nib Update
St Vincent's has given notice of its intention to end its current agreement with nib on 3 October 2024 due to unsuccessful negotiations for fair funding that reflects rising costs.
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Notice to nib Members
St Vincent's has asked nib for a fair funding deal that considers the rising costs of providing private hospital care.
Private hospitals need fair funding agreements with health insurers to provide patients with the best care.
But sadly, nib has made that harder by closing the door on a fair agreement with us.
As a result, St Vincent’s has officially informed nib that it will conclude its current agreement on Thursday, 3 October after a notice period of 65 business days.
This means that - after this date - unless an agreement has been reached in the meantime - nib members may be required to contribute more to the cost of their hospital care when using a St Vincent’s private hospital, as the benefits paid by their fund will decrease.
We encourage you to read the information and FAQs below. If you have any further questions, please contact our call centre on 1300 644 273.
Call Centre | 1300 644 273 | ||
|---|---|---|---|
| Time Zone | Monday - Friday | Saturday | Sunday |
| NSW / VIC / QLD AEST | 8am - 6pm | 8am - 4pm | CLOSED |
This issue solely affects nib members along with those health insurers nib underwrites. People who are members of other funds will not be affected. The full list of affected health funds and insurers are:
- nib
- Apia Health Insurance
- AAMI Health Insurance
- Suncorp Health Insurance
- Qantas Health Insurance
- IMAN Australian Health Plans
- GU Health
- ING Health Insurance
- Priceline Health Insurance
- Real Insurance
- Australian Seniors
- UnitedHealthcare Global
Patient Information
St Vincent’s has officially informed nib that its current agreement and payment terms will conclude on Thursday, 3 October.
For nib members scheduled for treatment/admission in a St Vincent’s private hospital prior to and including Thursday, 3 October, there will be no impact.
For members who book their treatment on, or prior to, Thursday, 3 October, you may still be covered depending on your scheduled admission date. Please refer to the information on this page or call us on 1300 644 273 for further clarity.
How are nib members impacted if accessing a St Vincent's hospital?
St Vincent’s intends to temporarily cover the gap/difference between its rising care expenses and the benefits paid by nib.
However, if nib doesn't raise its benefits to match our escalating care costs, individuals may incur extra expenses on the following specified dates:
Treatment type | Out-of-pockets for patients may apply from |
Emergency (inclusions/exclusions noted below in FAQs) | 4 January 2025 |
Treatment commenced on or before Thursday, 3 October | Covered until discharge |
Rehab and mental health on or before Thursday, 3 October | 4 April 2025 |
Oncology and renal started on or before Thursday, 3 October | 4 April 2025 |
Pregnancy and birth - Pre-booked on or before Thursday, 3 October | 4 July 2025 |
Other procedures/services - Pre-booked on or before Thursday, 3 October | 4 April 2025 |
Information for maternity patients who are nib members
- Admissions on or before Thursday, 3 October: there is no impact.
- For those pre-booked on or before Thursday, 3 October: there is no impact. St Vincent’s will cover the gap between its increased costs of care and the benefits paid by nib.
- For those not pre-booked – admissions after Thursday, 3 October: additional out-of-pocket costs may apply unless benefits paid by nib increase to cover St Vincent’s increased costs of care.
Information for mental health, chemotherapy, dialysis, or rehabilitation patients who are nib members
- For those who have started a course of treatment or are pre-booked on or before Thursday, 3 October: there is no impact. St Vincent’s will absorb the gap between its increased costs of care and the benefits paid by nib for six months from the commencement of treatment.
- For those who either haven’t started treatment or are not pre-booked – admissions after Thursday, 3 October: additional out-of-pocket costs may apply unless benefits paid by nib increase to cover St Vincent’s increased costs of care.
Information for nib members who require an emergency admission
The existing contract terms and payment schedules remain in effect for an additional three months following the expiration of the current agreement on Thursday, 3 October for emergency admissions only.
Emergency admissions encompass situations in which:
- There is a risk of severe illness or death, and immediate assessment and resuscitation are necessary.
- There is suspected acute organ or system failure.
- The patient is afflicted by an illness or injury that critically threatens the functioning of a body part or organ.
- The patient has experienced a drug overdose, exposure to toxic substances, or toxin-related effects.
- The patient is enduring severe psychiatric disturbance, putting their own or other’s health at immediate risk.
- Severe pain is present, and there is suspicion that the viability or function of a body part or organ is acutely threatened.
- There is acute significant haemorrhaging, necessitating urgent assessment and treatment.
- Immediate admission is required to prevent imminent morbidity or mortality, and transferring the patient to another facility is not feasible.
Frequently Asked Questions - Patients & Doctors
Private hospitals need fair funding agreements with health insurers to provide patients with the best care.
St Vincent’s has asked nib for a fair funding agreement to cover the rising costs of running our hospitals. But despite our best efforts, nib has closed the door on our request.
As a result, St Vincent’s has officially informed nib that the current agreement will conclude on Thursday, 3 October following a notice period of 65 business days. This means that after this date, nib members may be required to contribute more to the cost of hospital care when using a St Vincent’s private hospital, as the benefits paid by their fund will decrease.
Exiting our agreement with nib is not the outcome St Vincent’s wants. St Vincent’s has done its utmost to reach a fair agreement.
But as a not-for-profit, St Vincent’s needs to be able to cover its basic costs.
St Vincent’s is still open to discussions with nib during the notice period to prevent this outcome. For more information regarding Private Health Insurance and hospital agreements, refer to the Ombudsman Fact Sheet.
Just as inflation has driven up the cost of living for individuals and households, it has dramatically increased the costs of providing care in our hospitals. These rising costs include things like: wages, food, energy, personal protective equipment (PPE), IT, and maintenance.
St Vincent’s has asked nib for a fair funding agreement that considers these costs when we provide care to their members. But despite our best efforts, nib has closed the door on our request.
We want to work with nib – like we do with other health funds – to keep premiums affordable while providing quality services with excellent clinical outcomes. But St Vincent’s needs a baseline level of financial security to do that.
We will continue to engage in discussions with nib in the hope of reaching a fair agreement before we reach the end of the notice period on Thursday, 3 October.
Throughout the notice period – which concludes Thursday, 3 October – nib members will experience no disruptions and all procedures will continue without any changes.
If you already have a procedure scheduled in a St Vincent’s private hospital before, or on, Thursday, 3 October, nothing changes.
Patient admissions, contingent upon meeting eligibility criteria, will continue to be completely covered under the existing agreement and payment arrangements.
If a new agreement is not reached by the conclusion of the notice period on Thursday, 3 October, transitional measures will be introduced to minimise disruptions for patients and members.
To minimise inconvenience, we’re encouraging nib members and their doctors to schedule their admissions at a St Vincent's private hospital by Thursday, 3 October.
Please be aware that this issue solely affects nib members along with those health insurers nib underwrites. Patients who are members of other funds will not be affected. The full list of affected health funds and insurers are:
- nib
- Apia Health Insurance
- AAMI Health Insurance
- Suncorp Health Insurance
- Qantas Health Insurance
- IMAN Australian Health plans
- GU Health
- ING Health Insurance
- Priceline Health Insurance
- Real Insurance
- Australian Seniors
- UnitedHealthcare Global
If you're thinking about switching your health insurance to avoid additional out-of-pocket costs, the Ombudsman's Right to Change Brochure clarifies the 'portability' regulations, which means that if you switch to a similar insurance plan, you won't need to go through waiting periods again before receiving benefits.*
*You may have to serve waiting periods for any extra benefits or better conditions under the new cover.
Yes. Australia's private health insurance regulations permit members of any health insurance fund to transfer their coverage to a different insurer. If you acquire a similar product from another health fund, you won't need to go through waiting periods again.*
nib members seeking information about their insurance choices can approach other health funds or refer to the Ombudsman’s Right to Change Brochure.
For any inquiries regarding specific health insurance products, it's advisable to contact the relevant health fund directly. They can offer details about product coverage, waiting periods, exclusions, limitations, and comparable alternatives.
*You may have to serve waiting periods for any extra benefits or better conditions under the new cover.
St Vincent’s is committed to providing all patients with excellent and compassionate, person-centred care. We welcome patients from all health funds at St Vincent’s hospitals. However, after our current contract with nib expires on Thursday, 3 October, you may encounter additional out-of-pocket expenses when using a St Vincent’s private hospital.
We continue to engage in discussions with nib in the hope of avoiding this outcome.
Your health fund is obligated to inform you about the potential consequences of this scenario. You may gain further understanding of the impact of this situation on your coverage and fees by contacting nib.
For inquiries about other health insurance plans, it is advisable to contact health funds directly to receive information about coverage, waiting periods, exclusions, and limitations.
Normally your health insurance premiums ensure your health fund covers your hospital expenses, minus exceptions which are shown in your policy, such as a hospital excess or doctor’s fees.
Unfortunately, because nib has not agreed to cover the increased costs of providing hospital care to their policyholders at St Vincent’s private hospitals, its members will have to bear additional out-of-pocket expenses after the transition dates.
The specific extra costs you may be responsible for will be confirmed once we receive the non-contracted rates from nib. You can stay informed on the specific effects of this scenario in your coverage and fees by contacting nib.
St Vincent’s will continue to provide affected patients with information regarding treatment costs prior to their hospital admission.
Throughout the notice period – which concludes on Thursday, 3 October – nib members will experience no disruptions. Patient admissions, contingent upon meeting eligibility criteria, will continue to be completely covered under the existing agreement and payment arrangements.
To minimise inconvenience, we’re encouraging nib members and their doctors to sschedule their patient's admission by Thursday, 3 October.
Throughout the notice period – which concludes on Thursday, 3 October – nib members will experience no disruptions and all procedures will continue without any changes.
However, if the agreement between St Vincent’s and nib concludes at the end of the 65-business day notice period, doctors will need to consider their patient’s health fund and willingness to pay an out-of-pocket cost when advising their treatment at a St Vincent’s private hospital.
For patients who are nib members, a doctor’s practice may need to contact the patient in advance of their initial consultation to discuss their options.
St Vincent’s is committed to minimising any disruption this news might cause. We are equally committed to giving our patients the support and compassionate care St Vincent’s is famous for.
In addition to this website, a call centre has also been established to handle patient queries. The call centre number is 1300 644 273 and its operating hours are 8am-6pm Monday to Friday and 8am-4pm Saturdays. The call centre is closed on Sundays.
Switching Cover FAQs
Private health insurance is portable. This means if you switch to a like-for-like product then you should be covered as you were, ie: if you have already served your waiting periods you will not have to re-serve them.
The Ombudsman recommends assessing your health insurance needs, and comparing alternative health fund policies, on an annual basis. This becomes especially important if your situation changes, or if your health fund modifies the benefits and services covered by your policy, or the healthcare providers they have agreements with.
Please refer to the Ombudsman's Right to Change Brochure for more information.
Each year, thousands of Australians switch health insurance providers.
After you've selected a new health insurance company, they typically handle administrative tasks on your behalf, including cancelling your old insurance, stopping direct debits, and obtaining your clearance certificate.
In contrast to various other insurance types like car and life insurance, private health insurance operates under a 'community-rated' system. This system ensures that individuals, regardless of their age, health condition, or other risk factors, pay a uniform premium for identical coverage.
NB: health insurers can apply waiting periods for pre-existing conditions.
