If you need to have a blood test, you might be wondering if the cost will be covered by Medicare or your private health insurance. So let’s take a look at how pathology benefits work and who covers what.
Do HIF cover blood tests?
Yes, but it depends on whether or not this is included on your policy and whether you receive the treatment as an inpatient or an outpatient. If you undergo a pathology test while you are admitted to hospital or a day surgery as an inpatient, this would be claimable through HIF under your hospital cover.
However, if you have the pathology test as an outpatient – ie in your GP's rooms, HIF wouldn't be able to pay a benefit towards your treatment. Instead, outpatient services are only covered by Medicare (unless you’re an overseas visitor, in which case you'd need a level of Overseas Visitor Cover to claim for this service).
It's important to note though, that if cover for the cost of a blood test is provided by HIF or Medicare, some out-of-pocket costs may still apply. This occurs if your doctor's charges are are greater than the Medicare Benefit Schedule (MBS).
To confirm if a benefit is applicable, please ensure that you meet the requirements outlined below and also complete our Medical Estimate Form so a member of our team can check your eligibility.
- Hold an eligible level of HIF Hospital Cover
- The applicable waiting period has been served
- You will be treated as an inpatient;
Please note: For pre-existing conditions a twelve month waiting period will apply.
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