Young physician looking at his terminally ill patient's medical history

What is after-hours GP care?

Find out more about after-hours GP care and what is covered by your private health insurance.

Illnesses, injuries and other health concerns don’t always occur during office hours. From late nights to weekends and even public holidays, you can fall ill at any time and may require after-hours care from a GP. But if you do require after-hours care, will any of the costs you incur be covered by private health insurance?

The good news is that some Australian health funds provide benefits to help you get the medical attention you need, when you need it. Read on to find out exactly what is and isn’t covered by private health insurance for after-hours GP care.

Find out what policies are available and compare your options

Details Features
High 65 / 75 / 85% - $0/$250/$500 Excess
High 65 / 75 / 85% - $0/$250/$500 Excess
Combines High Hospital Cover with its highest level of extras cover.
  • Cover starting from $44.74 weekly
  • 12 month waiting period for pregnancy
  • 65% back on extras
  • Choice of $0, $250 and $500 excess
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Premier Package
Premier Package
Top tier combined hospital and extras policy that covers you for an extensive range of hospital and general treatment services.
  • All the benefits of HCI's Premier Hospital policy
  • All the benefits of HCI's Premier Extras policy
  • Cover for pregnancy and IVF treatment
  • Cover for general and major dental
Get Quote More info
Deluxe flexi
Deluxe flexi
Deluxe flexi provides cover for a range of treatments including hip replacement, spinal fusion, dialysis and major eye surgery.
  • No excess for kids
  • All joint replacements
  • Major eye surgery
  • Rehabilitation
Enquire Now More info
GoldStar
GoldStar
Premium hospital cover with complete cover for hospital expenses. Save 4% when you pay for 12 months of your cover upfront.
  • All theatre fees covered
  • Unlimited maternity cover
  • Choose no excess or $200, $400, $500 per admission
Get Quote More info
Smart Combination
Smart Combination
Smart combination provides a high level of cover for both hospital and extras.
  • Claim up to $2725 back on extras
  • Hip and knee replacements
  • General and major dental
  • Physio
Enquire Now More info
Prestige
Prestige
Highest level of combined cover offered by CBHS. Includes the same benefits as Comprehensive Hospital and Top Extras plus more. Restricted fund: Only current or former staff (and their families) of Commonwealth Bank Group and their subsidiaries which include Aussie, Bankwest, Colonial First State and more can join.
  • No excess or co-payments on hospital cover
  • Non-student dependent under 25 can be kept on policy
  • Access to Chronic Disease Management Programs
  • Widest range of extras including orthodontics
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Bronze Hospital (no pregnancy) and Bronze Extras Set Benefits
Bronze Hospital (no pregnancy) and Bronze Extras Set Benefits
High level of hospital cover and extras cover for a range of popular services including knee and should reconstructions.
  • Most comprehensive hospital options
  • Cover for general and major dental
  • Shared or single room in a private hospital
  • Intensive and coronary care
Enquire Now More info
Premium Hospital and Silver Extras Cover
Premium Hospital and Silver Extras Cover
Comprehensive hospital cover including pregnancy cover. Also included affordable mid-level extras cover for dental, optical and therapies.
  • Cover from $39.50 per week
  • Pregnancy and birth-related services cover
  • Heart surgery cover
  • 100% cash back on two dental check per year
Enquire Now More info
Top Hospital with Top Extras
Top Hospital with Top Extras
Get comprehensive hospital and extras cover and tailor your policy to your needs.
  • Pregnancy and birth services cover
  • Back surgery cover
  • $1000 general dental annual limit
  • $600 physiotherapy annual limit
Enquire Now More info
Young Couples Combined Cover
Young Couples Combined Cover
Mid-level hospital and basic level Extras package with an excess for young, healthy couples that are not quite ready to start a family.
  • Emergency ambulance cover
  • Cancer-related surgery cover
  • 70% back on extras
  • $300 dental annual limit per person
Enquire Now More info

What costs will your health fund cover?

If your GP is closed and you need after-hours medical care, some Australian health funds will provide benefits to help cover the cost of any treatment you receive. The exact type and level of cover provided differs between health funds, but you can generally receive cover for annual membership to an after-hours GP service, such as the National Home Doctor Service.

This membership is included as part of your health insurance premiums, allowing you to access bulk-billed treatment from a GP who comes to your home outside office hours. As the treatment is bulk-billed you will not have any out-of-pocket expenses, and you can also be supplied antibiotics and other common medications on the spot at no cost.

If required, the National Home Doctor Service then makes a follow-up appointment for you with your regular GP the following business day.

By including after-hours care in their policy benefits, the funds that offer this type of cover are providing extra peace of mind to their members.


After-hours primary healthcare

After-hours primary healthcare refers to the care a patient receives when their condition can’t wait for treatment until regular primary healthcare services are available on the next business day. This should never be considered an adequate substitute for “in-hours” healthcare, but it should be accessible for all Australians so that essential care and treatment is always available when needed.

In 2014, a government review into the delivery of after-hours primary healthcare in Australia saw the development of new funding arrangements for these services nationally. This led to the creation of a PIP After Hours Funding incentive to provide ongoing support to after-hours services tailored to meet the needs of local patients around the country.

It also led to the establishment of a new after-hours GP Advice and Support Line, which allows Australians to access tailored healthcare advice when they can’t receive face-to-face GP services outside of office hours.


What services are provided around Australia?

Are you sick or injured and unsure how to find a GP outside office hours? These resources can help you find a GP and get the healthcare you need:

  • National Home Doctor Service. The National Home Doctor Service service allows you to receive a home visit from a bulk-billing GP after hours by calling 13 SICK.
  • HealthEngine. HealthEngine is a handy site that allows you to find and book appointments with doctors, physios and a range of other healthcare professionals Australia-wide. The service is available 24 hours a day, 7 days a week.
  • DoctorDoctor. DoctorDoctor can help residents of Brisbane, Melbourne, Perth and Sydney access an after-hours GP through its on-call home doctor and phone triage service.
  • Doctor Home Visits. If you live in WA, Doctor Home Visits can help you find and book an after-hours GP.
  • After Hours GP Helpline. Need to find a doctor or pharmacy that is open now? After Hours GP Helpline can help you find a pharmacy close to you, or phone the helpline on 1800 022 222.

Are there any issues with after-hours GP care?

Although after-hours GP care offers many benefits, there are still some issues that have occurred with after-hours services that all patients should be aware of. For example, concerns have been raised about the continuity of care provided to patients who access out-of-hours healthcare but then don’t receive any follow-up care from their regular GP. This is a particular problem for older patients with complex chronic conditions that rely on careful medication management for effective treatment.

The after-hours healthcare system also works very differently in metropolitan areas to how it functions in remote and rural areas. Rural GPs are called upon to provide a wide range of services and increasingly treat patients with more and more complex conditions, all of which leads to high workloads and significant pressures for GPs, as well as impacting on the financial viability of offering after-hours services.

Finally, some GPs have voiced concerns that the rise of after-hours services is compromising the level of care delivered to patients through the use of experienced junior GPs, and that the generous rebates on offer to after-hours practitioners could lead to a Medicare cost blowout. These issues are likely to continue to be debated as the popularity of after-hours GP services continues to rise.

Compare your health insurance options

Picture: Shutterstock

Richard Laycock

Richard is the senior insurance writer at finder.com.au and is on a mission to make insurance easier to understand.

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