Can I claim for specialist appointments?

No. Your Hospital cover can only kick in when you’re an inpatient (admitted to hospital). Any out-of-hospital (outpatient) medical expenses – for things like scans, blood tests and consultations – won’t be covered.

If you’re eligible for Medicare, you shouldn’t have to pay the full amount though. Medicare pays 85% of the Medicare Benefits Schedule (MBS) fee for outpatient services, and you pay the rest.

If you have a lot of out-of-hospital costs in a calendar year, the Medicare Safety Net could help.