How does overseas visitors cover (OVHC) work for out of hospital services?

Most minor health issues can be treated by a local doctor - called a General Practitioner or GP in Australia. The GP can prescribe medication if needed. Usually you only go to hospital straight away if you have a medical emergency or are in a major accident.

If it’s not an emergency

If you’ve been hurt or are feeling sick, but it’s not life-threatening. For example, you’ve twisted your ankle, or have a minor cough or cold, then it’s not an emergency.

  1. Call us on 1300 174 537 to find a doctor near you
  2. Visit a doctor at a medical centre (choose a doctor who is a part of the CBHS International Health Network, if you can)
  3. The doctor will determine what treatment you need, prescribe medication if needed, or refer you to a specialist doctor, for example a gastroenterologist, dermatologist or surgeon (if you need an operation). You cannot visit a specialist physician in Australia without a referral from your doctor first.

If it’s an emergency

An emergency is when you’ve got an immediate illness or injury (you’re hurt), and it’s threatening your life. For example, you’re struggling to breathe, or you’ve been in a major accident (or someone close to you has).

  1. Dial 000 on your phone
  2. Tell them if you need a translator
  3. They’ll send emergency services, like an ambulance, to help you.

How do medical payments work?

The Australian Government has set a recommended fee for most medical services, such as visiting your doctor which is called the Medicare Benefits Schedule, or MBS. If you doctor charges the recommended MBS fee, we will pay the entire amount for you. However, if the doctor charges more than the recommended fee, you will have to pay the difference. We call this an ‘out-of-pocket expense’ or ‘gap’ payment.

Some doctors will send us the bill directly and some will ask you to pay on the day of your appointment. In this case, make sure you get a receipt and then claim online in member services by supplying the details of the appointment and your receipt. We’ll refund you based on your cover.

What if my doctor prescribes medication?

Sometimes your doctor will prescribe medicine as part of your treatment. A prescription is a piece of paper with the medication on that the doctor would like you to take written on it.

Take the prescription to the pharmacy or chemist, and they will supply you with the right medicine. If you're not sure how to use the medicine, ask the pharmacist before you go home.

What if it’s after hours and my medical centre is closed?

All public hospitals in Australia have a 24-hour emergency and casualty department where you can get help after hours and on the weekend. People waiting in emergency are assessed and treated based on the seriousness of their medical condition. The patients with the most urgent problems are seen and treated first. If you attend the emergency department with a less serious medical condition, you may need to wait a long time to be treated and you could have a large out of pocket expense.

How does visitors cover (OVHC) work for in-hospital services?

When you’re treated in hospital by a doctor, surgeon or anesthetist, you will be charged a fee. If the person treating you charges only the MBS fee (and the service is included in your health cover) you will be covered for the service. If they choose to charge above the MBS fee then you will have to pay the difference.

Before you go to hospital, you should ask your doctor and the hospital if there will be any additional costs that might be higher than those covered by your OVHC. It is also highly recommended that you contact us before you go to hospital so that we can tell you if there are any exclusions, restrictions or limits on the treatment you're seeking.

Have a question? Our team is here to help.

From when to see the doctor or what to do if you have to go to hospital - our team can give you answers.

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