- Has restrictions and exclusions.
- $500 excess per adult on the policy.
- Treatment in a private hospital for medically necessary treatment (restrictions and exclusions apply).
- 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 an excess of $500 to keep premium costs lower.
- The excess is payable by adults on the policy if they are admitted into hospital.
- 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 and earn less than $50,000 a year, 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
- Robotic surgery consumables.
For further information, please refer to the Important Information Guide.
We pay the default benefit for accommodation as determined by the Government and no benefit for theatre fees on:
- Medically necessary plastic and reconstructive surgery
- Surgery by a podiatrist
- Psychiatric services
We pay no benefit on:
- Pregnancy and birth-related treatment
- Labour ward
- Sterility reversals
- Infertility investigations, assisted reproductive services
- Joint replacements and revisions
- Eye lens, glaucoma and macular degeneration treatment
- Dialysis for chronic kidney disease
- Gastric banding and bariatric/obesity surgery (incl. reversal)
- Newborn/neonatal care
- Spinal surgery/treatment and related admissions (except as the result of an accident)
- Cochlear implants, related admissions and replacements
- Insulin pumps, related admissions and replacements
- Robotic surgery.
For full information on services covered, benefits, limits, excesses, pre-existing condition rules and waiting periods, download the Budget Hospital brochure and read in conjunction with the Important Information Guide.
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