Skip to content
Healthslips logo
Greenslips logo
Healthslips logo
Explore Overview
Cover Overview
Hospital Cover (9 articles) Extras Cover (5 articles) Ambulance Cover (5 articles) Excluded Treatments
Insurers Overview
AAMI Health Insurance ACA Health ahm AIA Health Insurance Allianz Care Australia APIA Health Insurance Astute Simplicity Health Australian Unity Bupa Health Insurance CBHS Corporate CBHS Health Defence Health Doctors Health Emergency Services Health Frank GMHBA GU Health HBF HCF HCi Health Partners HIF Hunter Health Insurance (by CDH Benefits Fund) ING Health Insurance Latrobe Health Services Medibank Mildura Health Fund Navy Health nib Nurses & Midwives Health onemedifund Peoplecare Phoenix Health Fund Police Health Priceline Health Insurance Qantas Insurance  Queensland Country Health Fund Real Health Insurance Reserve Bank Health Society (RBHS) rt health see-u By HBF Seniors Health Insurance  St Lukes Health Suncorp Health Insurance  Teachers Health Territory Health Fund  Transport Health TUH UniHealth Union Health  Westfund
Do you have a reference number?
Resume your calculation.
Healthslips logo Greenslips logo
Compare Every Insurer
No Commercial Bias
Cheapest Policy Guaranteed
Free Open Access
Compare Every Insurer
No Commercial Bias
Australian Health System
Guide

How are hospital cases managed within the Australian Health System?

Reviewed and updated 8 November 2024

Acute illness or trauma

If you arrive at a public hospital emergency department and are diagnosed with acute illness,  traumatic injuries or a deteriorating existing condition, you will receive emergency surgery if deemed appropriate.

You can be:

  • admitted to hospital via an emergency department
  • a currently admitted inpatient who experiences a sudden deterioration.

Elective surgery

If you are categorised as requiring surgery outside 10 days, you will be put into one of 3 categories:

CategoryDescriptionTimeframeExamples
Category 1– has the potential to deteriorate quickly and may become an emergency– procedures that are clinically indicated within 30 days – breast lump removal or biopsy
– neonatal surgery
– malignant skin lesion
– limb amputation
Category 2 – causes pain, dysfunction or disability
– unlikely to deteriorate quickly
– unlikely to become an emergency		– procedures that are clinically indicated within 90 days– heart valve replacement
– trigger finger release
– congenital cardiac defect
– nerve decompression
– fracture that will not heal
Category 3– causes minimal or no pain, dysfunction or disability
– unlikely to deteriorate quickly
– does not have the potential to become an emergency		– procedures that are clinically indicated within 365 days– carpal tunnel release
– joint replacement
– joint reconstruction
– tonsillectomy
– endometriosis
– insertion of
grommets

What does this mean if I need surgery?

If you want to enter the health system as a public patient under Medicare and you need elective surgery, you have to join a public waiting list. You might have to wait for months or even years for your surgery. 

If you enter the health system as a private patient (after seeing a specialist who has recommended surgery), you can book in at your chosen private hospital. The waiting time may be only days or weeks.

This is one reason why people have Private Health Insurance and use it to help pay for being treated in a hospital as a private patient.

We promise

Read more
Compare Every
Insurer

Compare all Australian health insurers and every policy
No Commercial
Bias

Compare using independent and comprehensive information
Cheapest Policy
Guaranteed

Compare all Private Health Information Statements, cheapest to most expensive
Free Open
Access

Compare without entering your name, email or phone number

Related Content

advertisement
calculate your health insurance