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Compare Hospital & Extras cover
Find the right level of cover for your needs
Advanced Hospital (Silver Plus) and Basic Extras
$20855*
A higher level option, perfect for those who are starting or growing their family. Cover for the basics including preventative and general dental, physio, optical and remedial massage.
View ProductKey Hospital benefits+
-
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
-
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. -
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. -
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. -
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.
-
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. -
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.
-
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. -
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. -
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis. -
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.
-
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$350 combined limit with general dental and root canal, gum disease treatments & surgical extractions -
General dentalCovers most fillings and simple extractions.
$350 combined limit with preventative dental and root canal, gum disease treatments & surgical extractions -
Root canal, gum disease treatments & surgical extractions
$350 combined limit with general dental and preventative dental -
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.
$150 limit -
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$350 combined limit with chiropractic & osteopathy, remedial massage, and myotherapy & acupuncture -
Chiropractic & osteopathy
$350 combined limit with physiotherapy, remedial massage, and myotherapy & acupuncture -
Remedial massage
$100 sub-limit, $350 combined limit with physiotherapy, chiropractic & osteopathy, and myotherapy & acupuncture
-
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$350 combined limit with general dental and root canal, gum disease treatments & surgical extractions -
General dentalCovers most fillings and simple extractions.
$350 combined limit with preventative dental and root canal, gum disease treatments & surgical extractions -
Root canal, gum disease treatments & surgical extractions
$350 combined limit with general dental and preventative dental
-
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.
$150 limit
-
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$350 combined limit with chiropractic & osteopathy, remedial massage, and myotherapy & acupuncture -
Chiropractic & osteopathy
$350 combined limit with physiotherapy, remedial massage, and myotherapy & acupuncture -
Remedial massage
$100 sub-limit, $350 combined limit with physiotherapy, chiropractic & osteopathy, and myotherapy & acupuncture -
Myotherapy & acupuncture
$350 combined limit with physiotherapy, chiropractic & osteopathy, and remedial massage
-
PharmacyFor non-PBS prescription pharmaceuticals only, after you pay a sum equal to the current Pharmaceutical Benefits Scheme (PBS) charge.
Excludes vitamins, minerals and supplements.
$100 combined limit with travel vaccinations -
Travel vaccinationsFor approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel.
$100 combined limit with pharmacy
Ultimate Hospital (Gold) and Basic Extras
$22690*
Our comprehensive hospital cover for all treatments including pregnancy & birth, and psychiatry in a private hospital. Cover for the basics including preventative and general dental, physio, optical and remedial massage.
View ProductKey Hospital benefits+
-
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. -
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). -
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.
-
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. -
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.
-
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. -
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. -
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis. -
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.
-
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$350 combined limit with general dental and root canal, gum disease treatments & surgical extractions -
General dentalCovers most fillings and simple extractions.
$350 combined limit with preventative dental and root canal, gum disease treatments & surgical extractions -
Root canal, gum disease treatments & surgical extractions
$350 combined limit with general dental and preventative dental -
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.
$150 limit -
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$350 combined limit with chiropractic & osteopathy, remedial massage, and myotherapy & acupuncture -
Chiropractic & osteopathy
$350 combined limit with physiotherapy, remedial massage, and myotherapy & acupuncture -
Remedial massage
$100 sub-limit, $350 combined limit with physiotherapy, chiropractic & osteopathy, and myotherapy & acupuncture
-
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$350 combined limit with general dental and root canal, gum disease treatments & surgical extractions -
General dentalCovers most fillings and simple extractions.
$350 combined limit with preventative dental and root canal, gum disease treatments & surgical extractions -
Root canal, gum disease treatments & surgical extractions
$350 combined limit with general dental and preventative dental
-
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.
$150 limit
-
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$350 combined limit with chiropractic & osteopathy, remedial massage, and myotherapy & acupuncture -
Chiropractic & osteopathy
$350 combined limit with physiotherapy, remedial massage, and myotherapy & acupuncture -
Remedial massage
$100 sub-limit, $350 combined limit with physiotherapy, chiropractic & osteopathy, and myotherapy & acupuncture -
Myotherapy & acupuncture
$350 combined limit with physiotherapy, chiropractic & osteopathy, and remedial massage
-
PharmacyFor non-PBS prescription pharmaceuticals only, after you pay a sum equal to the current Pharmaceutical Benefits Scheme (PBS) charge.
Excludes vitamins, minerals and supplements.
$100 combined limit with travel vaccinations -
Travel vaccinationsFor approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel.
$100 combined limit with pharmacy
Advanced Hospital (Silver Plus) and Classic Extras
$24835*
A higher level option, perfect for those who are starting or growing their family. Comprehensive care for a wide range of extras including dental & orthodontics, physio, chiro, and natural therapies.
View ProductKey Hospital benefits+
-
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
-
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. -
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. -
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. -
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.
-
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. -
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.
-
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. -
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. -
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis. -
Pregnancy and birth
Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.
Treatment for the baby is covered under the clinical category relevant to their condition (provided your baby is included under your cover). For example, respiratory conditions are covered under lung and chest.
Female reproductive conditions are listed separately under gynaecology.
Fertility treatments are listed separately under assisted reproductive services.
Miscarriage and termination of pregnancy is listed separately under miscarriage and termination of pregnancy. -
Weight loss surgery
Hospital treatment for surgery that is designed to reduce a person's weight, remove excess skin due to weight loss and reversal of a bariatric procedure.
For example: gastric banding, gastric bypass, sleeve gastrectomy.
-
No Gap Dental NetworkNo Gap Dental covers selected services such as scale and clean, fluoride treatment and mouthguards.
Please note: No Gap Dental providers are not available in all states and territories.
$800 combined limit with general dental and preventative dental -
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$800 combined limit with No Gap Dental Network and general dental -
General dentalCovers most fillings and simple extractions.
$800 combined limit with No Gap Dental Network and preventative dental -
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 -
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$500 combined limit with chiropractic & osteopathy -
Chiropractic & osteopathy
$500 combined limit with physiotherapy -
PodiatryExcludes podiatric surgery.
$350 combined limit with orthotics
-
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.
$800 combined limit with general dental and preventative dental -
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$800 combined limit with No Gap Dental Network and general dental -
General dentalCovers most fillings and simple extractions.
$800 combined limit with No Gap Dental Network and preventative dental -
Root canal, gum disease treatments & surgical extractions
$400 limit -
Crowns, bridges and denturesA full denture replacement is limited to once every three years.
$600 limit -
Orthodontics
$600 limit. A lifetime maximum of $2,400 per person applies.
-
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
-
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$500 combined limit with chiropractic & osteopathy -
Chiropractic & osteopathy
$500 combined limit with physiotherapy -
Natural therapies
Myotherapy, acupuncture & remedial massageCombined limit of $350. Remedial massage sub-limit is $150 -
PodiatryExcludes podiatric surgery.
$350 combined limit with orthotics -
OrthoticsAppliances must be recommended by a podiatrist or medical practitioner and supplied by an approved provider in a private practice.
$350 combined limit with podiatry
-
Dietetics
$300 limit -
Psychology
$350 limit -
Speech, eye & occupational therapy
$350 combined limit -
PharmacyFor non-PBS prescription pharmaceuticals only, after you pay a sum equal to the current Pharmaceutical Benefits Scheme (PBS) charge.
Excludes vitamins, minerals and supplements.
$400 limit -
Travel vaccinationsFor approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel.
$150 limit -
Asthma pumps & peak flow metersBenefit for each item is payable every 2 calendar years.
Combined limit of $110 -
Blood glucose monitors & blood pressure monitorsBenefit for each items is payable every 2 calendar years.
Combined limit of $220 -
Hearing aidsIncludes hearing aid appliance, replacement and repairs.
Benefit for each item is payable every 3 calendar years (does not apply to repairs).
$550 limit -
Health aidsFor hire or purchase of wheelchairs or crutches used in prevention or support post injury when recommended by a healthcare practitioner.
And for braces, splints, garments and non-surgical prostheses when recommended by a healthcare practitioner.
Benefit for each non-surgical prosthesis is payable every 2 calendar years (does not apply to wigs).
$500 limit
Ultimate Hospital (Gold) and Intermediate Extras
$25545*
Our comprehensive hospital cover for all treatments including pregnancy & birth, and psychiatry in a private hospital. Mid-level coverage offering 100% back on optical and on selected dental services up to yearly limits through our No Gap Dental Network.
View ProductKey Hospital benefits+
-
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. -
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). -
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.
-
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. -
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.
-
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. -
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. -
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis. -
Pregnancy and birth
Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.
Treatment for the baby is covered under the clinical category relevant to their condition (provided your baby is included under your cover). For example, respiratory conditions are covered under lung and chest.
Female reproductive conditions are listed separately under gynaecology.
Fertility treatments are listed separately under assisted reproductive services.
Miscarriage and termination of pregnancy is listed separately under miscarriage and termination of pregnancy. -
Weight loss surgery
Hospital treatment for surgery that is designed to reduce a person's weight, remove excess skin due to weight loss and reversal of a bariatric procedure.
For example: gastric banding, gastric bypass, sleeve gastrectomy.
-
No Gap Dental NetworkNo Gap Dental covers selected services such as scale and clean, fluoride treatment and mouthguards.
Please note: No Gap Dental providers are not available in all states and territories.
$600 combined limit with general dental and preventative dental -
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$600 combined limit with No Gap Dental Network and general dental -
General dentalCovers most fillings and simple extractions.
$600 combined limit with No Gap Dental Network and preventative dental -
Root canal, gum disease treatments & surgical extractions
$300 limit -
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 -
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$400 combined limit with chiropractic & osteopathy -
Chiropractic & osteopathy
$400 combined limit with physiotherapy -
PodiatryExcludes podiatric surgery.
$300 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.
$600 combined limit with general dental and preventative dental -
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
$600 combined limit with No Gap Dental Network and general dental -
General dentalCovers most fillings and simple extractions.
$600 combined limit with No Gap Dental Network and preventative dental -
Root canal, gum disease treatments & surgical extractions
$300 limit -
Crowns, bridges and denturesA full denture replacement is limited to once every three years.
$500 limit
-
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
-
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$400 combined limit with chiropractic & osteopathy -
Chiropractic & osteopathy
$400 combined limit with physiotherapy -
Natural therapies
Myotherapy, acupuncture & remedial massageCombined limit of $300. Remedial massage sub-limit is $150 -
PodiatryExcludes podiatric surgery.
$300 limit
-
Dietetics
$300 limit -
Health aidsFor hire or purchase of wheelchairs or crutches used in prevention or support post injury when recommended by a healthcare practitioner.
And for braces, splints, garments and non-surgical prostheses when recommended by a healthcare practitioner.
Benefit for each non-surgical prosthesis is payable every 2 calendar years (does not apply to wigs).
Combined limit of $500
Ultimate Hospital (Gold) and Comprehensive Extras
$25965*
Our comprehensive hospital cover for all treatments including pregnancy & birth, and psychiatry in a private hospital. Support for the entire family with a range of extras cover including 100% back on selected dental through our No Gap Dental Network up to yearly limits.
View ProductKey Hospital benefits+
-
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. -
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). -
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.
-
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. -
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.
-
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. -
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. -
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis. -
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.
-
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 ante-natal classes conducted by a private midwife or physiotherapist
$500 combined limit with myotherapy and exercise physiology -
Chiropractic & osteopathyLimit of one chiropractic x-ray per person.
Family limits are shared between all people on the membership but no one person can claim more than the per person limit.
$500 per person up to $1000 per family -
PodiatryExcludes podiatric surgery.
$350 limit -
Remedial massageFamily limits are shared between all people on the membership but no one person can claim more than the per person limit.
$150 per person up to $300 per family
-
Yearly Dental limits explained
To reward our members' loyalty, we increase Dental benefit limits for the first 6 years of membership
$800 per person, first year
$1,600 per family, first year
$800 per person, second year
$1,600 per family, second year
$900 per person, third year
$1,800 per family, third year
$900 per person, fourth year
$1,800 per family, fourth year
$1,000 per person, fifth year
$2,000 per family, fifth year
$1,200 per person, sixth year
$2,400 per family, sixth year
Family limits are shared between all people on the membership but no one person can claim more than the per person limit
Set amounts per item
or 100% of the cost for selected services at our No Gap Dental Network
Up to 100% of the cost per item for orthodontics
A lifetime maximum of $2400 per person applies for orthodontics -
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. Family limits are shared between all people on the membership but no one person can claim more than the per person limit.
$800 per person up to a maximum of $1600 per family for the first year combined limit with general dental, preventative dental, root canal, gum disease treatments & surgical extractions, crowns, bridges & dentures, and orthodontics -
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
Family limits are shared between all people on the membership but no one person can claim more than the per person limit.
$800 per person up to a maximum of $1600 per family for the first year combined limit with No Gap Dental Network, general dental, root canal, gum disease treatments & surgical extractions, crowns, bridges & dentures, and orthodontics -
General dentalCovers most fillings and simple extractions.
Family limits are shared between all people on the membership but no one person can claim more than the per person limit.
$800 per person up to a maximum of $1600 per family for the first year combined limit with No Gap Dental Network, preventative dental, root canal, gum disease treatments & surgical extractions, crowns, bridges & dentures, and orthodontics -
Root canal, gum disease treatments & surgical extractions
$800 per person up to a maximum of $1600 per family for the first year combined limit with No Gap Dental Network, general dental, preventative dental, crowns, bridges & dentures, and orthodontics -
Crowns, bridges and denturesA full denture replacement is limited to once every three years.
Family limits are shared between all people on the membership but no one person can claim more than the per person limit.
$800 per person up to a maximum of $1600 per family for the first year combined limit with No Gap Dental Network, general dental, preventative dental, root canal, gum disease treatments & surgical extractions, and orthodontics -
OrthodonticsFamily limits are shared between all people on the membership but no one person can claim more than the per person limit.
$800 per person up to a maximum of $1600 per family for the first year combined limit with No Gap Dental Network, general dental, preventative dental, root canal, gum disease treatments & surgical extractions, and crowns, bridges & dentures A lifetime maximum of $2400 per person applies.
-
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 ante-natal classes conducted by a private midwife or physiotherapist
$500 combined limit with myotherapy and exercise physiology -
Myotherapy & exercise physiology
$500 combined limit with physiotherapy -
Chiropractic & osteopathyLimit of one chiropractic x-ray per person.
Family limits are shared between all people on the membership but no one person can claim more than the per person limit.
$500 per person up to $1000 per family -
PodiatryExcludes podiatric surgery.
$350 limit -
Orthotics, splints & bracesOrthotics must be recommended by a podiatrist or medical practitioner and supplied by an approved provider in a private practice.
Braces and splints must be recommended by a podiatrist, physiotherapist or medical practitioner and supplied by an approved provider in a private practice.
$300 combined limit
-
Remedial massageFamily limits are shared between all people on the membership but no one person can claim more than the per person limit.
$150 per person up to $300 per family -
Acupuncture
$350 limit -
Dietetics
$350 limit -
PsychologyFamily limits are shared between all people on the membership but no one person can claim more than the per person limit.
$400 per person up to $800 per family -
Speech, eye & occupational therapy
$350 combined limit -
PharmacyFor non-PBS prescription pharmaceuticals only, after you pay a sum equal to the current Pharmaceutical Benefits Scheme (PBS) charge.
Excludes vitamins, minerals and supplements.
$500 limit -
Travel vaccinationsFor approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel.
$150 limit -
Asthma pumps & peak flow metersBenefit for each item is payable every 2 calendar years
Combined limit of $110 -
Blood glucose monitors & blood pressure monitors
Combined limit of $220 -
Hearing aidsIncludes hearing aid appliance, replacement and repairs.
Benefit for each item is payable every 3 calendar years (does not apply to repairs).
$550 limit -
Non-surgical prosthesesBenefit for each item is payable every 2 calendar years (does not apply to wigs).
Combined limit of $500 -
Sickness travel & accommodationWhere the minimum return distance is 200km and treatment is certified as necessary by a medical practitioner.
Valid receipts must be submitted for payment of benefits
$120 per membership for travel. $250 per membership for accommodation
Advanced Hospital (Silver Plus) and Advanced 80% Extras
$30890*
A higher level option, perfect for those who are starting or growing their family. Our highest level of extras cover to help with the cost of looking after your health. Get 80% back on an extensive range of extras up to yearly and lifetime limits.
View ProductKey Hospital benefits+
-
Tonsils, adenoids and grommets
Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.
-
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. -
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. -
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. -
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.
-
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. -
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.
-
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. -
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. -
Dialysis for chronic kidney failure
Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis. -
Pregnancy and birth
Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.
Treatment for the baby is covered under the clinical category relevant to their condition (provided your baby is included under your cover). For example, respiratory conditions are covered under lung and chest.
Female reproductive conditions are listed separately under gynaecology.
Fertility treatments are listed separately under assisted reproductive services.
Miscarriage and termination of pregnancy is listed separately under miscarriage and termination of pregnancy. -
Weight loss surgery
Hospital treatment for surgery that is designed to reduce a person's weight, remove excess skin due to weight loss and reversal of a bariatric procedure.
For example: gastric banding, gastric bypass, sleeve gastrectomy.
-
No Gap Dental NetworkNo Gap Dental covers selected services such as scale and clean, fluoride treatment and mouthguards.
Please note: No Gap Dental providers are not available in all states and territories.
Unlimited -
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
Unlimited -
General dentalCovers most fillings and simple extractions.
$1,000 limit -
Root canal, gum disease treatments & surgical extractions
$500 limit -
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.
$300 limit -
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$600 limit -
Chiropractic & osteopathy
$500 combined limit -
PodiatryExcludes podiatric surgery.
$600 combined limit with orthotics
-
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.
Unlimited -
Preventative dentalCovers selected services such as scale and clean, fluoride treatment and mouthguards.
Unlimited -
General dentalCovers most fillings and simple extractions.
$1,000 limit -
Root canal, gum disease treatments & surgical extractions
$500 limit -
Crowns, bridges and denturesA full denture replacement is limited to once every three years.
$800 limit. -
Orthodontics
$800 limit. A lifetime maximum of $2,400 per person applies.
-
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.
$300 limit
-
PhysiotherapyIncluding sports physiotherapy and hydrotherapy.
$600 limit -
Chiropractic & osteopathy
$500 combined limit -
Natural therapies
Myotherapy, acupuncture, remedial massage & Chinese medicineCombined limit of $400. Remedial massage sub-limit is $200 -
PodiatryExcludes podiatric surgery.
$600 combined limit with orthotics -
OrthoticsAppliances must be recommended by a podiatrist or medical practitioner and supplied by an approved provider in a private practice.
$600 combined limit with podiatry
-
Audiology, speech, eye & occupational therapy
$600 combined limit -
Dietetics
$600 limit -
Psychology
$600 limit -
PharmacyFor non-PBS prescription pharmaceuticals only, after you pay a sum equal to the current Pharmaceutical Benefits Scheme (PBS) charge.
Excludes vitamins, minerals and supplements.
$600 combined limit with travel vaccinations -
Travel vaccinationsFor approved travel vaccines, supplied and administered in Australia prior to departure and for the purpose of overseas travel.
$600 combined limit with pharmacy -
Hearing aidsBenefit for each item is payable every 3 calendar years (does not apply to repairs).
$600 combined limit with health aids & health devices -
Health aidsFor hire or purchase of wheelchairs or crutches used in prevention or support post injury when recommended by a healthcare practitioner.
And for braces, splints, garments and non-surgical prostheses when recommended by a healthcare practitioner.
Benefit for each non-surgical prosthesis is payable every 2 calendar years (does not apply to wigs).
$600 combined limit with hearing aids & health devices -
Health devicesIncludes: C-PAP/B-PAP, TENS machines, Asthma Pump, Nebulisers, Oral Device for Sleep Apnoea, Peak Flow Meters, Blood Glucose and Blood Pressure Monitors.
Benefit for selected items is payable every 2 calendar years.
$600 combined limit with hearing aids & health aids
Understanding your Hospital Cover
Understanding your Extras Cover
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.
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.
Why choose Australian Unity?
You choose who you see#
With choice of provider, you can get treated by any health provider who is in private practice and is recognised by Australian Unity.
Read moreNo 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 moreGet 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.