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Providing the following information will help us calculate the price that you would need to pay for your health cover.

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TOTAL FROM: $90.70 Monthly
30 day off cooling periodJoin now with peace of mind
96612F4D-7E4C-4DDF-A3C6-581A770EC7E9

Complete Hospital (Gold) with $100 daily co-payment and Top Extras

From

$163.36*

Hospital excess
You will only pay one excess per person admitted per calendar year. Co-payments apply daily up to $750 per admission. And excesses and co-payments are waived for dependants.
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$ after April 1

$163.36*

Minimum direct debit period

/ Fortnightly

30 day cooling off period

Join now with peace of mind

* Assumes a 4% discount for direct debit and 0% aged based discount. Any rebate and Lifetime Health Cover loading listed above has been factored into the price. Price includes cover for non-student dependants aged 23 and over.Price excludes cover for non-student dependants aged 23 and over.
John Small Health and Travel Advisory customers discount has been applied.

Hospital cover benefits

  • Cover for all clinical categories including pregnancy

  • Additional benefits such as emergency ambulance, hospital substitution programs, preventative health and health programs

  • Lower cost cover in exchange for paying an excess and daily co-payments if you need to use your hospital cover

  • Excess and co-payments are waived for dependants

Hospital Fact Sheet

Extras cover benefits

  • Benefits claimed as No Gap Dental do not count towards your yearly limit Cover for a wide range of dental including general dental, root canals, surgical extractions, crowns, bridges and dentures

  • Physiotherapy, chiropractic, optical, remedial massage, podiatry and a range of additional benefits including health aids and emergency ambulance

Extras Fact Sheet

Complete Hospital (Gold) with $100 daily co-payment cover

Inclusions

Waiting period

Rehabilitation
Hospital treatment for physical rehabilitation for a patient related to surgery or illness.
For example: inpatient and admitted day patient rehabilitation, stroke recovery, cardiac rehabilitation.
2 months
Palliative care
Hospital treatment for care where the intent is primarily providing quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain.
2 months
Hospital psychiatric services
Hospital treatment for the treatment and care of patients with psychiatric, mental, addiction or behavioural disorders.

For example: psychoses such as schizophrenia, mood disorders such as depression, eating disorders and addiction therapy.
2 months
Ambulance Cover
Ambulance transportation to hospital. You are covered for emergency ambulance transportation to hospital provided that the transport is coded and invoiced as emergency transport by a recognised State Ambulance authority. Some state schemes already cover ambulance services. Also includes two attendances where you are not taken to hospital.
0 months
Back, neck and spine
Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion.

For example: sciatica, prolapsed or herniated disc, spinal disc replacement and spine curvature disorders such as scoliosis, kyphosis and lordosis.

Joint replacements are listed separately under joint replacements.

Joint fusions are listed separately under bone, joint and muscle.

Spinal cord conditions are listed separately under brain and nervous system.

Management of back pain is listed separately under pain management. Pain management that requires a device is listed separately under pain management with device.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Blood
Hospital treatment for the investigation and treatment of blood and blood-related conditions.

For example: blood clotting disorders and bone marrow transplants.

Treatment for cancers of the blood is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Bone, joint and muscle
Hospital treatment for the investigation and treatment of diseases, disorders and injuries of the musculoskeletal system.

For example: carpal tunnel, fractures, hand surgery, joint fusion, bone spurs, osteomyelitis and bone cancer.

Chest surgery is listed separately under lung and chest.

Spinal cord conditions are listed separately under brain and nervous system.

Spinal column conditions are listed separately under back, neck and spine.

Joint reconstructions are listed separately under joint reconstructions.

Joint replacements are listed separately under joint replacements.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).

Management of back pain is listed separately under pain management. Pain management that requires a device is listed separately under pain management with device.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Brain and nervous system
Hospital treatment for the investigation and treatment of the brain, brain-related conditions, spinal cord and peripheral nervous system.

For example: stroke, brain or spinal cord tumours, head injuries, epilepsy and Parkinson's disease.

Treatment of spinal column (back bone) conditions is listed separately under back, neck and spine.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Breast surgery (medically necessary)
Hospital treatment for the investigation and treatment of breast disorders and associated lymph nodes, and reconstruction and/or reduction following breast surgery or a preventative mastectomy.

For example: breast lesions, breast tumours, asymmetry due to breast cancer surgery, and gynecomastia.

This clinical category does not require benefits to be paid for cosmetic breast surgery that is not medically necessary.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Cataracts
Hospital treatment for surgery to remove a cataract and replace with an artificial lens.
2 months or 12 months pre-existing
Chemotherapy, radiotherapy and immunotherapy for cancer
Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours.

Surgical treatment of cancer is listed separately under each body system.
2 months or 12 months pre-existing
Dental surgery
Hospital treatment for surgery to the teeth and gums.

For example: surgery to remove wisdom teeth, and dental implant surgery.
2 months or 12 months pre-existing
Diabetes management (excluding insulin pumps)
Hospital treatment for the investigation and management of diabetes.

For example: stabilisation of hypo- or hyper- glycaemia, contour problems due to insulin injections.

Treatment for diabetes-related conditions is listed separately under each body system affected. For example, treatment for diabetes-related eye conditions is listed separately under eye.

Treatment for ulcers is listed separately under skin.

Provision and replacement of insulin pumps is listed separately under insulin pumps.
2 months or 12 months pre-existing
Digestive system
Hospital treatment for the investigation and treatment of the digestive system, including the oesophagus, stomach, gall bladder, pancreas, spleen, liver and bowel.

For example: oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids.

Endoscopy is listed separately under gastrointestinal endoscopy.

Hernia and appendicectomy procedures are listed separately under hernia and appendix.

Bariatric surgery is listed separately under weight loss surgery.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Ear, nose and throat
Hospital treatment for the investigation and treatment of the ear, nose, throat, middle ear, thyroid, parathyroid, larynx, lymph nodes and related areas of the head and neck.

For example: damaged ear drum, sinus surgery, removal of foreign bodies, stapedectomy and throat cancer.

Tonsils, adenoids and grommets are listed separately under tonsils, adenoids and grommets.

The implantation of a hearing device is listed separately under Implantation of hearing devices.

Orthopaedic neck conditions are listed separately under back, neck and spine.

Sleep studies are listed separately under sleep studies.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Eye (not cataracts)
Hospital treatment for the investigation and treatment of the eye and the contents of the eye socket.

For example: retinal detachment, tear duct conditions, eye infections and medically managed trauma to the eye.

Cataract procedures are listed separately under cataracts.

Eyelid procedures are listed separately under plastic and reconstructive surgery.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Gastrointestinal endoscopy
Hospital treatment for the diagnosis, investigation and treatment of the internal parts of the gastrointestinal system using an endoscope.

For example: colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP).

Non-endoscopic procedures for the digestive system are listed separately under digestive system.
2 months or 12 months pre-existing
Gynaecology
Hospital treatment for the investigation and treatment of the female reproductive system.

For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.

Fertility treatments are listed separately under assisted reproductive services.

Pregnancy and birth-related conditions are listed separately under pregnancy and birth.

Miscarriage or termination of pregnancy is listed separately under miscarriage and termination of pregnancy.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Heart and vascular system
Hospital treatment for the investigation and treatment of the heart, heart-related conditions and vascular system.

For example: heart failure and heart attack, monitoring of heart conditions, varicose veins and removal of plaque from arterial walls.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Hernia and appendix
Hospital treatment for the investigation and treatment of a hernia or appendicitis.

Digestive conditions are listed separately under digestive system.
2 months or 12 months pre-existing
Implantation of hearing devices
Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.

Stapedectomy is listed separately under ear, nose and throat.
2 months or 12 months pre-existing
Insulin pumps
Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.
2 months or 12 months pre-existing
Joint reconstructions
Hospital treatment for surgery for joint reconstructions.

For example: torn tendons, rotator cuff tears and damaged ligaments.

Joint replacements are listed separately under joint replacements.

Bone fractures are listed separately under bone, joint and muscle.

Procedures to the spinal column are listed separately under back, neck and spine.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).
2 months or 12 months pre-existing
Joint replacements
Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of prostheses.

For example: replacement of shoulder, wrist, finger, hip, knee, ankle, or toe joint.

Joint fusions are listed separately under bone, joint and muscle.

Spinal fusions are listed separately under back, neck and spine.

Joint reconstructions are listed separately under joint reconstructions.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).
2 months or 12 months pre-existing
Kidney and bladder
Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.

For example: kidney stones, adrenal gland tumour and incontinence.

Dialysis is listed separately under dialysis for chronic kidney failure.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Lung and chest
Hospital treatment for the investigation and treatment of the lungs, lung-related conditions, mediastinum and chest.

For example: lung cancer, respiratory disorders such as asthma, pneumonia, and treatment of trauma to the chest.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Male reproductive system
Hospital treatment for the investigation and treatment of the male reproductive system including the prostate.

For example: male sterilisation, circumcision and prostate cancer.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Miscarriage and termination of pregnancy
Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy.
2 months or 12 months pre-existing
Pain management
Hospital treatment for pain management that does not require the insertion or surgical management of a device.

For example: treatment of nerve pain and chest pain due to cancer by injection of a nerve block.

Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under pain management with device.
2 months or 12 months pre-existing
Pain management with device
Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain.

For example: treatment of nerve pain, back pain, and pain caused by coronary heart disease with a device (for example an infusion pump or neurostimulator).

Treatment of pain that does not require a device is listed separately under pain management.
2 months or 12 months pre-existing
Plastic and reconstructive surgery (medically necessary)
Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or Accident, or congenital.

For example: burns requiring a graft, cleft palate, club foot and angioma.

Plastic surgery that is medically necessary relating to the treatment of a skin-related condition is listed separately under skin.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Podiatric surgery (provided by a registered podiatric surgeon)
Hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon, but limited to cover for:
  • - accommodation; and
  • - the cost of a prosthesis as listed in the prostheses list set out in the Private Health Insurance (Prostheses) Rules, as in force from time to time.

Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.
2 months or 12 months pre-existing
Skin
Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included.

For example: melanoma, minor wound repair and abscesses.

Removal of excess skin due to weight loss is listed separately under weight loss surgery.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Sleep studies
Hospital treatment for the investigation of sleep patterns and anomalies.

For example: sleep apnoea and snoring.
2 months or 12 months pre-existing
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
2 months or 12 months pre-existing
Assisted reproductive services
Hospital treatment for fertility treatments or procedures.

For example: retrieval of eggs or sperm, In vitro Fertilisation (IVF), and Gamete Intra-fallopian Transfer (GIFT).

Treatment of the female reproductive system is listed separately under gynaecology.

Pregnancy and birth-related services are listed separately under pregnancy and birth.
2 months or 12 months pre-existing
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.

For example: peritoneal dialysis and haemodialysis.
2 months or 12 months pre-existing
Pregnancy and birth
Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.

Treatment for the baby is covered under the clinical category relevant to their condition (provided your baby is included under your cover). For example, respiratory conditions are covered under lung and chest.

Female reproductive conditions are listed separately under gynaecology.

Fertility treatments are listed separately under assisted reproductive services.

Miscarriage and termination of pregnancy is listed separately under miscarriage and termination of pregnancy.
12 months
Weight loss surgery
Hospital treatment for surgery that is designed to reduce a person's weight, remove excess skin due to weight loss and reversal of a bariatric procedure.

For example: gastric banding, gastric bypass, sleeve gastrectomy.
2 months or 12 months pre-existing
Blood
Hospital treatment for the investigation and treatment of blood and blood-related conditions.

For example: blood clotting disorders and bone marrow transplants.

Treatment for cancers of the blood is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Bone, joint and muscle
Hospital treatment for the investigation and treatment of diseases, disorders and injuries of the musculoskeletal system.

For example: carpal tunnel, fractures, hand surgery, joint fusion, bone spurs, osteomyelitis and bone cancer.

Chest surgery is listed separately under lung and chest.

Spinal cord conditions are listed separately under brain and nervous system.

Spinal column conditions are listed separately under back, neck and spine.

Joint reconstructions are listed separately under joint reconstructions.

Joint replacements are listed separately under joint replacements.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).

Management of back pain is listed separately under pain management. Pain management that requires a device is listed separately under pain management with device.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Brain and nervous system
Hospital treatment for the investigation and treatment of the brain, brain-related conditions, spinal cord and peripheral nervous system.

For example: stroke, brain or spinal cord tumours, head injuries, epilepsy and Parkinson's disease.

Treatment of spinal column (back bone) conditions is listed separately under back, neck and spine.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Breast surgery (medically necessary)
Hospital treatment for the investigation and treatment of breast disorders and associated lymph nodes, and reconstruction and/or reduction following breast surgery or a preventative mastectomy.

For example: breast lesions, breast tumours, asymmetry due to breast cancer surgery, and gynecomastia.

This clinical category does not require benefits to be paid for cosmetic breast surgery that is not medically necessary.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Cataracts
Hospital treatment for surgery to remove a cataract and replace with an artificial lens.
2 months or 12 months pre-existing
Chemotherapy, radiotherapy and immunotherapy for cancer
Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours.

Surgical treatment of cancer is listed separately under each body system.
2 months or 12 months pre-existing
Dental surgery
Hospital treatment for surgery to the teeth and gums.

For example: surgery to remove wisdom teeth, and dental implant surgery.
2 months or 12 months pre-existing
Diabetes management (excluding insulin pumps)
Hospital treatment for the investigation and management of diabetes.

For example: stabilisation of hypo- or hyper- glycaemia, contour problems due to insulin injections.

Treatment for diabetes-related conditions is listed separately under each body system affected. For example, treatment for diabetes-related eye conditions is listed separately under eye.

Treatment for ulcers is listed separately under skin.

Provision and replacement of insulin pumps is listed separately under insulin pumps.
2 months or 12 months pre-existing
Digestive system
Hospital treatment for the investigation and treatment of the digestive system, including the oesophagus, stomach, gall bladder, pancreas, spleen, liver and bowel.

For example: oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids.

Endoscopy is listed separately under gastrointestinal endoscopy.

Hernia and appendicectomy procedures are listed separately under hernia and appendix.

Bariatric surgery is listed separately under weight loss surgery.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Ear, nose and throat
Hospital treatment for the investigation and treatment of the ear, nose, throat, middle ear, thyroid, parathyroid, larynx, lymph nodes and related areas of the head and neck.

For example: damaged ear drum, sinus surgery, removal of foreign bodies, stapedectomy and throat cancer.

Tonsils, adenoids and grommets are listed separately under tonsils, adenoids and grommets.

The implantation of a hearing device is listed separately under Implantation of hearing devices.

Orthopaedic neck conditions are listed separately under back, neck and spine.

Sleep studies are listed separately under sleep studies.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Eye (not cataracts)
Hospital treatment for the investigation and treatment of the eye and the contents of the eye socket.

For example: retinal detachment, tear duct conditions, eye infections and medically managed trauma to the eye.

Cataract procedures are listed separately under cataracts.

Eyelid procedures are listed separately under plastic and reconstructive surgery.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Gastrointestinal endoscopy
Hospital treatment for the diagnosis, investigation and treatment of the internal parts of the gastrointestinal system using an endoscope.

For example: colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP).

Non-endoscopic procedures for the digestive system are listed separately under digestive system.
2 months or 12 months pre-existing
Gynaecology
Hospital treatment for the investigation and treatment of the female reproductive system.

For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.

Fertility treatments are listed separately under assisted reproductive services.

Pregnancy and birth-related conditions are listed separately under pregnancy and birth.

Miscarriage or termination of pregnancy is listed separately under miscarriage and termination of pregnancy.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Heart and vascular system
Hospital treatment for the investigation and treatment of the heart, heart-related conditions and vascular system.

For example: heart failure and heart attack, monitoring of heart conditions, varicose veins and removal of plaque from arterial walls.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Hernia and appendix
Hospital treatment for the investigation and treatment of a hernia or appendicitis.

Digestive conditions are listed separately under digestive system.
2 months or 12 months pre-existing
Implantation of hearing devices
Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.

Stapedectomy is listed separately under ear, nose and throat.
2 months or 12 months pre-existing
Insulin pumps
Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.
2 months or 12 months pre-existing
Joint reconstructions
Hospital treatment for surgery for joint reconstructions.

For example: torn tendons, rotator cuff tears and damaged ligaments.

Joint replacements are listed separately under joint replacements.

Bone fractures are listed separately under bone, joint and muscle.

Procedures to the spinal column are listed separately under back, neck and spine.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).
2 months or 12 months pre-existing
Joint replacements
Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of prostheses.

For example: replacement of shoulder, wrist, finger, hip, knee, ankle, or toe joint.

Joint fusions are listed separately under bone, joint and muscle.

Spinal fusions are listed separately under back, neck and spine.

Joint reconstructions are listed separately under joint reconstructions.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under podiatric surgery (provided by a registered podiatric surgeon).
2 months or 12 months pre-existing
Kidney and bladder
Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.

For example: kidney stones, adrenal gland tumour and incontinence.

Dialysis is listed separately under dialysis for chronic kidney failure.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Lung and chest
Hospital treatment for the investigation and treatment of the lungs, lung-related conditions, mediastinum and chest.

For example: lung cancer, respiratory disorders such as asthma, pneumonia, and treatment of trauma to the chest.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Male reproductive system
Hospital treatment for the investigation and treatment of the male reproductive system including the prostate.

For example: male sterilisation, circumcision and prostate cancer.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Miscarriage and termination of pregnancy
Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy.
2 months or 12 months pre-existing
Pain management
Hospital treatment for pain management that does not require the insertion or surgical management of a device.

For example: treatment of nerve pain and chest pain due to cancer by injection of a nerve block.

Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under pain management with device.
2 months or 12 months pre-existing
Pain management with device
Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain.

For example: treatment of nerve pain, back pain, and pain caused by coronary heart disease with a device (for example an infusion pump or neurostimulator).

Treatment of pain that does not require a device is listed separately under pain management.
2 months or 12 months pre-existing
Plastic and reconstructive surgery (medically necessary)
Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or Accident, or congenital.

For example: burns requiring a graft, cleft palate, club foot and angioma.

Plastic surgery that is medically necessary relating to the treatment of a skin-related condition is listed separately under skin.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Podiatric surgery (provided by a registered podiatric surgeon)
Hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon, but limited to cover for:
  • - accommodation; and
  • - the cost of a prosthesis as listed in the prostheses list set out in the Private Health Insurance (Prostheses) Rules, as in force from time to time.

Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.
2 months or 12 months pre-existing
Skin
Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included.

For example: melanoma, minor wound repair and abscesses.

Removal of excess skin due to weight loss is listed separately under weight loss surgery.

Chemotherapy and radiotherapy for cancer is listed separately under chemotherapy, radiotherapy and immunotherapy for cancer.
2 months or 12 months pre-existing
Sleep studies
Hospital treatment for the investigation of sleep patterns and anomalies.

For example: sleep apnoea and snoring.
2 months or 12 months pre-existing
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
2 months or 12 months pre-existing
Assisted reproductive services
Hospital treatment for fertility treatments or procedures.

For example: retrieval of eggs or sperm, In vitro Fertilisation (IVF), and Gamete Intra-fallopian Transfer (GIFT).

Treatment of the female reproductive system is listed separately under gynaecology.

Pregnancy and birth-related services are listed separately under pregnancy and birth.
2 months or 12 months pre-existing
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.

For example: peritoneal dialysis and haemodialysis.
2 months or 12 months pre-existing
Pregnancy and birth
Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.

Treatment for the baby is covered under the clinical category relevant to their condition (provided your baby is included under your cover). For example, respiratory conditions are covered under lung and chest.

Female reproductive conditions are listed separately under gynaecology.

Fertility treatments are listed separately under assisted reproductive services.

Miscarriage and termination of pregnancy is listed separately under miscarriage and termination of pregnancy.
12 months
Weight loss surgery
Hospital treatment for surgery that is designed to reduce a person's weight, remove excess skin due to weight loss and reversal of a bariatric procedure.

For example: gastric banding, gastric bypass, sleeve gastrectomy.
2 months or 12 months pre-existing

Key

Covered

Top Extras cover

Claim up to $9,150 per person per calendar year

Extras covered

Yearly limits (per person)
/what you get back

Waiting periods

Emergency Ambulance

Where the transport is coded and
invoiced as emergency transport by a
recognised State Ambulance authority



Benefits are not payable if ambulance service is already covered by a State-based scheme or your ambulance subscription.


Where an Extras cover is taken with Hospital cover, benefits are payable under the Hospital cover only, except where the Extras product offers additional benefits not included on Hospital.

Unlimited

100% of the cost

0 months

Ambulance Attendance

For Ambulance attendances where you are not taken to hospital


Benefits are not payable if ambulance service is already covered by a State-based scheme or your ambulance subscription.



Where an Extras cover is taken with Hospital cover, benefits are payable under the Hospital cover only, except where the Extras product offers additional benefits not included on Hospital.

2 attendances per person

100% of the cost

0 months

No Gap Dental Network

Covers selected services such as examinations, some x-rays, scale and clean, fluoride treatment and mouthguards.

Benefits claimed as No Gap Dental do not count towards your yearly limit.

100% of the cost for selected services at our No Gap Dental Network

0 months

Orthodontics

 

$800 per person

Up to 100% of the cost per item

A lifetime maximum of $3,200 per person applies

12 months

Preventative Dental

Covers selected services such as scale and clean, fluoride treatment and mouthguards.

General Dental

Covers most fillings and simple extractions

$1000 per person, $2000 per family

Set amounts per item

0 months

0 months for selected diagnostic services

2 months

Root Canal, Gum Disease Treatments & Surgical Extractions

 

Crowns, Bridges & Dentures

A full denture replacement is limited to once every three years.

$1000 per person, $2000 per family

Set amounts per item

12 months

12 months

A full denture replacement is limited to once every three years.

Optical

For prescription glasses, contact lenses or repairs provided by a recognised optometrist in private practice. Excludes non-prescription sunglasses and contact lenses, and optical consultations.

$300 per person, $600 per family

Up to 100% of the cost per item

6 months

Physiotherapy

Including sports physiotherapy and hydrotherapy.

Exercise Physiology

Includes hydrotherapy

Combined maximum of $600 per person

$70 per consultation

2 months

2 months

Acupuncture

 

Remedial Massage

 

Myotherapy

 

Combined maximum of $400 per person

$50 per consultation

2 months

2 months

2 months

Podiatry

Excludes podiatric surgery

Orthotics, Braces, Splints and Garments

When recommended by a podiatrist/orthotist or medical practitioner and supplied by an approved provider in a private practice.

Combined maximum of $400 per person

$50 per podiatric consultation

Up to 80% of the cost per item

2 months

12 months

Chiropractic and Osteopathy

 

Combined maximum of $400 per person
$50 per consultation
$50 for a chiropractic x-ray

Limit of one chiropractic x-ray per person

2 months

Asthma Pumps and Peak flow meters

Blood glucose and Blood pressure monitors

C-PAP Devices and TENS Machines Includes C-PAP/B-PAP

TENS Machines must be recommended by a physiotherapist or medical practitioner and supplied by an approved provider in private practice.

Wheelchairs and Crutches

For hire or purchase of wheelchairs or crutches used in prevention or support post injury.

Non-surgical Prostheses

Combined maximum of $500 per person

Up to 80% of the cost per item

12 months

Benefit for each item is payable every 2 calendar years

12 months

Benefit for each item is payable every 2 calendar years

12 months

Benefit for each item is payable every 2 calendar years

2 months

12 months

Benefit for each item is payable every 2 calendar years (does not apply to wigs)

Hearing aids

Includes hearing aid appliance, replacement and repairs.


Benefit for each item is payable every 3 years (does not apply to repairs)

$1,000 per person

Up to 80% of the cost per item

12 months for items
2 months for repairs

Benefit for each item is payable every 3 years (does not apply to repairs)

Dietetics

 

$500 per person

$50 per consultation

2 months

Audiology, Speech, Eye and Occupational Therapy

 

Combined maximum of $400 per person

$80 per consultation

2 months

Psychology

 

$600 per person

$100 per consultation

2 months

Pharmacy

For non-prescription PBS pharmaceuticals only, after you pay a sum equal to the current Pharmaceutical Benefits Scheme (PBS) contribution. Excludes vitamins, minerals and Supplements

$500 per person

Up to $50 per script

2 months

Travel Vaccinations

For approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel

$250 per person

Up to $50 per script

0 months

School Accident Top-Up Benefit

A top-up benefit to help pay for out-of-pocket costs for services on your Extras cover if your child has an accident at school.


Benefit applies where you are otherwise eligible to claim for the service, to cover additional out-of-pockets.


Claim must be accompanied by a communication from the school’ from ‘A top-up benefit to help pay for out-of-pocket costs for services on your Extras cover if your child has an accident at school.

$200 per child dependant

Up to $200 of the out-of-pocket costs

0 months

Sickness Travel and Accommodation

For medically necessary treatment requiring a minimum return trip of 200km or more.

Combined maximum of $300 per membership

80% of the cost

2 months

^ Waiting periods and yearly limits may apply.

Top Extras cover cover

Claim up to $9,150 per person per calendar year

Extras covered

Where the transport is coded and invoiced as emergency transport by a recognised State Ambulance authority

Benefits are not payable if ambulance service is already covered by a State-based scheme or your ambulance subscription.

Where an Extras cover is taken with Hospital cover, benefits are payable under the Hospital cover only, except where the Extras product offers additional benefits not included on Hospital.

Yearly limits (per person)

Unlimited

100% of the cost

Waiting Periods

0 months

For Ambulance attendances where you are not taken to hospital

Benefits are not payable if ambulance service is already covered by a State-based scheme or your ambulance subscription.

Where an Extras cover is taken with Hospital cover, benefits are payable under the Hospital cover only, except where the Extras product offers additional benefits not included on Hospital.

Yearly limits (per person)

2 attendances per person

100% of the cost

Waiting Periods

0 months

Covers selected services such as examinations, some x-rays, scale and clean, fluoride treatment and mouthguards.

Yearly limits (per person)

Benefits claimed as No Gap Dental do not count towards your yearly limit.

100% of the cost for selected services at our No Gap Dental Network

Waiting Periods

0 months

Covers selected services such as scale and clean, fluoride treatment and mouthguards.

Yearly limits (per person)

$1000 per person, $2000 per family

Set amounts per item

Waiting Periods

0 months

Covers most fillings and simple extractions

Yearly limits (per person)

$1000 per person, $2000 per family

Set amounts per item

Waiting Periods

0 months for selected diagnostic services

2 months

 

Yearly limits (per person)

$1000 per person, $2000 per family

Set amounts per item

Waiting Periods

12 months

A full denture replacement is limited to once every three years.

Yearly limits (per person)

$1000 per person, $2000 per family

Set amounts per item

Waiting Periods

12 months

A full denture replacement is limited to once every three years.

 

Yearly limits (per person)

$800 per person

Up to 100% of the cost per item

A lifetime maximum of $3,200 per person applies

Waiting Periods

12 months

For prescription glasses, contact lenses or repairs provided by a recognised optometrist in private practice. Excludes non-prescription sunglasses and contact lenses, and optical consultations.

Yearly limits (per person)

$300 per person, $600 per family

Up to 100% of the cost per item

Waiting Periods

6 months

Including sports physiotherapy and hydrotherapy.

Yearly limits (per person)

Combined maximum of $600 per person

$70 per consultation

Waiting Periods

2 months

Includes hydrotherapy

Yearly limits (per person)

Combined maximum of $600 per person

$70 per consultation

Waiting Periods

2 months

 

Yearly limits (per person)

Combined maximum of $400 per person
$50 per consultation
$50 for a chiropractic x-ray

Limit of one chiropractic x-ray per person

Waiting Periods

2 months

 

Yearly limits (per person)

Combined maximum of $400 per person

$50 per consultation

Waiting Periods

2 months

 

Yearly limits (per person)

Combined maximum of $400 per person

$50 per consultation

Waiting Periods

2 months

 

Yearly limits (per person)

Combined maximum of $400 per person

$50 per consultation

Waiting Periods

2 months

Excludes podiatric surgery

Yearly limits (per person)

Combined maximum of $400 per person

$50 per podiatric consultation

Up to 80% of the cost per item

Waiting Periods

2 months

When recommended by a podiatrist/orthotist or medical practitioner and supplied by an approved provider in a private practice.

Yearly limits (per person)

Combined maximum of $400 per person

$50 per podiatric consultation

Up to 80% of the cost per item

Waiting Periods

12 months

TENS Machines must be recommended by a physiotherapist or medical practitioner and supplied by an approved provider in private practice.

Yearly limits (per person)

Combined maximum of $500 per person

Up to 80% of the cost per item

Waiting Periods

12 months

Benefit for each item is payable every 2 calendar years

For hire or purchase of wheelchairs or crutches used in prevention or support post injury.

Yearly limits (per person)

Combined maximum of $500 per person

Up to 80% of the cost per item

Waiting Periods

2 months

Includes hearing aid appliance, replacement and repairs.

Benefit for each item is payable every 3 years (does not apply to repairs)

Yearly limits (per person)

$1,000 per person

Up to 80% of the cost per item

Waiting Periods

12 months for items
2 months for repairs

Benefit for each item is payable every 3 years (does not apply to repairs)

 

Yearly limits (per person)

$500 per person

$50 per consultation

Waiting Periods

2 months

 

Yearly limits (per person)

Combined maximum of $400 per person

$80 per consultation

Waiting Periods

2 months

 

Yearly limits (per person)

$600 per person

$100 per consultation

Waiting Periods

2 months

For non-prescription PBS pharmaceuticals only, after you pay a sum equal to the current Pharmaceutical Benefits Scheme (PBS) contribution. Excludes vitamins, minerals and Supplements

Yearly limits (per person)

$500 per person

Up to $50 per script

Waiting Periods

2 months

For approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel

Yearly limits (per person)

$250 per person

Up to $50 per script

Waiting Periods

0 months

A top-up benefit to help pay for out-of-pocket costs for services on your Extras cover if your child has an accident at school.

Benefit applies where you are otherwise eligible to claim for the service, to cover additional out-of-pockets.

Claim must be accompanied by a communication from the school’ from ‘A top-up benefit to help pay for out-of-pocket costs for services on your Extras cover if your child has an accident at school.

Yearly limits (per person)

$200 per child dependant

Up to $200 of the out-of-pocket costs

Waiting Periods

0 months

For medically necessary treatment requiring a minimum return trip of 200km or more.

Yearly limits (per person)

Combined maximum of $300 per membership

80% of the cost

Waiting Periods

2 months

^ Waiting periods and yearly limits may apply.
The information on this page is a summary only. Please read the product Fact Sheet to understand the benefits, limits, restrictions, exclusions, waiting periods, pre-existing conditions and excesses that apply, and what it means to be 'Covered' including out-of-pocket costs.

What you need to join today

  • Medicare card

  • Payment details

  • Existing cover information (if applicable)

* Assumes a 4% discount for direct debit and 0% aged based discount. Any rebate and Lifetime Health Cover loading listed above has been factored into the price. Price includes cover for non-student dependants aged 23 and over.Price excludes cover for non-student dependants aged 23 and over.
John Small Health and Travel Advisory customers discount has been applied.

Complete Hospital (Gold) with $100 daily co-payment And Top Extras

From

$163.36*

Hospital excess
You will only pay one excess per person admitted per calendar year. Co-payments apply daily up to $750 per admission. And excesses and co-payments are waived for dependants.
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$ after April 1

$163.36*

Minimum direct debit period

/ Fortnightly

30 day cooling off period

Join now with peace of mind

* Assumes a 4% discount for direct debit and 0% aged based discount. Any rebate and Lifetime Health Cover loading listed above has been factored into the price. Price includes cover for non-student dependants aged 23 and over.Price excludes cover for non-student dependants aged 23 and over.