Using private health insurance

Did you know every time a patient uses their private health insurance when being admitted to one of our hospitals, it helps our hospital boost the services we can provide and also helps the hospital to purchase additional equipment?

You may have private health insurance that you would like to use while you are in hospital. You have the right to use public services as a public or private patient.

If you are a potential private patient the Patient Liaison Officer will discuss this issue with you, and will seek your consent to be admitted as a private patient. If you have any questions or concerns, a Patient Liaison Officer can be contacted via the switchboard of each hospital. They are available Monday to Friday at all sites and weekends at Wollongong, Shoalhaven and Shellharbour Hospitals. Alternatively, ask the clerk on your ward to arrange for them to come and see you.

All ISLHD Hospitals have electronic access to most health funds for the purpose of eligibility checks, and are able to provide a printed copy. 

In an emergency, you or the people supporting you, will be advised of any costs by the hospital’s Admission or Patient Service Office.

Private health insurance

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If you have private health insurance and decide to use it when admitted, you can receive:

  • choice of doctor (if they have admitting rights)
  • waiver of any health fund excess relating to accommodation
  • guarantee of no out of pocket expenses for prosthesis, blood tests, X-Rays or scans
  • access to a single room (If not required for clinical need)
  • Free daily newspaper
  • Free TV hire
  • Free parking

Plus accounts made easy through our simplified billing system

To ensure you have all relevant information with which to make an informed decision, please contact any Hospital Admission Office to be put in touch with one of our Patient Liaison Officers who will be happy to discuss any concerns.

What is a Patient Liaison Officer (PLO)?

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A Patient Liaison Officer assists by providing additional information to determine the correct financial classification for a particular admission episode. Patient Liaison Officers complete health fund membership checks and provide advice on whether you are covered for a single room or for the condition you are admitted for. They are also able to assist with pre-existing ailment forms, contacting overseas insurance organisations and any other aspect of your admission that requires follow up.

Contact details of PLOs

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Patients /family members can contact the Patient Liaison Officer if they have any questions relating to using their Private Health Cover. The contact numbers for each Hospital are below

Site Contact number
Wollongong Hospital 4222 5693
Shoalhaven Hospital 4423 9445
Shellharbour Hospital 4295 2384
Port Kembla Hospital 4223 8183
Milton-Ulladulla Hospital 4454 9101
David Berry Hospital 4464 1001
Coledale Hospital 4267 0114
Bulli Hospital 4283 0610

Overseas visitors

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If you are visiting from overseas and need to go to hospital, you must provide details about your private health insurance or travel insurance, your passport and Visa before you receive any treatment.

If your insurance does not cover your treatment you will need to pay before upfront regardless of whether the treatment is provided by the doctor, nurse or allied health staff member such as physio, speech pathologist or audiologist (except patients from reciprocal countries that require emergency care).

You will also need to pay for any visits to clinics before and after hospital admission and any visits to your home by the Hospital or community nurses.

If you are from a country that has a Reciprocal Health Care Agreement and you are to be admitted as an elective patient (booking via specialist) you will not be covered by the Reciprocal agreement. If you have valid health insurance that will cover you for the operation or procedure you will need to provide details to the hospital or you will have to pay all expenses before admission.

If you are unsure whether you are covered under the Reciprocal Health Care Agreement or have questions relating to charges or payment of services, we have Patient Liaison Officers located at each of our hospitals who will be able to assist.

Please note our Charges increase on 1 July of every year and therefore if your hospital admission is around this time the charges may change without notice.

Workers Compensation

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If you require treatment as a result of a work related accident or illness, you are entitled to have your health care costs paid under the Workers Compensation Act.

The hospital will ask you or an appropriate person to provide information about your injury and details of your employer so that the hospital can send hospital accounts to them, or their insurer or solicitor.  If this information is not available, the accounts will be sent to you for payment or to forward onto your employer.

Should you have any queries in relation to being admitted as workers compensation, Patient Liaison Officers at each of our sites will be able to assist you.

Public Liability

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If you have been injured in a public place caused by the negligence of someone else (an individual, owner, organisation or business) you could be admitted to hospital as a public liability patient. If you are a public liability patient you or an appropriate person will need to provide details of the solicitor to whom the accounts will be sent.

Should you have any queries in relation to being admitted as workers compensation, Patient Liaison Officers at each of our sites will be able to assist you.

Motor vehicle accidents

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If you have been injured as a result of a motor vehicle accident, the hospital may ask for details of the insurance company as Medical accounts (doctor accounts) may be sent to this insurer for payment.

Should you have any queries in relation to being admitted after a Motor Vehicle accident, Patient Liaison Officers at each of our sites will be able to assist you.

Department of Veterans Affairs (DVA) card holder

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If you hold a DVA health card, please present your card to hospital staff to ensure you are classified correctly.

Gold card holders are covered for all services listed on the Medical Benefits Schedule (MBS) however white card holders are only covered for conditions approved by the Department of Veteran Affairs. 

If you are a white card holder and you are unsure which conditions you are covered for, our Hospital staff will check on your admission to hospital.

Australian Defence Force Personnel

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If you are a serving member of the Australian Defence Force, you will be asked to provide the hospital with an approval number (DAN) prior to treatment being provided.

If you are admitted for urgent care and you have no family present, the hospital will contact your unit and/or the Defence Force hot line in order to inform them of your admission and obtain the approval number on your behalf.

Nursing Home Type patient

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All public, private and DVA patients who have been admitted to any hospital for 35 continuous days are entitled to acute care. If your treating doctor deems that you no longer requiring acute care either before or after this time (on the 36 day or later), you will become a nursing home type patient and will be asked to pay a daily charge as gazetted by NSW Health.  If this happens, you will be informed by hospital staff of the change in your service category before being charged.

Should you have any queries in relation to your service category changing to nursing Home type, Patient Liaison Officers at each of our sites will be able to assist you.