Top Hospital Gold
Upcoming product changes
Please note from 1 December 2019, the name of Top Hospital (Gold) will change to Top Silver Plus and cover for Hospital psychiatric services will be classed as restricted.
This means the product will no longer cover Hospital psychiatric services in a private hospital. As a restricted service, the product will continue to cover treatment in a public hospital as a private patient (at the default shared room rate set out by the Federal Government).
Scope of cover
Like all health funds, waiting periods may apply when you take out your cover.
You may have to wait if:
- You’re new to private health insurance
- You upgrade your cover to include things that weren’t covered before
- You switch health funds and increase your cover to include things that weren’t covered before.
If you’ve cancelled your membership with another health fund, you’ll need to join us within 60 days to keep up your continuity of cover and not re-serve any applicable waiting periods.
Hospital Waiting Periods
|Pre-existing conditions*||12 months|
|Pregnancy & birth related services||9 months|
|Psychiatric, rehabilitation and palliative care||2 months|
|All other hospital services||2 months|
|Emergency ambulance transport||1 day|
|Non-emergency ambulance transport||1 day|
*A pre-existing condition is an illness, ailment or condition where the signs or symptoms of which, in the opinion of the Fund Medical Advisor or other relevant medical practitioner appointed by Nurses & Midwives Health, existed at any time during the six months before taking out private health insurance or transferring to a higher level of cover. This rule applies to new members to private health insurance and existing members who are upgrading their level of cover. If you are a new member to private health insurance you will have to wait 12 months before you can receive benefits for items or services related to a pre-existing condition. If you change to a higher level of cover, you may have to wait 12 months to receive benefits, including benefits for services not previously covered. A 12 month waiting period applies to all pre-existing conditions except pregnancy & birth related services, which is a 9 month waiting period and psychiatric, palliative care and rehabilitation, which is a two month waiting period.