On this page
- Police Health's contracted hospitals
- What to consider when choosing a hospital
- Hospital 35-day rule
- What is not covered
Police Health’s contracted hospitals
To help you save, Police Health has contracts with most Australia's private hospitals. When you choose to go to one of these hospitals, you’re covered for the vast majority of hospital admissions.
These contracts (as part of Police Health Limited) ensure that an agreed schedule of fees (including in-patient accommodation, theatre and special unit accommodation fees as appropriate) is charged by the hospital and paid by us on our member's behalf.
Please note that a member's benefit entitlements will be affected by factors such as their level and type of cover and the financial status of their membership.
This will affect the amount we will reimburse to the hospital. We strongly recommend you contact us on 1800 603 603 to confirm your benefit entitlement prior to receiving hospital treatment.
If you choose a hospital we don’t have a contract with you may incur out-of-pocket expenses for hospital related services irrespective of your level of cover.
What to consider when choosing a hospital
Your specialist might practice at more than one hospital. If that’s the case you may be able to choose which hospital you’re admitted to.
Here are a few things to consider:
- Accommodation, including single rooms
- What the hospital specialises in
- How convenient the hospital is for you and your family
- If the hospital has an intensive care/emergency department
- Additional charges for things like newspapers, TV or car parking
- Your specialists operating schedule
Hospital 35-day rule
Hospital benefits are payable 365 days a year. However, if your hospital stay exceeds 35 consecutive days you must obtain and send us an Acute Care Certificate to continue receiving comprehensive benefits.
Benefits will be reduced and out of pocket expenses apply where an Acute Care Certificate is not obtained.
The hospital is aware of this and will usually arrange a certificate on your behalf.
What is not covered
This list outlines some situations not covered by Police Health, including services before waiting periods are served and treatments excluded by Medicare.
Please note that this list is non-exhaustive and does not represent "excluded or restricted" treatments.
What is not covered (non-exhaustive list*)
- Services incurred before Waiting Periods have been served
- Outpatient services, unless there is an agreement between Police Health and the hospital
- Treatment for which Medicare does not pay a benefit, including cosmetic surgery (Some benefits may be payable for hospital treatment following this surgery. Please call us for more details)
- Services that are provided outside of the Commonwealth of Australia
- Services where an entitlement exists or may exist under any compensation, sports club or third party insurance
- A claim for a service that is submitted more than two years after the date of service
- Pharmaceuticals not related to the reason for hospitalisation or not covered under the agreement with the hospital or provided on discharge
- Exceptional high cost drugs where no or limited benefits are paid
- Prostheses items that are not included on the Governemts Prescribed list of Medical deices and Human Tissue Products
- Charges greater than the benefit defined in the Governemts Prescribed list of Medical deices and Human Tissue Products
- Personal and take-home items, e.g. newspapers, toiletries, television, hairdressing, manicure, etc
- Treatment provided to a person in a private hospital emergency department
- Aged care and accommodation in an aged care facility
- If you’re in hospital for more than 35 consecutive days and not classified as an acute care patient, your benefits will significantly reduce
- Benefits for ambulance services covered by a third party arrangement such as a State/Territory transportation scheme
- Fees from a podiatric surgeon (benefits may be payable under our Extras cover) or related anaesthetic fees
- Use of robotic assisted systems not covered under the hospital contract
- This provides a general description of what is not covered. These are not “excluded or restricted” hospital treatments or services. Should you require information about a particular treatment or benefit please contact us.
* This provides a general description of what is not covered. These are not “excluded or restricted” hospital treatments or services. Should you require information about a particular treatment or benefit please call us on 1800 603 603.