You can use your private health insurance at Grampians Health Ballarat even if you have basic cover.

As part of the National Health Care Agreement (2019) between the Commonwealth and State governments, public hospitals must give you the option of being treated as a public or private patient upon admission. 

Choosing to use your private health insurance at Grampians Health Ballarat contributes additional funding to your local hospital, helping maintain facilities and provide more equipment and services to the community and the broader Grampians region.

How to use your private health insurance at Grampians Health Ballarat

For your elective admission from your specialist's rooms

For your elective admission, you will have already chosen your own specialist, and will have spoken with them in their own consulting rooms. They will have booked your admission at Grampians Health Ballarat. They will care for you during your stay with us, and we will assist you in making a post-operative appointment at your specialist's rooms.

For your admission from our Emergency Department (ED)

If you visit our Emergency Department and need to be admitted and you have a specialist in mind for your care, please tell the medical team in ED about your choice and they will contact your specialist for you. You will be admitted under the care of your chosen specialist.

If you don't have a specialist in mind, or your specialist is unavailable, you can choose to be cared for by the specialist on call at the time.

You can also choose to be admitted under the care of the specialist medical team at Grampians Health Ballarat - that is, a Consultant and a Registrar. This team will care for you, for the duration of your stay with us, and you will be admitted as a private patient under the care of that team.

It is important for you to know that this specialist team will also care for you if you are admitted outside normal business hours. This team will remain in charge of your care until they can personally hand your care over to your chosen specialist. You will still be admitted as a private patient.

We cover the gap

Using your private health insurance when you are admitted to Grampians Health Ballarat means that you'll benefit from lower costs for medical care. That's because we cover the gap between the amount your private health insurance pays and what the costs actually are*.

The Private Patient Liaison Team will take care of all the paperwork and details for you. We'll get you into hospital with a minimum of hassle, so you can focus on your recovery: it's just one more reason why Grampians Health Ballarat should be your first choice in Healthcare.

Out of pocket expenses*

It costs you nothing to use your private health insurance for your stay with us at Grampians Health Ballarat, even if you have an excess or co-payments on your policy.

Along with our state-of-the-art medical care, one of the best reasons to choose Grampians Health Ballarat is for the cost savings you could realise.

Other benefits include:

  • The Private Patient Liaison team will help you take care of all the paperwork and administrative work
  • You're free to choose your own specialist for treatment or care in hospital
  • Our staff are available to you for advice and answers, and can be contacted by calling 5320 4214, 5320 8693 or 0439 642 221

 *Exclusions to "No out of pocket expenses":

  • Please note that there may be private patients who need an MRI. This equipment is not owned and operated by Grampians Health Ballarat; this means that there will be an added expense if an MRI is required.
  • A small pharmacy fee is paid by all patients for discharge medication.

Private-to-pay patients

It is possible to access the benefits of private healthcare even if you do not have private health insurance. You must have your own specialist to care for you during your stay with us, if you are a private-to-pay patient.

Should you choose to be a private-to-pay patient, you will pay the full cost for private patient privileges over the duration of your stay.

As a private-to-pay patient you are required to pay an estimated cost of your procedure two weeks prior to your admission and before you can complete the booking process.

These estimated costs are based on the average length of stay for a procedure of each type and the cost of any prostheses that may be used by your specialist for your procedure. Not all procedures require prostheses; please check with your doctor. There are many prostheses types, they range from small to very large, and potentially very expensive items.

There may be additional costs associated with your stay, such as the cost for pathology, radiology or MRI (but there could be others) and they will be invoiced and forwarded to you for payment after your discharge.

To obtain an estimate for your intended stay, please phone the Private Patient Liaison Team on (03) 53204214, (03) 5320 8693, 0439 642 221 or email on

Who do I contact to discuss the option of private-to-pay?

Private Patient Billing Team
Contact Details
Phone: 5330 5132 or 5320 4562
Hours: 8am to 4pm Monday to Friday

How do I see a specialist?

You must get a referral from your General Practitioner to a specialist of your choice.

The specialist's rooms will be able to give you an estimate of their fees and you will need to contact the anaesthetic group for advice on their fees.

How do I pay for my admission?

In person: pay at the Accounts/Cashiers desk between 9am and 5pm Monday to Friday. Please remember to bring your signed Agreement with you.

By mail: please make cheque payable to "Ballarat Health Services" and forward with your signed Agreement in the reply paid envelope provided.

By credit card: telephone (03) 5320 4217.

Note: You will need to sign the Agreement when you come in to complete your admission paperwork

Medicare ineligible patients can find up-to-date information and rates here.

Compensable patients

If you are entitled to, or may be entitled to compensation, damages or other benefits in respect of the injury, illness or disease for which you are receiving hospital care and medical treatment, all fees and charges may be met by your compensation. This includes, for example the Accident Compensation Act 1985, (Vic), Transport Accident Act 1986 (Vic), Safety Rehabilitation and Compensation Act 1988 (Cth), or a claim for damages at Common Law.

In the event of your claim being rejected, you must still elect to be public or private for your admission.

Veterans Affairs patients

Please notify staff if you are the holder of a Department of Veterans’ Affairs (DVA) Gold or White Card, all of your claimable accounts will then be sent to DVA.

Please refer to the following link regarding hospital cover for Gold and White care holders


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