Election form - more information

Victorian Public Hospitals – Information for Patients

The Medicare Agreement between the Commonwealth and State governments requires that YOU (or your agent) ELECT to be treated as a PUBLIC (nonchargeable) or PRIVATE (chargeable) patient upon admission to this hospital. Hospital employees cannot direct you towards making a particular decision. Your election status (public or private) is valid from the commencement of your admission (admission date) through to the end of the admission. 

You (or your agent), having made an informed election to be treated as a public or private patient upon admission to this hospital, cannot change your initial election status except in the event of “unforeseen” circumstances.

Examples of unforeseen circumstances include, but are not limited to:

• Patients who are admitted for a particular procedure but are found to have complications requiring additional procedures
• Patients whose length of stay has been extended beyond those originally and reasonably planned by an appropriate health care professional
• Patients whose social circumstances change while in hospital (for example loss of employment).

Inadequate private health insurance cover is not a sufficient reason for changing your election status.

In situations where a change is made to election status because of unforeseen circumstances, the change in patient status is effective from the date of the change onwards, and is not retrospectively backdated to the date of the admission.

A public patient

• Must be eligible to receive treatment under Medicare
• Will be treated by doctors nominated by the hospital
• Cannot choose a specific doctor to provide his/her medical treatment, and
• Will not be charged for medical or hospital services.

You cannot choose to be a public patient if you:

• Elect to be treated by a doctor of your own choice
• Elect to occupy a bed in a single room, or
• Are not eligible to receive treatment under Medicare.

Note that single rooms are not available in all Victorian public hospitals. Where present, these are allocated first to patients with specific medical or clinical need for single room accommodation. Private patients desiring a single room will be allocated this accommodation only if the single room is not medically required for other patients.

A private patient

• Will be treated by his/her nominated doctor(s) provided that the doctor(s) has the right to practice at the hospital, and
• Will be responsible for the payment of the hospital accommodation fees, charges for all medical and diagnostic services, prosthesis, dental fees, and other related services.
   

Private health insurance

• Does not stop you from electing to be a public patient
• Will usually cover the cost of shared ward accommodation but may not fully cover costs (depending on level of cover) if single room accommodation is chosen.

Medicare will cover 75% of the Commonwealth Medical Benefits Schedule fee for the medical services provided to private patients while in hospital and private health insurance will cover the remaining 25% of the fee

Where a doctor charges a fee which exceeds the Commonwealth Medical Benefits Schedule fee, the patient will be responsible for paying the difference between the fee charged by the doctor and the Schedule fee.

Your authorisation is required by the hospital to enable release of a copy of your admitted patient election form to your health insurance fund (if this is requested by the fund). Failure to give this authorisation may result in the refusal of the health fund to provide benefits.

Compensable patients

If you are, or may be, entitled to, (or have already received) compensation, damages or other benefits in respect of the injury, illness or disease for which you are receiving hospital care and medical treatment, all fees and charges may be met by your compensation. This includes, for example, compensation under the Accident Compensation Act 1985 (Vic), Transport Accident Act 1986 (Vic), Victims of Crime Assistance Act 1996 (Vic), Safety Rehabilitation and Compensation Act 1988 (Cth), or a claim for damages at common law.

Veterans’ Affairs patients

Veterans’ Affairs patients are those for whom the Department of Veterans’ Affairs has agreed to accept responsibility for hospital charges for the condition for which you are being admitted.

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