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Going to hospital: What to do before being admitted to hospital

Going to hospital can be a scary and intimidating experience, so here’s everything you need to know to prepare for your stay.

Going to hospital can be a stressful time for you and your entire family. A hospital stay can be a confusing and intimidating experience for anyone, even if you’re only booked in for a minor procedure, so it’s important to be prepared before you’re admitted.

Read on to find out how to get ready for your hospital visit and what you can expect before being admitted. If you plan ahead, you can ensure that your stay is as stress free and comfortable as possible.

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Getting admitted to hospital

Planned hospital admissions usually follow a few simple steps:

  • Finding out about your condition. You can talk to your GP and specialist about your condition, your treatment options and the pros and cons of each option. This will help you get a better understanding of why you need to go to hospital, what will happen when you get there and how much the procedure will cost.
  • Understanding the costs. Before you go to hospital, it’s important to understand how much your treatment will cost. While Medicare covers public hospital treatment costs and private health insurance covers treatment as a private patient in a public or private hospital, you may still incur out-of-pocket expenses. This occurs when your specialist charges more than the Medicare Benefits Schedule (MBS) fee.However, you can reduce or eliminate these out-of-pocket costs if your specialist participates in your health fund’s gap cover scheme, so contact your insurer to find out if you will have to pay anything from your own pocket. Before you undergo a procedure, your hospital must get your informed financial consent. This means you know how much your treatment will cost.
  • Getting a referral. Most hospital admissions occur after your GP refers you to a specialist. Your specialist will determine whether you need to undergo hospital treatment and the type of treatment you need. Your specialist will then send a letter to the hospital to ask for your admission, including details on the urgency of your situation.
  • Waiting for admission. You will be placed on a waiting time register and the hospital will let you know how long you will have to wait before admission. When the time and date of treatment is set, the hospital will contact you to let you know when you need to go to hospital, where to go when you get there, special instructions for treatment and items you need to bring.
  • Filling out the required forms. You will need to complete hospital forms before your admission. Most hospitals will send an admission pack that will include some questions about your medical history and ask you to provide an emergency contact. You must complete these forms and return them to the hospital before your procedure.

What are your admission choices?

If you hold a Medicare card, you can choose to be treated as a public or private patient. If you’re admitted as a public patient, you will have to accept the following conditions:

  • You cannot choose your own doctor. Instead, you will be treated by a doctor or doctors nominated by the hospital.
  • You will not be charged for the cost of hospital accommodation, medical and diagnostic services or for a range of other in-hospital services.
  • You will receive follow-up care from the hospital’s outpatient clinic once you have been discharged.

If you are treated as a private patient, you will get the following benefits:

  • You can choose your own doctor.
  • You can get a single room (if a room is available and if it is included in your health insurance cover).
  • You can get cover for the cost of hospital accommodation and theatre fees as well as for medical and diagnostic services and more.
  • After you leave hospital, you will receive follow-up care from your specialist doctor in their private room.

Choosing your hospital

Several factors will influence your choice of hospital. One of the most important factors is whether you have hospital cover from a private health insurer. If you do, you can choose to be treated in a private or public hospital. However, in some cases your choice of hospitals may vary depending on where your specialist works.

If you do have hospital cover, your insurer will also affect your choice of hospital. Health funds have agreements in place with private hospitals around Australia to ensure that most or all of your hospital fees are covered. But if you choose a hospital that doesn’t have an agreement with your health fund, there’s no guarantee that your fund will foot the full bill for all of your treatment costs.

You will need to contact your health fund for a list of agreement or contracted hospitals.

What are gap cover schemes and how do they work?

Even if you have comprehensive hospital cover in place, you could still incur out-of-pocket expenses when you go to hospital. Out-of-pocket expenses arise when there is a difference between what your health fund and Medicare cover and how much the hospital and the treating specialists charge. This amount is the gap.

To help reduce or eliminate these out-of-pocket expenses, health funds run gap cover schemes. If a specialist participates in your health fund’s gap scheme, you either will not have to pay any gap at all or your out-of-pocket costs will be capped at a certain level.

When meeting with your specialist and discussing the costs of treatment, ask whether they participate in your health fund’s gap scheme.

Preparing for your stay

Before you go to hospital, there are a few important things you can do to prepare for your stay:

  1. Talk to your GP. Discuss your referral with your GP. You have the right to ask for another referral if you’re not happy with the specialist they’ve suggested. For example, you may wish to ask for an open referral, which allows you to choose from a list of specialists with the appropriate qualifications or for a referral to a specialist who participates in your health fund’s gap cover scheme.
  2. Talk to your specialist. If you have any questions about your medical condition or the treatment you need to undergo, ask your specialist. He or she can offer expert advice about the benefits and risks of treatment as well as help relieve any anxiety or confusion you may have. Discussions with specialists can sometimes be overwhelming as there is a lot of information to take in, so you may wish to take a friend or loved one with you.
  3. Talk to your health fund. Contact your health insurer to find out exactly what is covered by your policy. Will you have any out-of-pocket expenses? Can you reduce or eliminate those out-of-pocket expenses by choosing specific specialists or a certain hospital? You can also find out about any waiting periods, exclusions or excesses that apply to cover.

Waiting for treatment

Hospitals book patients in for treatment based on the urgency of their condition, with the sickest patients receiving treatment first. This means that you could wait for a few days before your admission or you could wait for several months.

If your health changes while you are waiting to be admitted to hospital, see your GP as soon as possible. Depending on the circumstances, they may need to notify the specialist or the hospital if the changes affect your treatment needs. Your GP can also offer advice on how to better manage your condition while you wait to undergo treatment.

Checklist of what to bring to hospital

Make sure to bring the following items with you when you go to hospital:

  • Your Medicare card
  • Your private health insurance details
  • Your admission letter from the hospital
  • Important everyday items, such as glasses, dentures and mobility aids
  • Regular medications
  • X-rays, ultrasounds and other scans relating to your hospital treatment
  • Toiletries and pyjamas
  • A change of clothes for when you return home
  • Books, magazines and other items to prevent boredom

Knowing your rights and responsibilities

You need to know your rights and responsibilities before you are admitted to hospital for treatment.

Your rights:

From your doctors, you have the right to the following:

  • A detailed explanation from your doctors about treatment options, their benefits, their risks and any potential alternatives
  • Advice on what to do and what to expect before and after treatment
  • An outline of their fees (including your out-of-pocket costs) before admission
  • The names and contact details of other specialists involved in your treatment
  • Confidentiality and the right to be treated with respect and dignity

From your hospital, you have the right to the following:

  • An outline of any out-of-pocket expenses prior to admission
  • Confidentiality and the right to be treated with respect and dignity

Your responsibilities:

As a patient, you will need to do the following:

  • Follow all the pre-surgery instructions given to you by your specialist to ensure your safety and to make treatment as effective as possible
  • Understand what your health insurance policy does and does not cover
  • Make sure your health insurance premiums are up to date
  • Advise your specialist of any allergies, current medications and medical history that may affect your treatment

Getting to hospital

The final thing you need to consider is how you will physically get to the hospital on the day of your admission. You could organise a lift to the hospital with a friend or loved one, or you may wish to arrange a taxi ahead of time.

Remember to allow time for traffic on the day. This will take any extra stress out of the situation and, along with the other tips in this guide, will hopefully ensure that your hospital stay goes as smoothly as possible.

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Tim Falk

A freelance writer with a passion for the written word, Tim loves helping Australians find the right home loans and savings accounts. When he's not chained to a computer, Tim can usually be found exploring the great outdoors.

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