Changes to your Basic Hospital Cover

Changes to your Basic Hospital Cover

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* Based on an Australian Government Rebate of %, % LHC loading, $ excess for a in . Please note that our prices will increase from 1 April

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Effective 1 April 2019

As part of the Federal Government’s Private Health Insurance Reforms, all health funds are required to align their hospital products to new Standard Clinical Categories and Gold/Silver/Bronze/Basic product tiers.

Each Standard Clinical Category has a defined list of services that are covered. While most of your current cover has directly matched the new categories, in some cases we’ve had to add or remove services to fit the new structure.

  • Where financially viable, we have increased cover for some services.
  • In the case where premiums would be significantly impacted, we have decreased cover.
  • We’ve also addressed the issue of affordability by removing cover for insulin pumps, which has a costly impact on premiums each year.
  • We’re required to include the new product tier in the name. As this product exceeds the minimum requirement for the ‘Basic’ tier, from now on we’ll refer to this product as ‘Basic Hospital (Basic Plus)’.

Upgrade without waiting periods

If the services that are being removed are important to you, you may want to upgrade your cover.

To help make the process easier, we’re waiving all hospital waiting periods if you upgrade to Mid Hospital (Basic Plus) or Mid Classic (Silver Plus) by 1 May 2019!

The upgrade waiver offer applies only to members who have held their current level of hospital cover for at least 12 months. If you’ve held your current level of hospital cover for less than 12 months, waiting periods may apply if you upgrade.

Basic Hospital Basic +

Legend

Covered
Not Covered
Restricted

Scope of cover

Additional Information
Current
1 April 2019
Increased cover: you are currently covered for Wisdom teeth in a private hospital. From 1 April, you will be covered in a private hospital for all services that fall under Dental Surgery.
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1 April 2019
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1 April 2019
Increased cover: You currently have private hospital cover for knee and shoulder reconstructions. From 1 April 2019, we'll cover all other joint reconstructions (e.g. ankle, wrist, hip) in a private hospital.
Current
1 April 2019
Increased cover: You currently have public hospital cover for grommets and from 1 April 2019, they will be covered in a private hospital.
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1 April 2019
Detrimental change: The benefits for shoulder and knee arthroscopes are changing from Covered to Restricted. If you choose to go to a private hospital you will have significant out-of-pocket expenses.
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1 April 2019
Detrimental change: Insulin pumps will no longer be covered on Basic Hospital. If this is something that is important to you, we have a range of alternate options that cover insulin pumps.
Current
1 April 2019
Accommodation – shared and private room (where available)
Current
1 April 2019
Theatre fees, intensive care fees
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1 April 2019
Labour ward fees
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Choice of doctor
Current
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Shared room
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Private room (where available)
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Fees are included in accommodation charges.
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Note: Restricted cover - For restricted services provided in a public hospital, we pay for accommodation in a shared room (as long as the hospital doesn’t charge more than the default rate set out by the Federal Government), and medical costs.

For a definition of each clinical category, visit the Department of Health website.