Who pays?

The health system can be confusing so it’s hard to be sure who pays for what. We make it clear in one table.

Please remember that this is only an overview. Benefits depend on your level of cover and any restrictions, exclusions or waiting periods you have.

View your full cover description for more detailed information.

  Medicare Peoplecare You
Hospital Extras
Ambulance (state-based providers only) No Yes Yes No

Outside of hospital (outpatient)

Things like specialist fees, radiology and pathology.

 Yes No  No  Yes 
Private Hospital (inpatient)

Remember that your waiting periods need to be served before you go into hospital and we can only pay for the services you’re covered for. If you have an excess or use things that hospitals can charge you for like TV access or newspapers, those will be at your own cost.

Medical

Things like specialist fees, radiology and pathology.

 Yes  Yes  No  Yes

Hospital

Things like accommodation fees, theatre fees and prostheses.

 No  Yes  No  No

Public Hospital (inpatient) as a Private patient

If you have an excess or use things that hospitals can charge you for like TV access or newspapers, those will be at your own cost. Your hospital might ask you to pay additional charges for your admission.

Medical

Things like specialist fees, radiology and pathology.

Yes

Yes

No

Yes

Hospital

Things like accommodation fees, theatre fees and prostheses.

Yes

Yes

No

No

Public Hospital (inpatient) as a Public patient

You may have out of pocket costs from your doctor or specialist even if you’re a public patient in a public hospital. If you have an excess or use things that hospitals can charge you for like TV access or newspapers, those will be at your own cost.

Medical

Things like specialist fees, radiology and pathology.

Yes

No

No

Yes

Hospital

Things like accommodation fees, theatre fees and prostheses.

Yes

No

No

Yes

Other services

Things like dental, optical & physio.

(There are some interesting items on Medicare like dental for kids and some free consults for chronic conditions you could get after seeing your GP)

Yes

No

Yes

Yes

You can check what you’re covered for by checking your cover description

in Online Member Services. Log in here and click the cover description link on the membership screen.