Guide to the RCH

Medicare Ineligible Patient

  • Who is a Medicare Ineligible Patient?

    A Medicare Ineligible Patient is a person who:

    • Does not hold a valid Medicare card; or
    • Is not an Asylum Seeker; or
    • Is a person who is from a country that does not have a Reciprocal Health Care Agreement with Australia or is a person for which their countries Reciprocal Health Care Agreement with Australia does not cover their treatment. For further information please view the Reciprocal Health Care Agreements with Australia.

    Will I have to pay for my health care at The Royal Children’s Hospital?

    Yes, as the hospital is not funded for treating Medicare ineligible patients, the provision of the treatment in RCH will need to be recovered in full from the patient’s next of kin.

    If you have private health insurance (or travel insurance), you may be able to recover the funds back from your insurance. We will issue you final invoice post discharge as soon as practicable, which you may be able to attain reimbursement from your health fund.

    The final invoices, will include total care cost less any upfront payment that has been paid by you. Any refund will be issued as soon as practicable by the Finance Department, however should there be any shortfall, we will further invoice you for the difference.

    To discuss about payment, please contact Patient Accounts at patient.liaison@rch.org.au or on +613 9345 6638 (Contact person: Pat Monea).

    What is included in the cost of care?

    The cost of health care at The Royal Children’s Hospital includes any Outpatient, Inpatient, Emergency, Allied Health, Theatre fees, Medical Imaging, Anaesthetic fees, Prosthetics, Pathology and Pharmacy costs.

    For further information regarding costs please speak with our Patient Liaison Officers or refer to the ‘Pricing Schedule below’.

    To organise payment, please contact Patient Accounts at patient.liaison@rch.org.au or on +613 9345 6638 (Contact Person: Pat Monea).

    What information will I be required to provide?

    When you come to hospital you will need to provide us with:

    • Your passport & Visa Status
    • Up-front payment for services
    • Relevant health insurance policy details
    • Verified overseas residential address and contact details (telephone numbers and email address), for example (but not limited to); address listed in passport, resident card from the country of origin, bank statement, utilities bills from the country of origin.
    • Australia residential details and verified sponsor details (as per example above c) including contact information during your stay in Australia

    A General Guide to Costs

    For a guide to the cost of treatment for Medicare ineligible patients who reside in Australia please see attached ‘Pricing Schedule’ below: (Pricing is valid as of May 2017). 

    Pricing Schedule – Medicare Ineligible patients

    Emergency Department Services

    • Emergency Department Consultation/ Review - $560 per visit
    • Emergency Department Observation Unit Stay - $1,450 per visit

    Inpatient Services
    Persons who are admitted as an inpatient will be required to pay for their hospital treatment based on full cost recovery. This includes (but is not limited to):

    • A daily accommodation fee
    • Theatre Banding Fees
    • Prostheses or Aids & Appliances
    • Medical Imaging
    • Pathology
    • Allied Health

    The following daily accommodation fee applies for each inpatient admission:

    Accommodation Fee Type

    Rate

    Single Day Admission

    $1,500

    Overnight Admission (per night)

    $1,950

    Paediatric Intensive Care Unit Bed (per night)

    $4,800

    Neonatal Intensive Care Unit Bed (per night)

    $4,200

    Hospital In The Home (per day)

    $600

    Outpatient Services

    • Outpatient Visit - $360
    • Pharmaceutical Services – Full Cost
    • Radiology and Pathology Services – Full Cost

    Debt Recovery Services

    Where accounts are not paid by the due date, all costs incurred by The Royal Children’s Hospital in relation to the collection of monies will be passed on to the patient.

    How do I pay my account?

    • Pay by Phone
      Contact Patient Accounts to pay by credit card for all hospital services on +613 9345 6638
    • Pay in Person
      Payments can be accepted as cash, credit card or EFTPOS. Payments can be made by visiting The Royal Children’s Hospital Cashier, located just off Main Street, Ground Floor.
    • Pay by Electronic Funds Transfer
      Payments can be made by Electronic Funds Transfer. Bank account details are available on your invoice.

    To find out more about your level of cover please contact our Patient Liaison Officers (+613 9345 5577) or Patient Accounts (+613 9345 6638) who can assist and discuss the costs of your care with you.