When you go to hospital, there are two types of costs, hospital costs and medical costs. They’re handled a bit differently, so it helps to understand what you might need to pay. 

What are hospital costs?

Hospital costs cover things like: 

  • Your room and meals 
  • Operating theatre fees 
  • Intensive care 
  • Dressings and bandages 

These things are usually billed directly to Frank. 

Depending on your cover, you may need to pay: 

Going to a contracted hospital 

Frank has agreements with hospitals across Australia. 

If you’re admitted to one of these hospitals, we’ll pay benefits towards: 

  • Accommodation and meals 
  • Nursing care 
  • Intensive care 
  • Theatre fees 
  • Approved medical devices and prostheses 

Going to a non‑contracted hospital

If your hospital doesn’t have an agreement with Frank: 

  • We’ll only pay the default benefit as set by the Australian Government 
  • You may have higher out‑of‑pocket costs 

What are medical costs? 

Medical costs are what your specialists charge (like your surgeon or anaesthetist).

For in‑hospital services: 

  • Medicare pays 75% of the MBS fee 
  • Frank pays 25% 

If your specialist charges more than the MBS fee, you may have a gap to pay. 

It’s a good idea to ask for a cost estimate before treatment (this is called Informed Financial Consent).  

If your specialist agrees to bill using Access Gap Cover 

  • They bill Medicare and Frank directly 
  • Medicare and Frank pay their shares 

You may pay:  

  • No gap, or
  • A known gap (which is capped) 

If your specialist doesn’t use Access Gap Cover 

Then: 

  • Medicare pays 75% of the MBS fee 
  • Frank pays the remaining 25% 
  • You pay any extra above the MBS fee 

If your hospital has an agreement with Frank, we can pay benefits towards: 

  • Accommodation and meals 
  • Nursing care 
  • Intensive care 
  • Theatre fees 
  • Approved prostheses and medical devices 

What if the hospital isn’t contracted?

You’re still covered, but you may pay more.  

  • Benefits are limited to the Australian Government default rate 
  • You’re more likely to have higher out‑of‑pocket costs 

You may also still pay extra if: 

  • Your specialist charges above the MBS fee 
  • Your treatment isn’t included in your policy 
  • An excess applies 

Can I upgrade my cover if I’m not covered? 

Yes, you can upgrade your cover at any time. 

Just keep in mind that waiting periods apply, typically; 

  • 12 months for pre‑existing conditions 
  • 2 months for most other treatments 

Upgrading can still be a good option for future treatments. 

If you’re unsure, contact Frank, we can help you check your cover and understand your options. 

Go to Step 3: Getting ready for your hospital stay

Going to hospital with Frank

Get clear on your cover, understand hospital costs and claiming, and know what to expect. So you can feel confident on your hospital journey.
 

Going to hospital guide

Member Info

Claiming Guide

Cover Changes

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Going to Hospital