If you have a Medicare card
If you are receiving inpatient treatment as a public patient
You will not have to pay for your treatment or stay if:
- you have a Medicare card, DVA card or are an asylum seeker
- your treatment is clinically necessary
- you are an inpatient for less than 35 days
- you are receiving treatment under the Mental Health Act 2015.
If you are receiving inpatient treatment as a private patient
We prefer that you assign your benefits to the hospital and allow us to lodge a claim with your health fund. This will be discussed on admission.
Your health fund may have an excess payment that you need to pay.
As a private patient it is your responsibility to check that your health care insurance policy covers the treatment you are receiving.
If you are a public inpatient or private inpatient
You will need to pay if:
- your treatment is not covered by Medicare
- you are classified as a Nursing Home Type Patient. This means you have been in hospital for more than 35 days and are not receiving acute treatment (this is active, short-term treatment for injury or illness). You may be waiting for a nursing home placement or home modifications.
Treatment not covered by Medicare
Your doctor may suggest a medicine or treatment that is not on the Pharmaceutical Benefits Scheme (PBS). This means there might be a cost that you have to pay yourself.
Your doctor may suggest a diagnostic test that is not fully covered by Medicare. This means there might be a cost that you have to pay yourself.
Your doctor will talk through the options with you, including alternatives and how much you can expect to pay.
If you are receiving outpatient treatment, you may have to pay for parts of your care/treatment such as:
- items that can’t be used by other patients, such as physiotherapy bands
- medicines not on the Pharmaceutical Benefits Scheme
- diagnostic tests not covered by Medicare.
Pharmaceutical Benefits Scheme (PBS)
The Pharmaceutical Benefits Scheme (PBS) is an Australian Government program that covers part of the cost of medicines to make them more affordable. The PBS is available to all Australian residents with a Medicare card.
Please note: Canberra Health Services may disclose your personal information to the Chief Minister, Treasury and Economic Development Directorate for the purposes of invoicing you for goods and services that you have received, and the recovery of any outstanding monies owed by you in relation to the provision of these goods and services. Canberra Health Services may not provide your requested goods or services if you do not agree to this collection and disclosure.
If you have a compensation claim (compensable patient)
You are a compensable patient if you receive health services related to an illness or injury, and either:
- a compensation agency or insurer has accepted liability for the illness or injury (including if you are accepted as a participant in the Lifetime Care and Support Scheme), or
- a compensation claim will be lodged for the illness or injury.
This might include an accident at work or motor vehicle accident.
If you are receiving treatment and are making a claim for compensation you won’t have to pay unless advised by the insurance company.
It is your responsibility to supply details of your insurance company claim number or details of a solicitor if this is related to workers compensation or an insurance claim.
If you require any further information, please contact the Patient Accounts – Invoicing & Receipting Team.
Phone: (02) 6207 6131 (option 2)
Email: chsbilling@act.gov.au
Fax: (02) 6174 5267
If you are a Medicare non-eligible patient or overseas visitor
You are Medicare non-eligible or ineligible if you:
- are not an Australian citizen
- do not hold a permanent resident visa
- do not hold a Special Category Visa (SCV)
- do not hold a valid Medicare Card.
We cannot give you free public hospital services. In most cases, you must meet the full costs of your hospital treatment. This includes emergency department treatment.
If you are from a country that holds a reciprocal healthcare agreement with Australia, you may not have to pay for your hospital care.
Please note that not all treatment is covered by the reciprocal healthcare agreement.
Treatment in the Emergency Department
When you arrive at the Emergency Department you will be required to pay an ED attendance fee. If you can't pay at the time of your visit we will give you some paperwork to sign with information about how to make the payment after you leave.
Reciprocal healthcare agreement
These are agreements with 11 countries that covers the cost of medically necessary care when visitors from these countries visit Australia.
We will give you an information sheet with our fees and charges when you come to our health care service.
Please let us know if you have health or travel insurance. You may have to make the claim through your insurance company. Where possible, we will bill your insurance company directly. You will need to pay the gap payment between what we charge and what your insurance company pays.
If you are receiving outpatient treatment and you are not covered by Medicare, and you are a non-eligible patient, you will have to pay for the services and any equipment you receive including the consultation with the doctor, nurse, midwife or allied health professional.
Please note:
- If you hold an Australian visa that requires you to hold adequate health insurance and you are unable to meet your financial obligations, Canberra Health Services may be required to report this debt to the Department of Home Affairs.
- Canberra Health Services may disclose your personal information to the Chief Minister and Economic Development Directorate for the purposes of invoicing you for goods and services that you have received, and the recovery of any outstanding monies owed by you in relation to the provision of these goods and services. Canberra Health Services may not provide your requested goods or services if you do not agree to this collection and disclosure.
As a non eligible patient, we may ask you to pay for some services upfront. These may include costs for attending the emergency department, elective surgery and some diagnostic services.
Otherwise, we will contact you and send you the invoices for the treatment/services you have received. The details of how to pay your account will be on the bottom of each invoice.
Walk-in Centres
There is no charge for attending a Walk-in Centre, even if you are an overseas visitor or are not eligible for Medicare. We have more information about where you can find a Walk-in Centre.
