Changes to your StarterPak Cover

Changes to your StarterPak Cover

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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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.
  • Where premiums would be significantly impacted, we have decreased cover.
  • We’re required to include the new product tier in the name. This product exceeds the minimum requirements for the ‘Basic’ tier so from now on we’ll refer to this product as StarterPak (Basic Plus).

Upgrade without waiting periods

If the services 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 Basic Hospital (Basic Plus), 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.

StarterPak 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. From 1 April 2019, grommets will be covered in a private hospital.
Current
1 April 2019
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1 April 2019
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1 April 2019
Detrimental change: Hospital admissions 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
Current
1 April 2019
Increased cover: Major eye and eye lens surgery is currently not covered under StarterPak. From 1 April 2019, these services will be covered in a public 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
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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
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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: Vascular system is currently Restricted, and from 1 April 2019 it will be Excluded. There’s no change in your cover for Heart-related services – this was already Excluded.
Current
1 April 2019
Detrimental change: Insulin pumps will no longer be covered on StarterPak. If this is something that is important to you, we have a range of alternate options that cover insulin pumps.
Current
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
Theatre fees, intensive care fees
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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
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1 April 2019
Labour ward fees (StarterPak)
Current
1 April 2019
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1 April 2019
No changes
Current
1 April 2019
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1 April 2019
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1 April 2019

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.

Extras

You’ll have a higher annual limit for Physio, Chiro, Osteo and Exercise Physiology


We’re increasing the combined annual limit from $300 per person to $400 per person (maximum $800 per couple / family).

We’re required to remove some Natural Therapies

Due to the Federal Government’s Private Health Insurance Reforms, health funds are no longer permitted to cover some natural therapy services from 1 April 2019.

See below for information on what will be removed and what will still be covered after 1 April 2019.

If you claim for a service that will be removed, we encourage you to make the most of your benefits while they’re available. The service must be provided by 31 March 2019, but you can submit your claim up to two years after the service date.

Natural Therapies

Removed:

  • Alexander technique
  • Aromatherapy
  • Bowen therapy
  • Buteyko
  • Feldenkrais
  • Homeopathy
  • Kinesiology
  • Naturopathy
  • Reflexology
  • Shiatsu
  • Western herbal medicine

You can still use your Natural Therapies limit to claim for:

  • Remedial massage
  • Acupuncture
  • Chinese herbal medicine consultations
  • Myotherapy

Healthy lifestyle

Removed:

  • Pilates (including Pilates classes run by a physiotherapist or exercise physiologist)
  • Yoga

You can still use your Healthy Lifestyle limit to claim for:

  • Gym membership*
  • Recognised weight management programs*^
  • Disease management subscriptions/memberships
  • Recognised health screening services/preventative screenings (where a Medicare benefit is not payable)