It is because we have been unable to reach agreement on the terms and conditions of a new agreement for our members that are admitted to this hospital.
As a result, Toowoomba Private Day Hospital has decided to terminate our agreement, not us.
We have agreements with over 500 hospitals across Australia for our members to access.
We are disappointed this has happened and are doing our best to resolve it in the interests of our members.
We suggest you discuss the situation with your doctor to understand if they have admitting rights at another nearby hospital where we have an agreement in place. Below is a list of alternate hospitals that offer similar services in your area.
As Toowoomba Private Day Hospital have not advised us what rates they will be charging once the contract ends, we are unable to currently give you an estimate of the out of pocket expenses for such admissions. The hospital should provide you with this information before your admission as part of obtaining your informed financial consent, and we recommend that you contact them to confirm what your out of pocket costs will be for your admission as soon as possible. If you know what procedure you are having (an MBS item is required to determine what second tier rates are payable), we can then let you know how much we will cover for your hospital admission.
If you are currently undergoing a course of treatment at this hospital, you will remain covered for at least another six months or until your course of treatment is concluded, whichever is earlier. If you are about to be admitted for the first time, the hospital must obtain your informed financial consent for any out of pocket costs prior to your admission. We recommend that you contact the hospital to confirm what your out of pocket expense will be well-before your admission. If you know what procedure you are having (an MBS item is required to determine what second tier rates are payable), we can also let you know how much we will cover. If this is unsatisfactory, we suggest you discuss it with your treating doctor to determine if there are any other alternatives for the location of your treatment.
Alternative agreement facilities
There are alternative nearby facilities that we do have agreement with and that perform ophthalmic services, being:
- St Andrew's Toowoomba Hospital
- Toowoomba Surgicentre (Cura).
St Vincent’s Private Hospital, Toowoomba is also nearby.
Defence Health attempts at all times to provide the best possible choice of private hospitals while maintaining contribution rates as low as possible.
Unfortunately, on this occasion, we have been unable to reach agreement on the level of charges with Toowoomba Private Day Hospital and the hospital has made the decision to terminate our contract.
We are not privy to the agreements between other funds and hospitals and so we are unaware of what charges they have agreed to. Defence Health tries to maintain an appropriate balance between the benefits paid to hospitals and our contribution rates.
There are transitional arrangements for all pre-booked admissions to ensure that you will not be affected by this termination. All pre-booked services are covered under the previous agreement provided it commences before 2 August 2026. Call us on 1800 335 425 if you want to confirm what your product covers and if any out of pocket expenses may apply.
Unfortunately, on this occasion, we have been unable to reach agreement on the level of charges with Toowoomba Private Day Hospital and they have terminated our contract.
If you require treatment, you should explore with your doctor the possibility of receiving treatment at an alternate hospital which our fund has a contract with. We have been able to reach agreement with over 500 hospitals across Australia for our members to access. Arranging for an admission at one of these facilities is the best way for you to reduce the chances that you will incur an out of pocket expense.
It is unusual for us to go out of contract with a hospital; however, this situation can occur from time to time. We currently have agreements with over 500 hospitals across Australia and we expect that these will continue.
There are alternative nearby facilities with whom we have agreements and that perform ophthalmic services, being:
- St Andrew’s Toowoomba Hospital
- Toowoomba Surgicentre (Cura).
St Vincent’s Private Hospital, Toowoomba is also nearby.
We also suggest you discuss it with your treating doctor to determine the best alternatives for you.
The majority of doctors have admitting rights at alternative hospitals. If your doctor cannot perform the treatment at another hospital, Toowoomba Private Day Hospital should obtain your informed financial consent prior to your admission, so we recommend that you contact them to confirm what your out of pocket expense will be for the hospital admission. If you know what procedure you are having (an MBS item is required to determine what second tier rates are payable), contact us on 1800 335 425 and we can then let you know how much we will cover of what the hospital will charge.
No. The non-agreement with Toowoomba Private Day Hospital only affects hospital benefits. Medical gap benefits will be paid as normal.
It only affects you if you need to attend Toowoomba Private Day Hospital as an in-patient and your Doctor wishes to admit you. If this scenario occurs, please contact us immediately to enable us to discuss your options with you. If your Doctor indicates that you may require a hospital admission, we suggest you advise them that it may be preferable to refer you to a doctor that has private practice rights at an agreement hospital other than Toowoomba Private Day Hospital. There are alternative nearby facilities with whom we have agreements and that perform ophthalmic services, being:
- St Andrew’s Toowoomba Hospital
- Toowoomba Surgicentre (Cura).
St Vincent’s Private Hospital, Toowoomba is also nearby.
Defence Health does not have an agreement with Toowoomba Private Day Hospital and, as a consequence, it is your preference to attend a hospital that Defence Health has an agreement with, in order to limit your out of pocket expenses. There are alternative nearby facilities with whom we have agreements and that perform ophthalmic services, being:
- St Andrew’s Toowoomba Hospital
- Toowoomba Surgicentre (Cura).
St Vincent’s Private Hospital, Toowoomba is also nearby.
Yes, you would be covered by the current agreement in this instance. For any pre-booked admissions that are made prior to midnight of the termination date, these scenarios would be covered under the current contractual arrangement provided the admission commences before 2 August 2026.