What is a Hospital Gap?

A Hospital Gap is the difference between what a hospital charges you as a private patient for accommodation, meals, time in theatre, labour ward and other fees and what your health insurer pays for those services.

Often there is an agreement between your insurer and your private hospital so you have no out-of-pocket expenses or you know your out-of-pocket costs.

Public hospitals do not have agreements with specific insurers but are generally treated as Agreement Hospitals.

If you are treated in a hospital that does not have an agreement with your health insurer, you could pay significant out-of-pocket costs for your treatment.

Always ask your hospital or health insurer for an estimate of the costs of your stay in hospital.