Comprehensive Hospital coverIntermediate Hospital coverPublic hospital cover
What you're covered for$250 excess | $500 excess$250 excess | $500 excessNil excess
Your choice of doctor/hospital Included service Included service Included service
Private hospital accommodation Included service Included service Excluded service
Theatre fees Included service Included service Excluded service
Surgically implanted prosthesis benefits (artificial hips, knees etc) Included service Included service Included service
Intensive care Included service Included service Included service
Medical gap cover Included service Included service Included service
Tonsil and adenoids removal Included service Included service Included service
Appendix removal Included service Included service Included service
Colonoscopies Included service Included service Included service
Grommets in ears Included service Included service Included service
Gynaecological services Included service Included service Included service
Hernia surgery Included service Included service Included service
Joint reconstructions Included service Included service Included service
Back surgery Included service Included service Included service
Brain surgery Included service Included service Included service
Plastic and reconstructive surgery (medically necessary) Included service Included service Included service
Digestive disorders Included service Included service Included service
Kidney stone and gall stone removal Included service Included service Included service
Accidents Included service Included service Included service
Removal of teeth Included service Included service Included service
In-hospital rehabilitation treatment Included service Included service Included service
Birth and pregnancy Included service Restricted service* Included service
Assisted reproductive services e.g. IVF Included service Restricted service* Included service
In-hospital psychiatric treatment

Benefit limitation period applies

CO-PAYMENT APPLIES

Restricted service Included service
Heart and lung surgery Included service Restricted service* Included service
Major eye surgery Included service Restricted service* Included service
Hip and knee joint replacement surgery Benefit limitation period applies Excluded service Included service
Gastric banding and obesity surgery Benefit limitation period applies Restricted service* Included service
Renal dialysis Included service Restricted service* Included service
Access gap cover Included service Included service Excluded service
Public hospital accommodation as a private patient (shared room) Included service Included service Excluded service
Nursing home type patients Included service Included service Excluded service
Mechanical appliances and artificial aids# Included service Excluded service Excluded service
Mammograms and bone density test Included service Excluded service Excluded service
Hearing aids Included service Excluded service Excluded service
Australian hearing services Included service Excluded service Excluded service
Nursing Included service Excluded service Excluded service
Hospital boarder Included service Excluded service Excluded service
Cosmetic surgery Excluded service Excluded service Excluded service

Please note that waiting periods may apply (including those for pre-existing conditions) and some products have restrictions, exclusions, benefit limitation periods, excesses and limits.

* For hospital services or treatments that have restricted benefit availability under Intermediate Hospital cover, no benefit is paid towards the cost of theatre charges raised for inpatient services in a private hospital or day surgery. If you have chosen Public Hospital cover and are an inpatient at a private hospital or day surgery, you will have a benefit entitlement to the default rate benefit for shared ward accommodation in a public hospital only.
# Benefits are not available on second hand equipment or on consumables. A benefit is payable for short term hiring (up to 3 months) of some mechanical aids. The purchase of some machines and monitors are limited to once every three membership years. Waiting periods will apply to all benefits outlined.

Included service Covered
Benefits will be paid for this service
Benefit limitation period applies Benefit limitation period
Hospital benefits payable on these hospital services during the designated benefit limitation period will be the minimum benefit declared by the Minister for Health and Ageing, except when a waiting period is being served, in which case no benefit applies. Find out more about benefit limitation periods.
Restricted service Restricted benefit
If a service is covered as a restricted benefit, this means you will be covered with your choice of doctor for shared ward accommodation in a public hospital only. If you go to a private hospital for a service with restricted benefits, it is likely to result in large out-of-pocket expenses.
Co-payment Co-payment
A co-paymet is the daily amount that a member contributes towards their accommodation costs for in-hospital psychiatric admissions only. It applies when admitted as a private patient to either a private or public hospital, including psychiatric day programs. It is separate to any excess applicable. See excess section over page for more information.
Excluded service Excluded benefit
If a service is an excluded benefit, this means that the service or condition won't be covered by your health insurance policy, meaning we won’t pay a benefit towards these services.