Changes to Mid Hospital

Changes to Mid Hospital

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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 Mid 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’re required to include the new product tier in the name, so it’ll now be called Mid Hospital (Basic Plus).

Mid Hospital Basic +

Legend

Covered
Not Covered
Restricted

Scope of cover

Additional Information
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Increased cover: Major eye and eye lens surgery were previously Restricted. From 1 April 2019, these services will be Covered.
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Detrimental change: Hospital admissions for vascular system are changing from Covered to Restricted. This is because of the new clinical categories - Heart and Vascular system are grouped together. If we had chosen to cover this service, it would have had a significant impact on premiums.
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Accommodation – shared and private room (where available)
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Theatre fees, intensive care fees
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Labour ward fees
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Choice of doctor
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Shared room
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Private room (where available)
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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.