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Understanding Private Health Insurance: Hospital Excess

Navy Health understands that Private Health Insurance can be quite confusing for our members with various impositions on your cover that may impact you using it when you need it.

Navy Health understands that Private Health Insurance can be quite confusing for our members with various impositions on your cover that may impact you using it when you need it. This post focuses on excesses and will provide you with an understanding of what an excess is, when you pay it and how it can help you reduce your PHI cost.

Overview

On various policies offered by Navy Health you may see the word “excess” with amounts of $200, $350, $500 or $750. Navy Health offers excesses in varying amounts on all of our products and are designed to assist members controlling their private health insurance costs.

What is hospital excess?

An excess is an amount you will pay towards the cost of your hospital treatment before Navy Health will contribute to the cost.

How often do I pay my excess?

Excesses are only payable once per rolling 12 months if you are admitted to hospital.

Example:
• John requires a colonoscopy, has a $200 excess on his policy and is being admitted on the 3rd October 2019.;
• On admission, John will pay the $200 directly to the provider.;
• After the colonoscopy, John is referred to a specialist, who recommends further surgery planned on 19 January 2020.
• John will not be required to pay excess again until 4th October 2020.

However, if you change to a higher level of excess within that 12 month period, you will be required to pay the difference between the lower amount and the higher amount for your next admission.

Who has to pay an excess?

Excess is only payable by the adults on the policy when they are admitted to hospital. Dependants under the age of 27 with a Young Adult Membership (YAM) or student dependents under 31 are not required to pay the excess if they are admitted to hospital.

How can an excess reduce my premium?

The higher the excess the lower your premium! However, if you are admitted into hospital you will have to pay the excess amount at the time of treatment.
People that take a higher excess are making a decision, based on their individual health circumstances.

How can I change my excess amount??

You can call Navy Health to discuss your options on 1300 306 289.

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