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Your price

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

My personal details:

My required cover type
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My income information:

Please enter your income to show pricing inclusive of the Australian Government Rebate (AGR) or select ‘No Rebate’ for no AGR.

 The Australian Government Rebate on private health insurance helps make private health cover more affordable. Your rebate is determined by your income and your age if you are 65 years or over. You can receive your rebate as a reduction to your price or as a rebate on your tax return. 

By providing your estimated income range, we will provide a price for your health cover that includes the Australian Government Rebate. For more information click here.

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If you have dependent children, your income threshold for the rebate increases by $1,500 for each child after the first. To determine whether your child is a dependent for tax purposes or if you want more information about your rebate entitlements or eligibility, please contact your registered tax agent or visit the ATO website.
Please select an annual income range.

My insurance history:

Please answer these questions about your history of holding private hospital cover to help us determine whether a Lifetime Health Cover loading will apply to your price.

The Australian Government’s Lifetime Health Cover (LHC) loading may impact the price you pay for the private hospital part of your health cover.

If you (or if applicable your partner) did not hold private hospital cover continuously for the last 10 years; or on the 1st of July following your 31st birthday; you pay 2% extra, plus an extra 2% for every year after this date you didn’t have it. For more information on the Lifetime Health Cover (LHC) loading click here.

I have held private hospital cover continuously for the previous 10 years, or since turning 31 years old.
My partner has held private hospital cover continuously for the previous 10 years, or since turning 31 years old.

*If you tick this option, the price we show will not include any Lifetime Health Cover loading (LHC). Any applicable LHC loading will be confirmed once we receive a Transfer Certificate from your previous insurer.

Unable to process your request at this point in time, please try again later.

Need help? Call one of our health insurance experts on 13 29 39

Price based on :

Singles cover in VIC. I'm Under 65 with an income $90,000 or less and assumes a 0% Lifetime Health Cover loading, Rebate Tier 0 and a 4% discount for direct debit.

Top Choice (Silver Plus)

Comprehensive coverage for a wide range of procedures and extras, that excludes the things you're unlikely to use.

$193.10*

Hospital excess
Connection Timed Out. Please try again.

$ after April 1

$89.10*

Minimum direct debit period

/ Fortnightly

* 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. First payment is minimum of one month.

Important: Please note, from 1 July 2020, there are changes affecting this cover. Click here for details.

Hospital cover benefits

  • Cover for a wide range of procedures including joint replacements, cataracts, heart and vascular system

  • Save money with cover that excludes things you may not need such as weight loss surgery, assisted reproductive services, pregnancy and birth

  • Accident Cover

Package Fact Sheet

Extras cover benefits

  • Get up to $3,450 per person, per calendar year on extras

  • Cover for a broad range of extras including optical, physio, chiro, remedial massage and acupuncture

  • Up to 100% back on selected preventative dental services through our No-Gap Dental Network up to yearly limits

Package Fact Sheet

Top Choice (Silver Plus) Hospital cover

Inclusions

Waiting period

Rehabilitation
Hospital treatment for physical rehabilitation for a patient related to surgery or illness.

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

For example: psychoses such as schizophrenia, mood disorders such as depression, eating disorders and addiction therapy.
2 months
Emergency ambulance cover
Ambulance transportation to hospital. You are covered for emergency ambulance transportation to hospital provided that the transport is coded and invoiced as emergency transport by a recognised State Ambulance authority. Some State schemes already cover ambulance services.
0 months
Also includes two ambulance attendances per person per calendar year, where you are not taken to hospital.
Dental surgery
Hospital treatment for surgery to the teeth and gums.

For example: surgery to remove wisdom teeth, and dental implant surgery.
12 months pre-existing
Joint reconstructions
Hospital treatment for surgery for joint reconstructions.

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

Joint replacements are listed separately under Joint replacements.

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

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

Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).
12 months pre-existing
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
12 months pre-existing
Blood
Hospital treatment for the investigation and treatment of blood and blood-related conditions.

For example: blood clotting disorders and bone marrow transplants.

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

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

Chest surgery is listed separately under Lung and chest.

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

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

Joint reconstructions are listed separately under Joint reconstructions.

Joint replacements are listed separately under Joint replacements.

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

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

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

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

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

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

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

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

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
12 months pre-existing
Chemotherapy, radiotherapy and immunotherapy for cancer
Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours.

Surgical treatment of cancer is listed separately under each body system.
12 months pre-existing
Diabetes management (excluding insulin pumps)
Hospital treatment for the investigation and management of diabetes.

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

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

Treatment for ulcers is listed separately under Skin.

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

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

Endoscopy is listed separately under Gastrointestinal endoscopy.

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

Bariatric surgery is listed separately under Weight loss surgery.

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

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

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

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

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

Sleep studies are listed separately under Sleep studies.

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

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

Cataract procedures are listed separately under Cataracts.

Eyelid procedures are listed separately under Plastic and reconstructive surgery.

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

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

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

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

Fertility treatments are listed separately under Assisted reproductive services.

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

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

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

Digestive conditions are listed separately under digestive system.
12 months pre-existing
Kidney and bladder
Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.

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

Dialysis is listed separately under Dialysis for chronic kidney failure.

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

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

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

For example: male sterilisation, circumcision and prostate cancer.

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

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

Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under Pain management with device.
12 months pre-existing
Plastic and reconstructive surgery (medically necessary)
Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or Accident, or congenital.

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

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

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
12 months pre-existing
Skin
Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included.

For example: melanoma, minor wound repair and abscesses.

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

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
12 months pre-existing
Back, neck and spine
Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion.

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

Joint replacements are listed separately under Joint replacements.

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

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

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

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

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

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
12 months pre-existing
Implantation of hearing devices
Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.

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

Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.
12 months pre-existing
Sleep studies
Hospital treatment for the investigation of sleep patterns and anomalies.

For example: sleep apnoea and snoring.
12 months pre-existing
Insulin pumps
Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.
12 months pre-existing
Cataracts
Hospital treatment for surgery to remove a cataract and replace with an artificial lens.
12 months pre-existing
Joint replacements
Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of prostheses.

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

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

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

Joint reconstructions are listed separately under Joint reconstructions.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).
12 months pre-existing
Pain management with device
Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain.

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

Treatment of pain that does not require a device is listed separately under Pain management.
12 months pre-existing
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.

For example: peritoneal dialysis and haemodialysis.
12 months pre-existing
Joint reconstructions
Hospital treatment for surgery for joint reconstructions.

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

Joint replacements are listed separately under Joint replacements.

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

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

Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).
12 months pre-existing
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
12 months pre-existing
Blood
Hospital treatment for the investigation and treatment of blood and blood-related conditions.

For example: blood clotting disorders and bone marrow transplants.

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

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

Chest surgery is listed separately under Lung and chest.

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

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

Joint reconstructions are listed separately under Joint reconstructions.

Joint replacements are listed separately under Joint replacements.

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

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

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

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

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

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

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

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

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
12 months pre-existing
Chemotherapy, radiotherapy and immunotherapy for cancer
Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours.

Surgical treatment of cancer is listed separately under each body system.
12 months pre-existing
Diabetes management (excluding insulin pumps)
Hospital treatment for the investigation and management of diabetes.

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

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

Treatment for ulcers is listed separately under Skin.

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

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

Endoscopy is listed separately under Gastrointestinal endoscopy.

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

Bariatric surgery is listed separately under Weight loss surgery.

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

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

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

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

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

Sleep studies are listed separately under Sleep studies.

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

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

Cataract procedures are listed separately under Cataracts.

Eyelid procedures are listed separately under Plastic and reconstructive surgery.

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

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

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

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

Fertility treatments are listed separately under Assisted reproductive services.

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

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

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

Digestive conditions are listed separately under digestive system.
12 months pre-existing
Kidney and bladder
Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.

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

Dialysis is listed separately under Dialysis for chronic kidney failure.

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

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

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

For example: male sterilisation, circumcision and prostate cancer.

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

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

Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under Pain management with device.
12 months pre-existing
Plastic and reconstructive surgery (medically necessary)
Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or Accident, or congenital.

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

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

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
12 months pre-existing
Skin
Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included.

For example: melanoma, minor wound repair and abscesses.

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

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
12 months pre-existing
Back, neck and spine
Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion.

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

Joint replacements are listed separately under Joint replacements.

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

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

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

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

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

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
12 months pre-existing
Implantation of hearing devices
Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.

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

Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.
12 months pre-existing
Sleep studies
Hospital treatment for the investigation of sleep patterns and anomalies.

For example: sleep apnoea and snoring.
12 months pre-existing
Insulin pumps
Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.
12 months pre-existing
Cataracts
Hospital treatment for surgery to remove a cataract and replace with an artificial lens.
12 months pre-existing
Joint replacements
Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of prostheses.

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

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

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

Joint reconstructions are listed separately under Joint reconstructions.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).
12 months pre-existing
Pain management with device
Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain.

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

Treatment of pain that does not require a device is listed separately under Pain management.
12 months pre-existing
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.

For example: peritoneal dialysis and haemodialysis.
12 months pre-existing

Exclusions

Assisted reproductive services
Hospital treatment for fertility treatments or procedures.

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

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

Pregnancy and birth-related services are listed separately under Pregnancy and birth.
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.

Key

Excluded
Covered
Restricted

Understanding your Hospital Cover

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.

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.

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.

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 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.

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.

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.

Top Choice (Silver Plus) Extras cover

Claim up to $3450 per person, per calendar year

Extras covered

Yearly limits (per person)
/what you get back

Waiting periods

No Gap Dental Network

No 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.

Preventative dental

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

General dental

Covers most fillings and simple extractions.

Root canal, gum disease treatments & surgical extractions

 

$700 combined limit for No Gap Dental Network, preventative dental, general dental and root canal, gum disease treatments & surgical extractions

Set amounts per item
or 100% of the cost for selected services at our No Gap Dental Network

0 months

0 months

0 months for selected diagnostic services

2 months includes most fillings and simple tooth extractions

6 months

Crowns, bridges and dentures

 

$1000 limit

Crowns and bridges sub-limit is $600

Dentures sub-limit is $600

Set amounts per item

12 months

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

Optical

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

$250 limit

Up to 100% of the cost per item

6 months

Physiotherapy

Including sports physiotherapy and hydrotherapy.

$500 limit
$40 per consultation

2 months

Chiropractic & osteopathy

 

Combined limit of $300

$40 per initial consultation
$30 per subsequent consultation

2 months

Podiatry

Excludes podiatric surgery.

$400 limit

$40 per initial consultation
$30 per subsequent consultation

2 months

Myotherapy and acupuncture

 

Remedial massage

 

Combined limit of $300 for myotherapy, acupuncture and remedial massage

$30 per consultation

2 months

2 months

Top Choice (Silver Plus) cover cover

Claim up to $3450 per person, per calendar year

Extras covered

No 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.

Yearly limits (per person)

$700 combined limit for No Gap Dental Network, preventative dental, general dental and root canal, gum disease treatments & surgical extractions

Set amounts per item
or 100% of the cost for selected services at our No Gap Dental Network

Waiting Periods

0 months

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

Yearly limits (per person)

$700 combined limit for No Gap Dental Network, preventative dental, general dental and root canal, gum disease treatments & surgical extractions

Set amounts per item
or 100% of the cost for selected services at our No Gap Dental Network

Waiting Periods

0 months

Covers most fillings and simple extractions.

Yearly limits (per person)

$700 combined limit for No Gap Dental Network, preventative dental, general dental and root canal, gum disease treatments & surgical extractions

Set amounts per item
or 100% of the cost for selected services at our No Gap Dental Network

Waiting Periods

0 months for selected diagnostic services

2 months includes most fillings and simple tooth extractions

 

Yearly limits (per person)

$700 combined limit for No Gap Dental Network, preventative dental, general dental and root canal, gum disease treatments & surgical extractions

Set amounts per item
or 100% of the cost for selected services at our No Gap Dental Network

Waiting Periods

6 months

 

Yearly limits (per person)

$1000 limit

Crowns and bridges sub-limit is $600

Dentures sub-limit is $600

Set amounts per item

Waiting Periods

12 months

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

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

Yearly limits (per person)

$250 limit

Up to 100% of the cost per item

Waiting Periods

6 months

Including sports physiotherapy and hydrotherapy.

Yearly limits (per person)

$500 limit
$40 per consultation

Waiting Periods

2 months

 

Yearly limits (per person)

Combined limit of $300

$40 per initial consultation
$30 per subsequent consultation

Waiting Periods

2 months

Excludes podiatric surgery.

Yearly limits (per person)

$400 limit

$40 per initial consultation
$30 per subsequent consultation

Waiting Periods

2 months

 

Yearly limits (per person)

Combined limit of $300 for myotherapy, acupuncture and remedial massage

$30 per consultation

Waiting Periods

2 months

 

Yearly limits (per person)

Combined limit of $300 for myotherapy, acupuncture and remedial massage

$30 per consultation

Waiting Periods

2 months

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Enjoy no gap preventative
dental treatments

Get preventative dental treatment with no out-of-pocket costs (up to your yearly limit, depending on your level of cover) when you visit any provider in our No Gap Dental Network.

Covered treatments include :

  • Initial and preventative examination

  • Scale, clean and topical fluoride treatment

  • Custom mouthguards for protection during contact sports

Understanding your Extras Cover

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.

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.

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.

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.

Further healthcare benefits

Depending on your level of cover (check your product Fact Sheet)

Accident Cover

If you need hospital treatment for an injury sustained during an Accident that occurred after joining this cover, and the hospital treatment is within a Clinical Category that is listed as Restricted or Not Covered, that hospital treatment will be treated as Covered.

Preventative health services

Claim back on selected personalised support programs designed to bring about positive change in your life - such as bone density scans, diabetes support, mammograms and health coaching.
Learn more

Health support programs

We give you added support to improve and sustain your health and wellbeing. Access health coaches, dieticians, physiotherapists, midwives and more through our partner Remedy Healthcare.
Learn more

Why choose Australian Unity?

You choose who you see#

With your choice of provider, you can get treated by any health provider who is in private practice and is recognised by Australian Unity. Provider recognition conditions apply.

Read more

Claim sooner when you switch^

Switch to Australian Unity within 30 days of leaving your old fund and we will recognise the waiting periods you've already served.

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

#Exclusions apply for certain relationships between provider and member.

^Note that previous claims will count towards yearly limits.

What you need to join today

  • Medicare card

  • Payment details

  • Existing cover information (if applicable)

* Assumes a 4% discount for direct debit and 0% aged based discount. Any rebate and Lifetime Health Cover loading listed above has been factored into the price. First payment is minimum of one month.

Top Choice (Silver Plus)

$193.10*

Hospital excess
Connection Timed Out. Please try again.

$ after April 1

$89.10*

Minimum direct debit period

/ Fortnightly

* 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. First payment is minimum of one month.