- Comprehensive hospital cover, with a $400 excess.
- Has restrictions and exclusions.
- Treatment in a private hospital for medically necessary treatment.
- Medicare covers 75% of the Medical Benefit Schedule (MBS) fee set by the Government for doctors’ charges and TUH covers the remaining 25%. Note that there may be extra for you to pay if your doctor charges over the MBS and does not participate in the Access Gap Cover Scheme.
- Accommodation, theatre fees, intensive care, cardiac care, industry approved prostheses and hospital medication in almost all private hospitals in Australia. Find out more
- This cover has a $400 excess to reduce premium costs.
- The excess is payable by adults on the policy if they are admitted to hospital (including same day surgery and procedures, such as chemotherapy and dialysis).
- The excess is only payable once per adult per calendar year.
- Covers single dependants until age 21, and full-time student dependants up to age 25.
- Non-student dependants who are single can stay on your policy as an extended dependant until the age of 25 for an additional premium loading.
What’s not included?
- Hospital treatment that is not medically necessary or treatment which is not eligible for Medicare benefits;
- GP visits or other specialist appointments before you are admitted or after you are discharged from hospital;
- Gap fees charged by specialists over the Medicare Benefits Schedule;
- Experimental procedures/therapies;
- High-cost medications; and
- Robotic surgery consumables.
We pay the default benefit for accommodation as determined by the Government and no benefit for theatre fees for:
We pay no benefit for:
- Congenital defects and conditions
- Newborn/neonatal care
- Pregnancy and birth-related
- Labour ward
- Infertility investigations, assisted reproductive services
- Gastric banding and bariatric/obesity surgery, including reversal
For full information on included services, benefits, limits, excesses, pre-existing condition rules and waiting periods, download the guide below and read in conjunction with the Important Information Guide.
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