PHI 17/18 Categorisation of 23 Hour Hospitals for Second Tier Default Benefits

Page last updated: 23 March 2018

PDF version of PHI 17/18 Categorisation of 23 Hour Hospitals for Second Tier Default Benefits (PDF 46 KB)

The Department has received several queries from insurers relating to categorisation of 23 hour hospitals for the purposes of determining second tier default benefits.

In general, categorising a hospital for the purposes of eligibility for Second-tier default benefits should be done using the list at Schedule 5 Subsection 1(3) of the Private health insurance (Benefit Requirements) Rules 2011 (the Rules).

Consistent with advice previously provided by the Department to a number of insurers in October 2010 the Department confirms that insurers can continue to categorise 23 hour hospitals in category (g) until such time as the Department amends the categories within the Rules.

The Department is currently reviewing these hospital categories as part of the Second Tier administrative reforms. Industry will be advised in a circular of any changes to the Rules resulting from these reforms and broader private health insurance reforms. More information is available at Private Health Insurance Reform Implementation Timeline.