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Compare featured Hospital & Extras cover
Find the right level of cover for your needs
Find the right level of cover for your needs
Cover requirements
Essential Choice (Bronze Plus)
From
$5744*
Hospital excess
On Essential Choice (Bronze 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 dependents listed on your membership are admitted to hospital.
Includes 4% direct debit discount
An affordable combination that covers all the Hospital essentials with great value Extras. Enjoy both peace of mind and great value for money.
Cover includes non-student dependants aged 23 and over.
Key Hospital benefits+
-
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.
-
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. -
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. -
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).
-
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.
-
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.
-
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. -
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.
-
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. -
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. -
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. -
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. -
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. -
Dental surgery
Hospital treatment for surgery to the teeth and gums.
For example: surgery to remove wisdom teeth, and dental implant surgery. -
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. -
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. -
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. -
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. -
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. -
Hernia and appendix
Hospital treatment for the investigation and treatment of a hernia or appendicitis.
Digestive conditions are listed separately under digestive system. -
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). -
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. -
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. -
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. -
Miscarriage and termination of pregnancy
Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy.
-
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. -
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. -
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. -
Sleep studies
Hospital treatment for the investigation of sleep patterns and anomalies.
For example: sleep apnoea and snoring. -
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
-
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. -
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. -
Cataracts
Hospital treatment for surgery to remove a cataract and replace with an artificial lens.
-
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis. -
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. -
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. -
Insulin pumps
Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.
-
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). -
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. -
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. -
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. -
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.
-
No Gap Dental NetworkNo Gap Dental covers selected services such as scale and clean, fluoride treatment and mouthguards.
Please note: No Gap Dental providers are not available in all states and territories.
Benefits claimed as No Gap do not count towards the yearly limit. -
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$700 limit combined with General Dental, Root Canal, Gum Disease Treatments and Surgical Extractions and Crowns, Bridges and Dentures -
General dentalCovers most fillings and simple extractions
$700 limit combined with Preventative Dental, Root Canal, Gum Disease Treatments & Surgical Extractions and Crowns, Bridges & Dentures -
Root canal, gum disease treatments & surgical extractions
$700 limit combined with Preventative Dental, General Dental and Crowns, Bridges & Dentures -
OpticalFor prescription glasses, contact lenses or repairs provided by a recognised optometrist in private practice. Excludes non-prescription sunglasses and contact lenses, and optical consultations.
$200 limit -
PhysiotherapyIncludes sports physiotherapy and hydrotherapy
$350 limit combined with Exercise Physiology -
Chiropractic & osteopathy
$250 combined limit -
Remedial massage
$200 limit combined with Acupuncture and Myotherapy -
PodiatryExcludes podiatric surgery
$200 limit -
Psychology
$100 limit
-
No Gap Dental NetworkNo Gap Dental covers selected services such as scale and clean, fluoride treatment and mouthguards.
Please note: No Gap Dental providers are not available in all states and territories.
Benefits claimed as No Gap do not count towards the yearly limit. -
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$700 limit combined with General Dental, Root Canal, Gum Disease Treatments and Surgical Extractions and Crowns, Bridges and Dentures -
General dentalCovers most fillings and simple extractions
$700 limit combined with Preventative Dental, Root Canal, Gum Disease Treatments & Surgical Extractions and Crowns, Bridges & Dentures -
Root canal, gum disease treatments & surgical extractions
$700 limit combined with Preventative Dental, General Dental and Crowns, Bridges & Dentures -
Crowns, bridges and denturesA full denture replacement is limited to once every three years.
$700 limit combined with Preventative Dental, General Dental and Root Canal, Gum Disease Treatments & Surgical Extractions
-
OpticalFor prescription glasses, contact lenses or repairs provided by a recognised optometrist in private practice. Excludes non-prescription sunglasses and contact lenses, and optical consultations.
$200 limit
-
PhysiotherapyIncludes sports physiotherapy and hydrotherapy
$350 limit combined with Exercise Physiology -
Exercise PhysiologyIncludes hydrotherapy
$350 limit combined with Physiotherapy -
Chiropractic & osteopathy
$250 combined limit -
Acupuncture
$200 limit combined with Remedial Massage and Myotherapy -
Remedial massage
$200 limit combined with Acupuncture and Myotherapy -
Myotherapy
$200 limit combined with Acupuncture and Remedial Massage -
PodiatryExcludes podiatric surgery
$200 limit
-
Dietetics
$200 limit -
Psychology
$100 limit -
Travel vaccinationsFor approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel
$100 limit
Core Hospital (Bronze Plus) and Focus Extras
From
$6151*
Hospital excess
You will only pay one excess per person admitted per calendar year. Plus you won’t pay an excess if your dependent is admitted to hospital.
Includes 4% direct debit discount
Straightforward cover for simple and common procedures. Designed for singles, couples and families looking for more than the basics. Focus in on the essentials with 60% back on key services. Plus, 100% back on Optical, selected dental services through our No Gap Dental Network and unlimited emergency ambulance .
Cover includes non-student dependants aged 23 and over.
Key Hospital benefits+
-
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. -
Dental surgery
Hospital treatment for surgery to the teeth and gums.
For example: surgery to remove wisdom teeth, and dental implant surgery. -
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. -
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).
-
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.
-
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.
-
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. -
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. -
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. -
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. -
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. -
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. -
Dental surgery
Hospital treatment for surgery to the teeth and gums.
For example: surgery to remove wisdom teeth, and dental implant surgery. -
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. -
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. -
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. -
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. -
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. -
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. -
Hernia and appendix
Hospital treatment for the investigation and treatment of a hernia or appendicitis.
Digestive conditions are listed separately under digestive system. -
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). -
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. -
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. -
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. -
Miscarriage and termination of pregnancy
Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy.
-
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. -
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. -
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
-
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. -
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. -
Cataracts
Hospital treatment for surgery to remove a cataract and replace with an artificial lens.
-
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis. -
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. -
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. -
Insulin pumps
Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.
-
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). -
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. -
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. -
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. -
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. -
Sleep studies
Hospital treatment for the investigation of sleep patterns and anomalies.
For example: sleep apnoea and snoring. -
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.
-
Emergency AmbulanceWhere 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 -
No Gap Dental NetworkCovers selected services such as scale and clean, fluoride treatment and mouthguards.
Benefits claimed as No Gap Dental do not count towards the yearly limit. Please Note: No Gap Dental providers are not available in all states and territories. Covers selected services such as scale and clean, fluoride treatment and mouthguards. -
General DentalCovers most fillings and simple extractions
$700 per person, $1400 limit per family combined with Preventative Dental, Root Canal, Gum Disease Treatments & Surgical Extractions, Crowns, Bridges & Dentures -
Root Canal, Gum Disease Treatments & Surgical Extractions
$700 per person, $1400 per family combined with Preventative Dental, General Dental and Crowns, Bridges and Dentures -
Crowns, Bridges & DenturesA full denture replacement is limited to once every three years.
$700 limit per person, $1400 limit per family. Combined with Preventative Dental, General Dental and Root Canal, Gum Disease Treatments and Surgical Extractions -
OpticalFor prescription glasses, contact lenses or repairs provided by a recognised optometrist in private practice. Excludes non-prescription sunglasses and contact lenses, and optical consultations.
$200 per person, $400 per family -
PhysiotherapyIncludes sports physiotherapy and hydrotherapy
$400 limit combined with Exercise Physiology -
Chiropractic and Osteopathy
$250 combined limit -
Remedial Massage
$200 limit combined with Acupuncture and Myotherapy -
Psychology
$200 limit
-
Emergency AmbulanceWhere 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 -
Ambulance AttendanceFor 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
-
No Gap Dental NetworkCovers selected services such as scale and clean, fluoride treatment and mouthguards.
Benefits claimed as No Gap Dental do not count towards the yearly limit. Please Note: No Gap Dental providers are not available in all states and territories. Covers selected services such as scale and clean, fluoride treatment and mouthguards. -
Preventative DentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$700 per person, $1400 limit per family combined with General Dental, Root Canal, Gum Disease Treatments & Surgical Extractions, Crowns, Bridges & Dentures -
General DentalCovers most fillings and simple extractions
$700 per person, $1400 limit per family combined with Preventative Dental, Root Canal, Gum Disease Treatments & Surgical Extractions, Crowns, Bridges & Dentures -
Root Canal, Gum Disease Treatments & Surgical Extractions
$700 per person, $1400 per family combined with Preventative Dental, General Dental and Crowns, Bridges and Dentures -
Crowns, Bridges & DenturesA full denture replacement is limited to once every three years.
$700 limit per person, $1400 limit per family. Combined with Preventative Dental, General Dental and Root Canal, Gum Disease Treatments and Surgical Extractions
-
OpticalFor prescription glasses, contact lenses or repairs provided by a recognised optometrist in private practice. Excludes non-prescription sunglasses and contact lenses, and optical consultations.
$200 per person, $400 per family
-
PhysiotherapyIncludes sports physiotherapy and hydrotherapy
$400 limit combined with Exercise Physiology -
Exercise PhysiologyIncludes hydrotherapy
$400 limit combined with Physiotherapy -
Chiropractic and Osteopathy
$250 combined limit -
Acupuncture
$200 limit combined with Remedial Massage and Myotherapy -
Remedial Massage
$200 limit combined with Acupuncture and Myotherapy -
Myotherapy
$200 limit combined with Acupuncture and Remedial Massage
-
Dietetics
$200 limit -
Psychology
$200 limit -
Travel VaccinationsFor approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel
$150 limit
Top Choice (Silver Plus)
From
$10253*
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
Comprehensive coverage for a wide range of procedures and extras, that excludes the things you're unlikely to use.
Cover includes non-student dependants aged 23 and over.
Key Hospital benefits+
-
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.
-
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. -
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. -
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).
-
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. -
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.
-
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. -
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.
-
Dental surgery
Hospital treatment for surgery to the teeth and gums.
For example: surgery to remove wisdom teeth, and dental implant surgery. -
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). -
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
-
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. -
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. -
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. -
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. -
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. -
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. -
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. -
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. -
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. -
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. -
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. -
Hernia and appendix
Hospital treatment for the investigation and treatment of a hernia or appendicitis.
Digestive conditions are listed separately under digestive system. -
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. -
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. -
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. -
Miscarriage and termination of pregnancy
Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy.
-
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. -
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. -
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. -
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. -
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. -
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. -
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. -
Sleep studies
Hospital treatment for the investigation of sleep patterns and anomalies.
For example: sleep apnoea and snoring. -
Insulin pumps
Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.
-
Cataracts
Hospital treatment for surgery to remove a cataract and replace with an artificial lens.
-
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). -
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. -
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis. -
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. -
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. -
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.
-
No Gap Dental NetworkNo Gap Dental covers selected services such as scale and clean, fluoride treatment and mouthguards.
Please note: No Gap Dental providers are not available in all states and territories.
$700 combined limit with general dental, preventative dental and root canal, gum disease treatments & surgical extractions -
General dentalCovers most fillings and simple extractions.
$700 combined limit with No Gap Dental Network, preventative dental and root canal, gum disease treatments & surgical extractions -
Root canal, gum disease treatments & surgical extractions
$700 combined limit with general dental, preventative dental and root canal, gum disease treatments & surgical extractions -
OpticalFor 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 -
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$500 limit -
Chiropractic & osteopathy
$300 limit -
PodiatryExcludes podiatric surgery.
$400 limit -
Remedial massage
$300 combined limit with myotherapy & acupuncture
-
No Gap Dental NetworkNo Gap Dental covers selected services such as scale and clean, fluoride treatment and mouthguards.
Please note: No Gap Dental providers are not available in all states and territories.
$700 combined limit with general dental, preventative dental and root canal, gum disease treatments & surgical extractions -
Preventative dentalPreventative dental also includes scale and clean, fluoride treatment and mouth guards.
$700 combined limit with No Gap Dental Network, general dental and root canal, gum disease treatments & surgical extractions -
General dentalCovers most fillings and simple extractions.
$700 combined limit with No Gap Dental Network, preventative dental and root canal, gum disease treatments & surgical extractions -
Root canal, gum disease treatments & surgical extractions
$700 combined limit with general dental, preventative dental and root canal, gum disease treatments & surgical extractions -
Crowns, bridges and dentures
$1000 limit Crowns and bridges sub-limit is $600. Dentures sub-limit is $600
-
OpticalFor 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
-
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$500 limit -
Chiropractic & osteopathy
$300 limit -
PodiatryExcludes podiatric surgery.
$400 limit -
Myotherapy and acupuncture
$300 combined limit with remedial massage -
Remedial massage
$300 combined limit with myotherapy & acupuncture
* Price includes cover for non-student dependants aged 23 and over.* Price excludes cover for non-student dependants aged 23 and over.
+ Waiting periods may apply.
^ 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.