Bupa and the health funds who are members of the Australian Health Service Alliance (AHSA), are not properly covering the cost of private hospital treatments.
As a result, from 26 November, Healthscope will introduce a Hospital Facility Fee of $100 per admission (overnight patients) and $50 per admission (same day patients) for members of the following funds:
- Bupa
- Bupa International
- ACA Health
- AIA Health Insurance
- Australian Unity
- CBHS Corporate
- CBHS Health
- Defence Health
- Doctors Health
- Emergency Services Health
- Frank Health Insurance
- GMHBA
- HBF (only for treatment outside of WA)
- HCI
- HIF
- Health Partners
- Navy Health
- Nurses & Midwives Health
- Onemedifund
- Peoplecare
- Phoenix Health Fund
- Police Health
- Queensland Country Health Fund
- RBHS (Reserve Bank Health Society)
- see-u by HBF
- Teachers Health
- Territory Health Fund
- TUH
- UniHealth
- Union Health
- Westfund
Not included under the Fee: Latrobe Health Services
The Fee will sit alongside other hospital out of pocket fees patients are already required to pay, which may include insurer excesses and co-payments.
It is a one-off fee per admission that will be charged upon admission to the hospital.
Exceptions
The Fee will apply to all admitted patients who are members of Bupa and the AHSA health funds who do not meet any of the exclusion criteria. These are:
- Members of all other health funds
- Chronic Admitted Same Day Patients (e.g. Chemotherapy patients, Renal Dialysis)
- Mental Health Day Program Patients
- Rehabilitation Day Program Patients
- Patients transferred from another Healthscope site
- Related readmissions within 28 Days
- Palliative Care patients
- Babies born in a Healthscope hospital
- Patient at Northern Beaches Hospital
How can I avoid the fee?
Patients who are members of Bupa, Bupa International or one of the 29 AHSA insurers can avoid the Healthscope Hospital Facility Fee by switching their cover to a comparable product with another fund. Australia's private health insurance laws allow members to move their cover to another health fund without re-serving waiting periods.
To find out more about switching insurer
Please read the following guide by the Commonwealth Ombudsman.
A Difficult Decision
This decision was not made lightly and follows extensive negotiations with Bupa and the Australian Health Service Alliance (AHSA) to reach an agreement for them to sustainably cover the cost of their members’ care in our 38 hospitals.
Understanding Your Concerns
We understand the concerns you may have about this fee, and want to be clear that we have taken every available step to avoid imposing additional costs on patients.
Ensuring a Sustainable Future
Private hospitals still require a long-term solution to ensure the sector remains viable and patients are not forced into a burdened public hospital system.
Patient-Centric Approach
Our hospitals will apply these fees in the most compassionate and reasonable way possible.
Bridging the Funding Gap
The Hospital Facility Fee will go towards closing the funding gap we currently face for providing quality care to patients.
FAQs
Healthscope has taken the difficult decision to introduce a new Hospital Facility Fee for members of Bupa, Bupa International and 29 health funds who are members of the Australian Health Service Alliance (AHSA) to sustainably cover the cost of their care.
Healthscope is acutely aware that amid a cost-of-living crisis in this country, the last thing that some of our patients need is another fee when accessing the care in our hospitals – but Bupa, Bupa International and the 29 Alliance insurers have led us to believe we have no choice.
The Fee will sit alongside other hospital out of pocket fees patients are already required to pay, which may include insurer excesses and co-payments.
Healthscope wanted to avoid this outcome, however lengthy negotiations with these insurers have not resulted in sustainable funding from these insurers. We will not compromise on patient care.
The fee is $100 for overnight patients per admission and $50 for same day patients per admission.
It is a one-off fee per procedure that will be charged upon admission to the hospital.
Patients who are members of these funds should consider switching their cover to a comparable product with another fund. They should ensure they discuss all their health insurance needs with the fund.
The fee will be charged from 26th November.
It is a one-off fee per procedure that will be charged upon admission to the hospital.
Healthscope will introduce a Hospital Facility Fee of $100 per admission (overnight patients) and $50 per admission (same day patients) for members of the following funds:
· Members of Bupa and Bupa International
· Members of ACA Health Benefits Fund, AIA Health Insurance, Australian Unity, CBHS Corporate, CBHS Health, Defence Health, Doctors Health, Emergency Services Health, Frank Health Insurance, GMHBA, HBF (only for treatment outside of WA), HCI, HIF, Health Partners, Navy Health, Nurses & Midwives Health, Onemedifund, Peoplecare, Phoenix Health Fund, Police Health, Queensland Country Health Fund, RBHS (Reserve Bank Health Society), see-u by HBF, Teachers Health, Territory Health Fund, TUH, UniHealth, Union Health, Westfund
Not included under the Fee: Latrobe Health Services
Members of all other health funds (except Bupa, Bupa International and 29 health funds who are members of the Australian Health Service Alliance (AHSA)).
The fee will also not apply to patients who are members of these funds under the following circumstances:
- Chronic Admitted Same Day Patients (e.g. Chemotherapy patients, Renal Dialysis)
- Mental Health Day Program Patients
- Rehabilitation Day Program Patients
- Patients transferred from another Healthscope site
- Related readmissions within 28 Days
- Palliative Care patients
- Babies born at Healthscope hospitals
In special cases hospital General Managers will have the ability to waive the fee on an individual patient basis based on discussions with the relevant VMO and/or patient
Patients who are members of these funds should consider switching their cover to a comparable product with another fund. Ensure you discuss all your health insurance needs with the fund.
If you wish to avoid the fee, members of these funds should consider switching their cover to a comparable product with another fund. They should ensure they discuss all their health insurance needs with the fund. Healthscope will apply these fees in the most compassionate way possible, and so there is some hospital-level discretion that will be applied on a case-by-case basis subject to the approval of the hospital General Manager.
At this stage we have no plans to introduce any further fees. We have not taken the decision to introduce this fee lightly, however we have been left with no choice because Bupa and the 29 health funds who are members of the Australian Health Service Alliance (AHSA) are not sustainably covering the cost of hospital care.