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From
$0.00*
Monthly
Hospital excess
On Top Choice (Silver Plus), you will only have to pay half the excess for day surgeries. If the applicable total excess isn't paid after your first hospital admission you will have to pay the remaining balance of the excess on any subsequent admission(s) within the same calendar year. Plus you won't pay an excess if any children or student dependants listed on your membership are admitted to hospital.
Includes 4% direct debit discount
30 day cooling off period
Join now with peace of mind
30 day cooling off period
Join now with peace of mind
TOTAL FROM:
$90.70
Monthly
30 day off cooling periodJoin now with peace of mind
From
$106.98*
Hospital excess
On Top Choice (Silver Plus), you will only have to pay half the excess for day surgeries. If the applicable total excess isn't paid after your first hospital admission you will have to pay the remaining balance of the excess on any subsequent admission(s) within the same calendar year. Plus you won't pay an excess if any children or student dependants listed on your membership are admitted to hospital.
$ after April 1
$106.98*
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 a wide range of procedures including joint replacements, cataracts, heart and vascular system
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Save money with cover that excludes things you may not need such as weight loss surgery, assisted reproductive services, pregnancy and birth
-
Accident Cover
Extras cover benefits
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Get up to $3,450 per person, per calendar year on extras
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Cover for a broad range of extras including optical, physio, chiro, remedial massage and acupuncture
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Up to 100% back on selected preventative dental services through our No-Gap Dental Network up to yearly limits
Top Choice (Silver Plus) Hospital 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.
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.
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.
0 months
Also includes two ambulance attendances per person per calendar year, where you are not taken to hospital.
Also includes two ambulance attendances per person per calendar year, where you are not taken to hospital.
Dental surgery
Hospital treatment for surgery to the teeth and gums.
For example: surgery to remove wisdom teeth, and dental implant surgery.
For example: surgery to remove wisdom teeth, and dental implant surgery.
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).
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
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
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.
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.
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.
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.
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
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.
Surgical treatment of cancer is listed separately under each body system.
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.
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.
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.
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.
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.
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.
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
Hernia and appendix
Hospital treatment for the investigation and treatment of a hernia or appendicitis.
Digestive conditions are listed separately under digestive system.
Digestive conditions are listed separately under digestive system.
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.
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.
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.
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.
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
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.
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
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.
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
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.
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
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.
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
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.
Stapedectomy is listed separately under Ear, nose and throat.
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:
Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.
- - 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
Sleep studies
Hospital treatment for the investigation of sleep patterns and anomalies.
For example: sleep apnoea and snoring.
For example: sleep apnoea and snoring.
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
Cataracts
Hospital treatment for surgery to remove a cataract and replace with an artificial lens.
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).
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
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.
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
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis.
For example: peritoneal dialysis and haemodialysis.
2 months or 12 months pre-existing
More Inclusions
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).
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
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
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.
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.
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.
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.
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
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.
Surgical treatment of cancer is listed separately under each body system.
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.
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.
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.
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.
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.
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.
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
Hernia and appendix
Hospital treatment for the investigation and treatment of a hernia or appendicitis.
Digestive conditions are listed separately under digestive system.
Digestive conditions are listed separately under digestive system.
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.
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.
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.
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.
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
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.
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
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.
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
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.
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
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.
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
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.
Stapedectomy is listed separately under Ear, nose and throat.
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:
Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.
- - 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
Sleep studies
Hospital treatment for the investigation of sleep patterns and anomalies.
For example: sleep apnoea and snoring.
For example: sleep apnoea and snoring.
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
Cataracts
Hospital treatment for surgery to remove a cataract and replace with an artificial lens.
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).
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
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.
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
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis.
For example: peritoneal dialysis and haemodialysis.
2 months or 12 months pre-existing
Exclusions
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.
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.
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.
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.
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.
For example: gastric banding, gastric bypass, sleeve gastrectomy.
Key
Excluded
Covered
Restricted
Top Choice (Silver Plus) Extras cover
Claim up to $3450 per person, per calendar year
Extras covered
Yearly limits (per person)
/what you get
back
Waiting periods
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.
$250 limit
Up to 100% of the cost per item
6 months
Physiotherapy
Including sports physiotherapy and hydrotherapy.
$500 limit
$40 per consultation
2 months
Chiropractic & osteopathy
Combined limit of $300
$40 per initial consultation
$30 per subsequent consultation
2 months
Podiatry
Excludes podiatric surgery.
$400 limit
$40 per initial consultation
$30 per subsequent consultation
2 months
Myotherapy and acupuncture
Remedial massage
Combined limit of $300 for myotherapy, acupuncture and remedial massage
$30 per consultation
2 months
2 months
Top Choice (Silver Plus) cover cover
Claim up to $3450 per person, per calendar year
Extras covered
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)
$250 limit
Up to 100% of the cost per item
Waiting Periods
6 months
Including sports physiotherapy and hydrotherapy.
Yearly limits (per person)
$500 limit
$40 per consultation
Waiting Periods
2 months
Yearly limits (per person)
Combined limit of $300
$40 per initial consultation
$30 per subsequent consultation
Waiting Periods
2 months
Excludes podiatric surgery.
Yearly limits (per person)
$400 limit
$40 per initial consultation
$30 per subsequent consultation
Waiting Periods
2 months
Yearly limits (per person)
Combined limit of $300 for myotherapy, acupuncture and remedial massage
$30 per consultation
Waiting Periods
2 months
Yearly limits (per person)
Combined limit of $300 for myotherapy, acupuncture and remedial massage
$30 per consultation
Waiting Periods
2 months
Enjoy no gap preventative
dental treatments
Get preventative dental treatment with no out-of-pocket costs (up to your yearly limit, depending on your level of cover) when you visit any provider in our No Gap Dental Network.
Covered treatments include :
-
Initial and preventative examination
-
Scale, clean and topical fluoride treatment
-
Custom mouthguards for protection during contact sports
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.
Top Choice (Silver Plus)
From
$106.98*
Hospital excess
On Top Choice (Silver Plus), you will only have to pay half the excess for day surgeries. If the applicable total excess isn't paid after your first hospital admission you will have to pay the remaining balance of the excess on any subsequent admission(s) within the same calendar year. Plus you won't pay an excess if any children or student dependants listed on your membership are admitted to hospital.
$ after April 1
$106.98*
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.