Is hospital cover worth it?

Once a year, most people look into their finances and ask themselves, is hospital cover worth it?

Hospital cover does three key things:

  1. Get timely access to important health services, without the long public waiting lists (for services on your cover)
  2. Avoid paying the Medicare Levy Surcharge – an extra tax for high-income earners
  3. Choose your specialist

There are a bunch of other great things RBHS hospital cover does such as give you fantastic cover for expensive ambulance services and helps you improve your health with our fantastic health programs.

Below we provide some of the latest statistics along with information on how that affects you and your hospital cover.

Hospitals in Australia, 2017-18 [1]

Public hospitals 693
Private hospitals 657
Total 1350

Commentary: Private hospitals equate to just under half of Australia’s total hospitals (49%). If you don’t have hospital cover, you could miss out on using half of Australia’s available facilities. That means available beds and specialists!

Key private hospital info for 2018-19 [2]

  • More than 66% of all elective surgery procedures were conducted in private hospitals.
  • Private hospitals don’t just perform routine treatment. Private hospitals performed 59% of surgical hospitalisations and 60% of mental health hospitalisations.
  • 83% of hospitalisations in private hospitals were funded by private health insurance.

Hospitalisations between between 2014-15 and 2018-19 [3]

  • Public patient hospitalisations increased by an average of 4.3% each year.
  • Private health insurance hospitalisations increased by an average of 2.5% each year. They increased by 2.0% each year in public hospitals and by 2.6% each year in private hospitals.

Commentary: Demand for our hospitals is increasing. That means that hospital cover is useful to cope with that demand and get your treatment when you need it.

Private health insurance in 2018-19 [3]

  • Nationally, for all hospitals combined, 41% of hospitalisations were for private health insurance patients

Commentary: Think that on any given day, 2 in 5 patients nationally are in hospital using their health fund cover.

How much do common surgeries cost?

We used the Australian Government’s new Medical Costs Finder to show the type of costs health funds like us typically pay for common surgeries. This means that if you were to go to hospital privately without hospital cover, these are the types of sums you would need to pay. Please note that there are typically patient out-of-pocket costs to pay on top of these figures.

Surgery Total health fund payment*
Cataract $3,070
Heart surgery $16,400
ACL repair $5,900
Single hip replacement $22,900
Endoscopic prostate removal $5,600

*Median data for all Australian from the 2019 financial year used. This means that for half of the surgeries listed, health funds paid more than above.



[1] Australian Institute of Health and Welfare, "Hospital resources 2017–18: Australian hospital statistics," 26 June 2019. [Online]. Available:

[2] Australian Institute of Health and Welfare, "Admitted Patients," 9 July 2020. [Online]. Available:

[3] Australian Institute of Health and Welfare, "Spending on admitted patients," 9 July 2020. [Online]. Available:

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