What's not covered - Hospital

What's not covered - Hospital

Dependent on your level of cover, there are a few things that aren’t covered by your hospital cover. They are:

 

  • Treatment & services received within your waiting periods
  • Treatments & services that Medicare doesn’t cover (like cosmetic surgery)
  • Treatment & services received outside Australia
  • Treatment & services covered by compensation or another type of insurance (like third party or sports club insurance)
  • Treatment & services received more than 2 years ago
  • Outpatient treatment & 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 body part)
  • Ambulance subscriptions or state-based ambulance levies
  • Ambulance services paid for by the Government, compensation or another type of insurance
  • Ambulance services that aren’t medically necessary
  • 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.