What do I need to know before I go into hospital?

At Frank, we understand that going into hospital can be scary, confusing and sometimes stressful. When you go into hospital there will be bills from the hospital, your surgeon, anaesthetist and any other doctors involved in your admission. They all work differently, so there are important questions you should ask before you go into hospital.

Questions for your specialist

1. Which hospitals do you practice in?

This is important because the type of cover you have dictates the type of hospital you can be treated in.

If you are on Frank’s Private Hospital (Bronze), Bronze Plus Hospital (Bronze +), Better Hospital (Bronze+), Silver Hospital (Silver)Max Hospital 750 (Silver+) or Gold Hospital (Gold) Hospital covers, you can be treated in any public hospital or any of Frank's participating private hospitals, provided your treatment is covered privately by your policy.

If you go to a hospital that is not a participating private hospital there will be additional charges that are not covered by Frank. Make sure you ask the hospital (or Frank) if the hospital has an agreement with us.

2. Are you registered with Frank Health Insurance (or Frank’s parent company GMHBA) for simplified billing? If so, will you be billing Frank directly?

This is important because it makes things easier for you! Simplified billing means the specialist sends the bill straight to Frank so you don’t need to worry about making a claim.

3. Will you be charging me an out-of-pocket expense?

There’s a limit to what Frank and Medicare will pay towards a doctor’s bill, but there's no limit to what a doctor can charge.

This means your doctor can choose to charge more than you’re covered for. To avoid any surprises, check with them to see if there will be any out-of-pocket expenses.

4. Will there be any other doctors billing me?

Any doctors that are involved in your hospital stay will bill for their costs separately to your specialist. Other doctors may include an assistant in your operation, an anaesthetist, pathologist, radiologist, etc.

These doctors may also bill us directly if they are registered for simplified billing but pathology and radiology fees will not receive the additional benefit. These doctors may charge an out-of-pocket expense, please check directly with them what these costs may be.

5. What are the Medicare Benefits Schedule (MBS) item numbers for my procedure?

These item numbers are helpful to have handy when you contact Frank.

We use them to make sure that your procedure is included on your level of cover and to estimate any benefits payable to you if the doctor hasn't already provided this information.

Questions for the hospital

1. Are you one of Frank’s participating private hospitals?

Frank has agreements with most private hospitals relating to billing, fees and benefits. These agreements are made through the Australian Health Service Alliance (AHSA). It's important that your hospital is a participating private hospital to avoid additional costs to you.

The list is subject to change, so check with your hospital or with Frank before confirming your admission.

2. Will there be any additional charges that aren't covered by the participating private hospital agreement?

You’ll field the cost of things that are not required for your medical treatment (like the use of a TV or newspapers), so it’s important to check what these costs will be with the hospital.

There may also be a charge to you for medications prescribed when you leave hospital.

3. When will I need to pay my excess?

Most hospitals will expect payment of your excess on admission.

Questions for Frank

1. Am I covered in a private hospital, or a public one?

Frank has a range of hospital cover based on what you need: Private Hospital (Bronze)Better Hospital (Bronze+) and Gold Hospital (Gold).

Better Hospital (Bronze+), Max Hospital 750 (Silver+) and Gold Hospital (Gold) include treatment in a public hospital as well as any of Frank’s participating private hospitals.

Check the exclusions on your cover carefully to make sure that you’re covered for the procedure you’re about to have.

2. Have I served my waiting periods?

If you have not served your waiting periods with Frank prior to your admission you may not be covered for any of your costs. You can double-check this in your online members area or by contacting Frank.

3. Does my cover include benefits for this procedure?

Some of Frank’s covers exclude certain services to help keep costs down.

All of Frank’s exclusions are listed on Frank's hospital cover pages. If it's excluded then you won’t be covered for that procedure.

4. Do I need to pay an excess?

An excess applies when you are admitted into hospital as a private patient.

This excess is only payable one per calendar year.

5. Am I covered for a single room?

If you are admitted to hospital as a private patient, your accommodation costs will not be determined by your room type. This means that whether you are in a single or shared room, your accommodation out-of-pocket expenses will be the same.

6. Are my payments up to date?

In order to claim your hospital and medical benefits, your Frank membership must be paid up to date.

The hospital will contact us before your admission to check that you are covered and your claim will be paid.

To make sure you’re up to date with your payments check your member area or give us a call.