Non-Medicare and Long Stay Nursing Home Patient Fees

Non-Medicare Fees

A non-Medicare patient is defined as a patient who does not fall into the Medicare eligible, Compensable, or Veterans’ Affairs categories.

Note that for emergency department services in Country Accident and Emergency, the fees apply to services provided by a Senior Medical Officer (SMO).

Non - Medicare admitted fee per day

Effective 1 July 2020

  • Non-medicare patient - except obstetrics: sub acute and non acute services - $2220
  • Non-medicare patient - except obstetrics: surgical interventions - $3905 
  • Non-medicare patient - except obstetrics: medical interventions- $2220 
  • Non-medicare patient - except obstetrics: births and deliveries - $3110 

Non-Medicare Emergency Department fee per day

Effective 1 July 2020

  • Country accident & emergency - public - $519
  • Country accident & emergency - private - $430
  • Large country - *public - $336
  • Large country - *private - $268
  • Other metro - *public - $519
  • Specialist - *public -  $519
  • Teaching - *public - $519

*The following criteria form the basis for the hospital groupings of large country, other country, other metro, specialist, and teaching:

  • Geographical locality provides a strong indicator of the role and range of services available at each site; eg. metropolitan Adelaide, large regional Country centres, or other localities. 
  • Specialist hospitals target services to women of child bearing age and children.
  • Teaching is provided to support education and training of future and current health professionals. In general, teaching is provided at larger hospital sites where a more comprehensive range of services is available to treat patients.

Long Stay Nursing Home Type Fees

A long stay patient is defined as a patient who has been an admitted patient in a hospital for a continuous period exceeding 35 days. If the patient is non-acute as determined by doctor advice, and hence becomes a long stay nursing home type (LSNHT), a patient contribution charge applies from the 36th day onwards, payable by the patient. This charge represents 87.5% of the Commonwealth single standard pension benefit plus rent assistance. Private LSNHT patients are to be charged both the patient contribution and the basic benefits amounts for each overnight stay.

Long Stay Nursing Home Type (LSNHT) fee per day

Effective 1 July 2020

  • Long Stay Nursing Home Type (LSNHT) basic benefit  - $125

Effective 20 March 2020

  • Long Stay Nursing Home Type (LSNHT) patient contribution -  $62.50