Changes to Basic Hospital

Changes to Basic Hospital

Your 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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What's changed?

As part of the private health insurance reforms, all health funds have 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 our Basic Hospital cover 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’ve increased cover for some services.
  • In the case where premiums would be significantly impacted, we’ve 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, it’ll now be called Basic Hospital (Basic Plus).

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.
Current
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
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1 April 2019
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1 April 2019
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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
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1 April 2019
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1 April 2019
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1 April 2019
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1 April 2019
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1 April 2019
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1 April 2019
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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
Current
1 April 2019
Labour ward fees
Current
1 April 2019
Choice of doctor
Current
1 April 2019
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1 April 2019
Shared room
Current
1 April 2019
Private room (where available)
Current
1 April 2019
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1 April 2019
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1 April 2019
Fees are included in accommodation charges.
Current
1 April 2019
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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.

Learn more about the clinical categories

What does the Basic Plus tier mean?

‘Plus’ means your cover includes more than the minimum requirement for the Basic tier. Our Basic Hospital, Mid Hospital and Starterpak cover all fit into the Basic Plus tier, but they’re not the same. It’s wise to double check what is and included on your cover from time to time, to make sure it’s still right for you.