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Reviewed and updated 3 April 2024

What is a Hospital Cover excess? 

An excess is the lump sum you must pay if you have Hospital Cover and are admitted into hospital as a private patient.

It is your contribution towards a claim you make on your Hospital Cover.

Generally, if you agree to pay a higher excess for your Hospital Cover, you pay less in premiums. If you pay a lower excess, you pay more for your premium.

The idea of paying an excess is to help keep health insurance affordable.

You may be required to pay an excess every time you go to hospital or only the first time. You need to check this with your insurer.


How much is an excess?

In Australia, the most you will pay for your excess is $750 per person per year up to a maximum of $1,500 for a family.

This is how excesses work in practice:

An excess of $750

Mary has an excess of $750 on her Hospital Cover and is admitted as a private patient to hospital for a hip replacement. On admission, Mary must pay the hospital $750. Her health insurer will pay the rest because it is covered under her policy.

An excess of $250

Fred has an excess of $250 on his Hospital Cover and is admitted as a private patient to hospital for a hip replacement. On admission, Fred must pay the hospital $250. His health insurer will pay the rest because it is covered under his policy.


When do I pay an excess?

When you are admitted to a hospital as a private patient and before you receive treatment, you have to pay the excess to the hospital.


Will I have to pay an excess if I take out Extras Cover and Overseas Student Health Cover?

No. You do not pay an excess for:

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