitals you can contact our Accounts Department on (03) 9508 5410.
Self-funded all-inclusive packages - surgical admissions
If you do not have private health insurance, our fixed price all-inclusive packages ensure you receive transparent pricing of all costs before your admission to hospital.
Our packages provide peace of mind in situations that require further care during your stay at Cabrini Malvern, with no additional out-of-pocket costs to be incurred if further theatre time or additional nights of stay are required.
Frequently Asked Questions
What is included in my hospital account?
Your hospital account includes the costs associated with your hospital stay including accommodation, theatre fees and any prostheses used.
Does my hospital account cover all my costs?
No, you will receive separate accounts from your doctor, physician, surgeon and anesthetist. If applicable, you may also receive accounts for allied health services and ambulance fees.
Diagnostic services such as medical imaging (x-ray) and pathology will be billed separately to your hospital account and are claimable from Medicare and your private health insurance. There may be ‘out of pocket expenses’ payable. This may be ‘capped’ by your health fund.
Costs of medications you are taking prior to your admission and dispensed by Cabrini pharmacy while an inpatient, and medications supplied to you on discharge, are not covered by your health fund and are payable on discharge. Medications required during your stay are included in your hospital account. Some ‘high cost’ medications will be charged to you, however this will be discussed with you prior to treatment.
In some situations, there may be a gap payable on certain prosthetic items. This will be discussed with you prior to surgery.
Interstate, international and mobile telephone calls, guest meals, late discharge fee and ‘sleep over’ fees are not covered in your hospital account and are payable on discharge. No charges are made for local calls.
I’m not sure what my health fund does and does not cover. What should I do?
Not all private health funds offer the same benefits. It is recommended that you contact your health fund prior to admission.
I have agreed to pay an excess, gap or co-payment. When do I pay it?
You may have chosen a level of cover that has an excess, gap or co-payment. You may also have certain excluded items, benefit limitations or procedures that are not covered and are therefore your responsibility. These costs are payable on admission to hospital.
I have recently joined/changed my health insurance. Will this affect my cover?
If you have recently joined your health fund, upgraded your level of cover or transferred from another fund, you may have a waiting period before full benefits apply. Waiting periods may also apply if you are being admitted to hospital for treatment of a pre-existing ailment.
What is a pre-existing ailment and how will it affect my claim?
A pre-existing ailment is a disease or problem that you may have before joining or changing your health fund status (even if you are unaware of this ailment at the time of joining your fund or upgrading your level of cover.) In these cases, your health fund may impose a waiting period before it will pay benefits, or may pay benefits at your previous level of cover.
I am not sure if I am up-to-date with my health insurance payments. Does this matter?
You will be required to bring your health insurance payments up-to-date, in order to receive full benefits. If this does not occur, your account will be treated as uninsured and you will be required to pay the estimated costs of your account prior to or on admission.
I am a gold/white cardholder with Veterans’ Affairs. Am I covered?
As a gold/white cardholder, you are fully covered for your hospitalisation (shared room only) costs and any diagnostic accounts. However, where you are allocated a single room at your own request you will required to pay a fee each night. White cardholders are required to have prior approval to ensure their admission will be covered.
Should you choose to come into hospital as a private patient under your private health insurance and hold a Veterans’ Affairs’ gold card, you will be billed for your diagnostic accounts and are required to claim them from Medicare and your private heath fund.
How are pharmaceuticals billed?
During your stay in hospital, Cabrini will pay for new medicines prescribed by your doctor for use in hospital. Some ‘high cost’ medications will be charged to you, however this will have been discussed with you prior to admission where possible. Medicines prescribed for you prior to your admission to hospital are not the responsibility of the hospital. You are asked to bring these with you, in their original containers. Prescriptions dispensed for these drugs will be charged to you. Medicines prescribed for use following discharge will be charged to you.
Who can I contact if I have a question about my account or potential costs associated with my hospital stay?
The Patient Services Department is open from 8 am-5 pm Monday to Friday. Patient Accounts staff can be contacted directly as follows:
- Malvern and Prahran overnight patients estimates for uninsured patients and health cover queries 9508 1789
- All other queries 9508 1466
- Day Procedure Centre Patients all queries 9508 1777
- Brighton all queries 9508 8670
I don’t have private health insurance, but I intend to pay for my hospitalisation myself. How do I find out how much I will pay?
If you are not privately insured, you will be required to pay the estimated costs of your hospitalisation prior to or on admission. Staff from the Patient Services Department will provide you with an estimate of these costs based on information provided by your doctor. In some instances, your account may vary from the estimated costs (e.g. if you stay in hospital longer, or the doctor performs extra procedures or prosthesis items). This additional payment is required on discharge.
I am claiming through one of the following: Workers Compensation/TAC/other legal claim. What must I do?
You will be required to provide evidence of acceptance of your claim (including claim number, contact person and other relevant details). Where approval has been given, your account will be forwarded to your employer/insurer for payment.
If your claim has not been accepted (or is not yet determined) your account will be treated as uninsured and you will be responsible for payment of the estimated costs.
Once approved, you are fully covered for theatre costs and accommodation in a ward or share room. However, where you are allocated a single room at your own request you will be required to pay a fee per night.
It does not automatically follow that you will receive approval for a period of hospitalisation even though you may have been covered under the same claim for previous visits. Each hospitalisation must be approved by the employer/ insurer.
I have health insurance with my overseas insurer. How does this work?
Cabrini does not accept any form of overseas health insurance. Prior to your hospitalisation, you should obtain an estimate of expenses from the Patient Services Department; this account must be paid on admission. On discharge, a detailed account will be supplied for you to claim from your overseas insurance. Any diagnostic services must be paid on discharge.