Singles Health Insurance
Whether you’re young and healthy, older and wiser, or somewhere in between choose from our wide range of options to suit your needs. Get cover towards the cost of treatments in hospital, as well as extras treatments including dental, optical, physiotherapy, and more.
1On selected covers, up to yearly limits. Dental benefit at No Gap Dental Network.
2Not available on all products
3Provider recognition conditions apply
2Not available on all products
3Provider recognition conditions apply
Get up to 60% back on physio, remedial massage and more.2
Get up to 100% back on selected dental treatments1
Agreements with over 500 hospitals across Australia
Accident cover2 and emergency ambulance
Gap cover scheme to reduce out of pocket costs2
Choose your own extras provider3
Your price
Providing the following information will help us calculate the price that you would need to pay for your health cover.
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Price based on :
Singles cover in VIC. I'm Under 65 with an income $101,000 or less and assumes a 0% Lifetime Health Cover loading, Rebate Tier 0 and a 4% discount for direct debit.
Compare featured Hospital & Extras cover
Find the right level of cover for your needs
Find the right level of cover for your needs
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Enjoy 10 weeks free when you join hospital & extras cover. T&C’s apply.
Key:
Hospital - For the meaning of 'Covered' refer to Hospital product Fact Sheet. Extras -
Benefits paid under your cover up to specified yearly limits, per person, per calendar year.
Please refer to ‘Understanding your Hospital cover’ section below.
Please refer to ‘Understanding your Hospital cover’ section below.
Covered for day procedures. Restricted for overnight stays. Refer to product Fact Sheet for more information.
Essential Choice (Bronze Plus)
From
$62.84*
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.
Bonus Inclusions
- Excess is halved for day surgeries and waived for dependents
- Preventative Health and Health Support Programs
- Increased cover if injury/illness is caused by an Accident
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.
Extras cover
Claim up to $2,300 per person, per calendar year ^
-
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
Dental
$700 combined 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
Optical
-
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
Therapies
See individual limits below
-
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
Other
-
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
$65.41*
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.
Bonus Inclusions
- Excess and co-payments waived for dependants
- Hospital substitution programs
- Emergency Ambulance transportation
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.
Extras cover
Claim up to $2,300 per person per calendar year ^
-
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
Ambulance
Unlimited Emergency Ambulance transportation
-
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
Dental
See individual limits below
-
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
Optical
$200 per person, $400 per family
-
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
Therapies
See individual limits below
-
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
Other
See individual limits below
-
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
$114.77*
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.
Bonus Inclusions
- Cover for Accidents that occur after joining this level of cover
- Excess waived for dependants
- Half excess for day surgeries
- Hospital care at home & rehabilitation at home
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.
Extras cover
Claim up to $3450 per person, per calendar year ^
-
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
Dental
-
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
Optical
-
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
Therapies
-
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
* 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.
+ Waiting periods may apply.
^ Waiting periods and yearly limits may apply.
/
Understanding your Hospital Cover
Waiting periods
A waiting period is the amount of time you have to wait after joining or upgrading until you can make a claim for a service or treatment.
Hospital excess
Excess is the additional amount you agree to pay towards accommodation costs if you need hospital treatment. Please refer to your product Fact Sheet for details about the maximum excess payable in a calendar year and any excess waivers that may apply.
Pre-existing conditions
A pre-existing condition is an ailment, illness or condition that in the opinion of a medical practitioner appointed by Australian Unity (not your own doctor), the signs or symptoms of that ailment, illness or condition existed at any time in the period of six months ending on the day on which you joined Australian Unity or upgraded your cover, irrespective of whether you were aware of it. If you make a hospital claim in the first 12 months of your joining or upgrading your cover, we will ask you to get your consulting doctors or other practitioner (e.g. your dentist, GP or specialist) to complete a medical report. You should ask us to carry out this assessment before going into hospital.
Accidents
Accident means an unplanned and unforeseen event, occurring by chance, and leading to bodily injuries caused solely and directly by an external force or object requiring treatment from a Medical Practitioner (defined here as a medical doctor who is not the member or a relative of the Member) within 7 days of the event, but excludes injuries arising out of: surgical procedures; unforeseen illness; pregnancy; drug use; and aggravation of an underlying condition or injury.
Restricted
Restricted services are hospital claims which are limited to a minimum (default) benefit. This is the minimum dollar amount set by the Australian Government for accommodation as a private patient in a shared room of a public hospital. A Restricted service does not pay any money towards the cost of intensive or coronary care, labour ward or theatre fees in a private hospital or private day centre. Therefore you may incur a large out-of-pocket expense. Contact us for more information.
Exclusions
If you select a hospital cover that has treatments listed as ‘Excluded’ or 'Not Covered', this means that we will not pay any benefits for the treatment you have received and this can result in you incurring large out-of-pocket costs. Always refer to your product Fact Sheet for more details about your hospital cover entitlements.
Out-of-pocket costs
If you are admitted to hospital (including for Covered treatments) you may have out-of-pocket costs, e.g. an excess, a ‘gap’ in your doctors’ medical bills, emergency department fees, or the additional cost of a private room in a public or non-agreement hospital. If you want more specific information about what you can expect these costs to be, we recommend you obtain a quote from your doctors/hospital before undergoing treatment. Then contact us for details of benefits before proceeding with your treatment. Additionally, benefits are not payable for claims where you have the right to claim compensation, damages or benefits from another source (e.g. TAC or WorkCover), now or at a later date.
/
Understanding your Extras Cover
Waiting periods
A waiting period is the amount of time you have to wait after joining or upgrading until you can make a claim for a service or treatment.
Preventative Health Services
Preventative Health Services can offer practical support to help bring about positive change in members’ lives to help you get and stay healthy. They include things like losing weight, getting fit, quitting smoking, and working with a health coach to improve your general health and wellbeing. You’ll receive personalised and practical support plus information designed to bring about positive change giving you the tools needed to enjoy a longer, healthier and happier life.
To check your eligibility, which providers and programs you are able to use and any waiting periods that may apply, please contact us on 13 29 39. More information can be found here.
Where an Extras cover is taken with Hospital cover, benefits are payable under the Hospital cover only.
To check your eligibility, which providers and programs you are able to use and any waiting periods that may apply, please contact us on 13 29 39. More information can be found here.
Where an Extras cover is taken with Hospital cover, benefits are payable under the Hospital cover only.
Out-of-pocket costs
Extras cover can help you get money back on common health treatments that aren’t generally covered by Medicare. You’ll get either a percentage of the cost back, or a set dollar amount, on included Extras every time you claim, until you reach your yearly limit. Therefore, you only pay the difference between what you get back from Australian Unity and the cost set by your provider.
Please call us or refer to your Member Guide and Terms & Conditions for further information on how this cover works. If you want more specific information about what you can expect your out-of-pocket costs to be, we recommend you obtain a quote from your provider before undergoing treatment, along with a list of item numbers. You can then contact us or log in to Online Member Services for details of benefits before proceeding with your treatment.
Please call us or refer to your Member Guide and Terms & Conditions for further information on how this cover works. If you want more specific information about what you can expect your out-of-pocket costs to be, we recommend you obtain a quote from your provider before undergoing treatment, along with a list of item numbers. You can then contact us or log in to Online Member Services for details of benefits before proceeding with your treatment.
Recognised providers
We only pay benefits when you see a recognised provider in a private practice. Please contact us to check if your provider is recognised by us. Providers recognition conditions 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.
Why Choose Australian Unity?
Extensive hospital network
We have agreements with over 500 hospitals across Australia so you can access care where you need it and make the most of your cover.
Read more No gap dental cover
Get up to 100% back on selected preventative dental treatment when you visit any provider in our No Gap Dental Network.
Read more Manage your cover online
Log in to make claims, check your remaining limits, make payments, keep your details up to date and more.
Read more Get rewards and discounts
We offer our members a wide range of ongoing discounts and rewards so you will get more than just great health insurance.
Read more