How to lower your hospital costs

A couple discussing how they can lower their hospital costs using their private health insurance cover


How to lower your hospital costs


Hospital cover that suits you and your lifestyle is important. But making sure you know everything you need to about what can impact your premium and how you can use your cover takes some time and effort. Here are some questions to ask when you’re thinking about your private hospital cover – whether it’s how much you’re paying or how you can get better value when you come to using it.

Is your cover right for you?

Making sure you’ve got the right level of cover to suit you, the ones you love and where you’re at in life is important. If you’re young and single, you’ll need cover that’s different than cover for a couple or a family.

Being covered for the things you need (and not paying for the things you don’t) means there’s no set and forget when it comes to your private hospital cover.

So, take the time to review your private health insurance every once in a while – especially when you’re approaching a life milestone – having a baby, coupling up (or de-coupling), having kids or getting older.

Having the right private hospital cover means you’ll get better value when it comes to using it. 

Medicover can help

For RT Health members, the best way to ensure you have no, or lower, out-of-pocket costs is to choose your treating specialists carefully.

We know that medical care (especially procedures) can be stressful. That’s why we give members access to Medicover – a way you can reduce your out-of-pocket costs for medical services in hospital.

Your doctors can choose whether to participate in Medicover on a case-by-case basis, so if they’re not already part of Medicover, you’ll need to ask them if they’re willing to take part.

Remember, there is often more than one doctor treating you in in hospital. So it’s likely you’ll need to have separate discussions with your surgeon, anaesthetist, pathologist and so on.

There are some key questions to ask, so be sure to read more about how you can make Medicover work for you, get lower hospital costs and avoid bill shock when having treatment in hospital.

It’s your right to be informed

Avoiding out-of-pocket costs when going to hospital means you get more value from your private hospital cover.  That means making sure you’ve got all the info you need, including informed financial consent.

Here are some questions to ask your specialist when it comes to your medical costs.

  • What are the MBS item numbers for my treatment and what will I be charged for each of these items?
  • Can I have a written quote or advice on costs of my procedure (and any out-of-pocket costs), including fee estimates for any other treating doctors, so I can review before agreeing to the treatment?
  • Will you treat me under RT Health’s Medicover program?
  • How and when will I be billed for any out-of-pocket costs?

Once you’ve got the details, we’ll be able to chat with you about your cover and to answer any questions you may have about how we can help.

Hospital at Home

Our Hospital at Home program means you may be able to have some of your treatment at home. Eligible treatments at home take the place of services you’d usually have to visit or stay in hospital for.

If you’d usually be covered for the treatment in hospital, and your treating doctor agrees, you may be able to have treatment at home instead*. We’ll work with you, your doctor and hospital to cover the cost of the treatment at home if you need:

  • intravenous (IV) therapy antibiotics
  • complex wound care with negative pressure wound therapy
  • rehabilitation after a hip or knee replacement
  • IV chemotherapy. 

Depending on where you live and the treatment you need, you might also be able to choose your Hospital Substitute Treatment (HST) provider.

Treatment where and when you need it is one of the advantages of being with RT Health. We’re expanding our Hospital at Home provider network, so chat with your treatment providers about how you might be able to access some of your care from home.

Use our participating hospitals

At RT Health, we’re lucky to have a wide network of participating hospitals across the country for our members to use. Our hospital network is one of the biggest in the industry. 

Having your treatment or procedure in a participating hospital helps you cut down on out-of-pocket costs.

Our handy Find a hospital tool will help you find a hospital near you, if and when you need one. 

Check your excess

The excess you choose when you first join us or change your level of hospital cover impacts your premium, as well as the amount you’ll need to pay if you go into hospital.

An excess is the amount you’ll pay upfront (out of your own pocket) before you’re admitted to hospital for planned treatment.

Generally, the higher your excess, the lower your premiums (and vice versa).

Choosing a hospital cover with a higher excess is a way to reduce the cost of your cover, without reducing the level of cover you have. The flip side is that you’ll have a higher excess to pay if you’re admitted to hospital.

You can change your excess amount at any time. Choosing a higher level of excess is likely to make your membership premiums cheaper.

But it pays to know that lowering your excess (for example, from a $700 excess to a $350 excess) counts as an upgrade to your cover. That means you may have to pay your previous higher excess until you’ve served the waiting period for the new, lower level excess. This means that if you opt to increase your excess to lessen your premiums for a while, you will need to serve a waiting period if you later want to switch back to the lower excess.

No excess for the kids: If you’ve got your hospital cover with RT Health, you'll never pay any excess for kids under the age of 22 on your membership.

We're here to help

We get it. Private health insurance can be complicated, but we’re here with you every step of the way.

If you have any questions about your cover, our friendly Member Care team can answer any questions you have. Give us a call on 1300 886 123 or get in touch via email to help@rthealth.com.au


Important information

*Limits apply on HST services rendered. These limits sit with the provider and your doctor should check these from the outset and advise you accordingly.



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