Please DO NOT DELETE this page.

Blog //
  • Membership

Finding out the cost of your hospital treatment

28 May, 2018
Piggy bank with stethoscope

It’s not always easy to work out how much you’ll need to pay for medical treatment as a private patient in a hospital in Australia.

Healthcare in Australia can be complex and can be paid for by a combination of the following:

  • Commonwealth Government (through Medicare)
  • State and Territory governments
  • private health insurance
  • out-of-pocket costs that you may need to pay

Before you have treatment, it’s a good idea to ask how much it will cost.

What is informed financial consent?

Informed financial consent is way for you to know how much your treatment is likely to cost.

Before you receive treatment, you have a right to ask your doctor, your private health fund, and your hospital how much it will cost. You also have the right to know if they’ll be any out-of-pocket costs that you’ll need to pay. Your out-pocket-costs are commonly known as the gap payment.

What do you need to ask?

The Australian Medical Association recommends that you ask your treating doctor or specialist the following questions before you go to hospital:

  • what are your fees?
  • are there fees for other doctors like anaesthetists or surgeons?
  • will I have to pay any out-of-pocket costs?
  • can I have an estimate of all your fees in writing?
  • if the cost changes, when will you let me know?
  • what if I need a prosthesis or implant?
  • do you participate in my health insurer’s gap cover scheme and will you treat me under it?

You should ask your hospital:

  • do you have an agreement with my private health fund?
  • will I need to pay any extra costs during my treatment or gap payments?

If you have private health insurance, you should ask your private health fund:

  • does my policy cover this procedure or treatment?
  • will I need to pay an excess, co-payment or any other charges?
  • am I on a waiting period and do I need to provide you with medical certificates?

It’s best to ask for all of this is writing. The Australian Medical Association has an Informed Financial Consent Form template that gives you an idea of what to expect in a written estimate of fees.

How do doctors set their fees?

In Australia, doctors can decide how much to charge for their services. This means that doctor’s fees will vary.

You can use the Medical Costs Finder at the Department of Health to:

  • get an idea of how much people have paid in out-of-pocket costs for a procedure
  • compare the costs your specialists have quoted for a hospital procedure with the average cost in your area

How much will Medicare cover?

The Australian Government sets a fee for most medical services. This is known as Medicare Benefits Schedule (MBS) fee. This is the amount the Australian Government thinks the service should cost, but doctors are free to charge more than this amount.

Medicare will cover:

If Medicare doesn’t recognise a procedure or service, it means they won’t cover it. It also means your private health insurer probably won’t cover it either.

If you’re not sure if Medicare will cover a service or how much they’ll pay, you can call the Medicare general enquiries line on 132 011. It’s open 24 hours a day, 7 days a week.

What about emergency admissions?

If you’re admitted to an emergency department of a hospital, it might not be possible for your doctor to get your informed financial consent before they treat you. When this happens, your doctor should provide you or someone representing you with the estimate as soon as possible.

More information


1911_CBHS Skyscraper Banner-07

Suggested Articles

  • AGM

    Advance Notice of Annual General Meeting and Director Nominations

    CBHS wishes to advise its members that the Annual General Meeting this year will be held on Thursday 5 November 2020 at the CBHS registered office, Level 5, 79 George Street, Parramatta, NSW 2150.
    • Membership
    7 July 2020
  • Slice of Eggs on Cakes

    Healthy snacking at home with CBHS nutritionist Chantal

    CBHS nutritionist Chantal Collins has eight tips for creating everyday healthy snacking habits that won’t undo your health and wellness goals.
    • Nutrition
    6 July 2020
  • Member Stories Jake and  Carol

    “You don’t wait when it’s to do with your children”

    When Carol and her son Jake both began experiencing the same cardiac issue, a second opinion with a world-leading doctor helped them find answers.
    • Membership
    22 June 2020
  • Member Stories Danielle

    When your world changes in one week, we’re here

    COVID-19 restrictions have forced many employers to let staff go. Danielle was one of the Australians left with no income, and wondering how to pay the bills.
    • Membership
    22 June 2020

What Our Members Think

I joined as a CBHS member in 1978. Through many health events and challenges CBHS has always been there for me and my family. Their exceptional service over this time has always been appreciated.

- Jenny J

What Our Members Think

I've not long joined CBHS from another fund, but so far I've been impressed by the super helpful and friendly staff, the higher claim limits and rebates at a very competitive premium, and how easy it is to lodge manual claims through the app. Thanks CBHS - you've won me over! 😃

- Jessica B

What Our Members Think

What I love about CBHS is their customer service - friendly staff and always ready to help and email you the information you ask about. Keep up the great work!!!

- Linda S

What Our Members Think

I love CBHS as its so so easy to lodge a claim and whenever i need a question answered friendly consultant is one phone call away. The phone back option instead of waiting is brilliant!

- Rachel N

What Our Members Think

I have been with CBHS since I began at CBA 15 years ago...Now I have three beautiful children, one who has a disability. Our top extras cover has been really essential for his early intervention. I do love the ease of claiming online.

- Annette E

What Our Members Think

I am relatively new to CBHS and am loving it already. I worked for a CBA subsidiary a long time ago but was still eligible to join. So much better that the for-profit funds - our premium is only a little more and we pay a lower co-contribution and get great benefits. I am loving the massage rebate for my partner and gym rebate for me!

- David G

What Our Members Think

I'm extremely happy with CBHS! I have been a customer for about six years. I think the price is reasonable. And i would refer you to my family and friends any day. Thank you CBHS!!!

- Karen W

What Our Members Think

Love CBHS as I never have to doubt that they've got my back when I need it. Been through other insurers who have limited options or limits, yet cost the same or more.

- Mark F