Choosing Hospital Cover

Choose a level of cover from the list to view what's covered.

What is hospital cover?

Hospital cover is exactly what it sounds like: it's insurance that helps to cover costs in hospital. It gives you access to care as a private patient in both public, and private hospitals (depending on your cover) and helps towards covering the costs of treatment, accommodation, and nursing care.

Which hospital cover is best for me?

Before taking out hospital cover, work out exactly why you want it. Are you simply looking for entry level cover and happy to exclude services to keep the price down, is there a specific treatment you want to be covered for, or do you want the benefits of everything Frank has to offer?

The higher the level of cover the more coverage you get. It’s always best to check the exclusion list on the policy and decide how important the treatment or service is to you. 

What's covered?

When you take out Frank hospital cover, we’ll chip in for: 

• Eligible hospital and medical costs – giving you the option to be treated as a private patient in either public or private hospitals (just note that services may be excluded or restricted depending on your level of cover, and waiting periods may apply). You may be able to choose your doctor, your hospital, and even get a private room if one is available. Learn more about hospital cover.
• Emergency ambulance cover – we've got you if you need the lights and sirens. All Frank hospital covers include emergency ambulance. 

What's not covered?

Hospital cover can only pay benefits toward eligible in-patient care. So, it won’t pay benefits towards care you receive outside of the hospital (that's when you’re not admitted as an inpatient). For instance, seeing your specialist for appointments before or after an elective surgery will be charged to Medicare, and you may have an out of pocket (or gap) fee, but health insurance can’t pay benefits toward these appointments.  

Things like x-rays, pathology or radiology, where you aren't admitted as an inpatient to hospital also aren’t covered, even if they're done in a hospital building. 

All Frank's hospital covers include emergency ambulance, but this does not cover non-emergency ambulance transport ie. from hospital to your home or ambulance tranfers between hospitals. Publicly funded ambulance services and State Government transport schemes are also excluded (eg. TAS/ACT/NSW/QLD). 

Learn more about hospital cover and going to hospital in our going to hospital guide. 

How hospital cover works

There’s a limit to what Frank and Medicare will pay towards a doctor’s bill, but your treating doctor or specialist is able to charge what they deem appropriate for the services they provide, which means they often charge more than the Medicare Benefits Schedule (MBS) fee.

Medicare covers a portion of your medical fees as a private hospital patient, but you may still have significant out‑of‑pocket costs, and that’s where your Frank hospital cover steps in to help reduce what you pay. 

Are there services Frank won’t pay on?

Yes there are, but if you have a read, you'll see they're fair.

Read the full list of things Frank won’t pay on.

Do I have to pay an excess?

Yes. If you are admitted to hospital, you will have to pay an excess directly to the hospital, usually before admission. 

Learn more about Frank’s hospital excess.

Can I get more information about fees?

It’s important to have an idea of what your out-of-pocket costs will be before you go to hospital. We’ve put together this handy guide with more information about doctor’s fees, medical gaps and questions to ask your specialist – all the nitty gritty about being admitted to hospital. 

Will I have to wait before I claim?

Only if you’re new to health insurance or have recently upgraded your level of cover and are looking at going to hospital as a private patient.

With our covers (and most other health insurers) you have to wait a specific amount of time between signing up and making your first claim. This is called a waiting period. There is also a 12 month waiting period for pre-existing conditions. The good thing is there’s no waiting periods for emergency ambulance, or accidents that occur after joining Frank (provided the service is included in your cover), however if you have less than 12 months membership on your current hospital cover you might have to pay for some or all of the hospital and medical charges if:

• You are admitted to hospital and you choose to be treated as a private patient; and
• We later determine that your condition was pre-existing.

The following table shows the waiting periods that apply.

Find out more about waiting periods.

What's the difference between hospital cover and extras cover?

You’ve got options with Frank: 

• Hospital cover – this helps with the costs when you’re admitted to hospital as a private patient. 

• Extras cover – this pays benefits towards the cost of services not usually covered by Medicare, like dental, chiro and physio.  

• Hospital + extras (combined cover) – this gives you the perks of both. 

What’s the Medicare levy surcharge and what level hospital cover do I need to avoid it? 

The Medicare Levy Surcharge (MLS) is an extra tax set by the Australian Government for individuals and families earning a higher income who do not have eligible hospital cover. It aims to encourage those on higher incomes to take out private hospital cover, helping to reduce pressure on the public hospital system. 

Any level of Frank hospital cover will help you avoid the MLS. 

FAQs about hospital cover