|Comprehensive Hospital cover||Intermediate Hospital cover||Public hospital cover|
|What you're covered for||$250 excess | $500 excess||$250 excess | $500 excess||Nil excess|
|Your choice of doctor/hospital|
|Private hospital accommodation|
|Surgically implanted prosthesis benefits (artificial hips, knees etc)|
|Medical gap cover|
|Tonsil and adenoids removal|
|Grommets in ears|
|Plastic and reconstructive surgery (medically necessary)|
|Kidney stone and gall stone removal|
|Removal of teeth|
|In-hospital rehabilitation treatment|
|Birth and pregnancy||*|
|Assisted reproductive services e.g. IVF||*|
|In-hospital psychiatric treatment||
|Heart and lung surgery||*|
|Major eye surgery||*|
|Hip and knee joint replacement surgery|
|Gastric banding and obesity surgery||*|
|Access gap cover|
|Public hospital accommodation as a private patient (shared room)|
|Nursing home type patients|
|Mechanical appliances and artificial aids#|
|Mammograms and bone density test|
|Australian hearing services|
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.
Benefits will be paid for this service
|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.
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.
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.
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.