Choosing hospitals and specialist doctors

If you need to go to hospital to see a specialist, you have the right to choose which hospital and specialist you're referred to by your GP. The hospital you choose for your first specialist appointment is probably going to be the same place you'll have treatment if you need it.

In Victorian public hospitals, you can choose to be treated as a private or public patient. Public patients don’t need to pay for their stay in hospital and are usually treated by a team of doctors nominated by the hospital.

Private patients can be treated by a doctor of their choice, provided that doctor has a right to practice at the hospital. Private patients are billed according to their health insurance.

WorkCover, Transport Accident Commission (TAC) and Department of Veterans’ Affairs patients will have their hospital expenses covered by these third-party providers.Overseas patients from countries that do not have reciprocal rights with Australia under Medicare will need to pay for their hospital accommodation and treatment. Special arrangements also exist for overseas students and visitors.

Choosing a specialist as a private patient

Your doctor will suggest the most appropriate specialist for you. Many private patients find their specialist through a recommendation from their local doctor. Some rely on recommendations from family, friends or work colleagues, and others do their own research.

Choosing a hospital

Victoria’s Department of Health provides statistical information on the performance of Victoria’s public hospitals and health services, so you can compare hospitals in certain areas of care, including:

• emergency care
• patients treated
• planned surgery (also known as elective surgery)
• quality, safety and patient experience
• dental care
• mental health.

Treatment in a public hospital

You can choose to be admitted as either a public or private patient. Even if you have private health insurance, you can still choose to be a public patient in a public hospital.

Being a private patient in a public hospital

As a private patient in a public hospital, you can:

• be treated by your chosen specialist, as long as the specialist has the right to practise at the hospital

• receive 75% of the Medicare Benefits Scheme (MBS) fee for associated medical costs but you will have to pay all remaining costs for things like hospital accommodation and other medical and diagnostic services, such as scans.

To find out more about what is covered, visit the Australian Government Private Health Insurance Ombudsman or contact your health insurance company.

Treatment in a private hospital

As a private patient using the private hospital system, you can choose your doctor or specialist, and the private hospital where you would like to have your procedure, provided your chosen doctor is able to treat you at that hospital.

Private health insurance

Even if you have private health insurance, you will probably still have to pay extra for your hospital stay.

Health insurance companies often have agreements with ‘preferred’ hospitals to keep your out-of-pocket expenses down if you choose to be treated at one of those hospitals. If you choose a hospital outside of this list, your out-of-pocket expenses may be higher. Contact your health insurance company or the hospital for information about costs.

Where to get help

• Your GP (doctor)
• Private health website