Love no public waiting lists?

Love no public waiting lists?

Our Hospital Covers

We love keeping our hospital cover simple with 2 types of private hospital cover. (or if you only want cover in a public hospital just let us know because we have that too).

  Private Hospital Cover Basic Private Hospital Cover
 
  • Our highest level of cover for all public and most private hospital services 365 days per year
  • Private hospital cover for most things 365 days per year
  • Public hospital benefit for a few Restricted services (see below)
Excess Options No excess
$250 excess
$500 excess		 $500 excess
Public or Private Hospital
  • shared or private room
Same day hospital stays
Theatre fees
Intensive care
Pharmacy in hospital
Medical Gap
Voluntary sterilisation
Obstetrics Restricted
Cardio-thoracic services Restricted
Assisted reproductive services Restricted
Psychiatric Restricted
Rehabilitation Restricted
Eye surgery Restricted
Joint replacements Restricted
Dialysis Restricted
Plastic and Reconstructive Surgery
Other Medicare Services
Cosmetic Surgery
Services not covered by Medicare
100% national Ambulance Cover
Excess
  • An excess is the amount you pay up front if you go to hospital.
  • You can choose an excess on your cover to save on your premium.The higher your excess, the less you pay in premiums.
  • No excess for kids under 21.
  • Public Hospital or Day Surgery: You only pay half the excess
  • The good news is, no matter how many times someone on your membership goes to hospital during a financial year, the most excess you’ll pay is:
What's your excess? Maximum excess for the year
  Single Couple/Family
$250 excess $250 $500
$500 excess $500 $1,000
Key Features
  • We have agreements with around 21,000 doctors and 500 private hospitals across the country
  • We pay benefits for Medicare listed items while you’re in hospital.

 

Hospital Cover - What we'll pay for

  • Public or Private Hospital bed - shared or private room (if available)
  • Same day patient fees
  • Theatre fees
  • Intensive care
  • Labour ward
  • In hospital psychiatric treatment
  • In hospital rehabilitation treatment
  • In hospital pharmacy
  • Surgical Prostheses (for more info, see our Jargon Buster)
  • Ambulance Services Australia-wide (read more)

Hospital Cover - What we won't pay for

  • Treatment within your waiting periods
  • Any treatment Medicare doesn’t cover (such as cosmetic surgery)
  • Services outside Australia
  • Treatment covered by compensation or some other insurance (like third party or sports club insurance)
  • Claims made more than 2 years after your treatment
  • Outpatient services (unless there’s a special agreement between us and the hospital)
  • Some high cost drugs
  • Prostheses that aren’t approved by the Commonwealth Government. (A prosthesis is an artificial substitute for a missing body part)
  • Ambulance subscriptions or state-based ambulance levies
  • Ambulance services paid for by the government, compensation or another type of insurance
  • Pharmacy - most pharmacy items that you’re given while you’re in hospital are covered by your hospital bill. The hospital may charge you extra for pharmacy items that you take home with you and this isn’t covered by your hospital cover.

Restricted Services (Basic Private Hospital Cover only)

  • With Basic Private Hospital, you're covered in a private hospital for most things.
  • You have full cover if you go into a public hospital as a private patient.
  • If you need treatment in a private hospital for a 'restricted service' (these are listed in the table on the previous page), you'll pay a large amount out of your own pocket. We'll only pay the basic public hospital accommodation benefit set by the Commonwealth Government (which is only a tiny portion of the total cost of a private hospital stay). This is the trade off you make for paying lower premiums.
  • If you have private hospital treatment for a 'restricted service', we don't pay anything towards the theatre fees or other private hospital charges.

Other Important Info

There are some other important things you need to know about your hospital cover.

Here’s a quick list, so please make sure you read more about these things: