Top Silver Plus

Top Silver Plus
Silver +

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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Top Silver Plus Silver +

Still want extensive cover but don’t think you’ll need Hospital psychiatric services? Our Top Silver Plus product could be the one for you.

This product gives you a very high level of cover with only one restriction (Hospital psychiatric services) so you’ll be covered for a wide range of services including pregnancy, heart procedures, and hip or knee joint replacements.

Legend

Covered
Not Covered
Restricted

Scope of cover

Additional Information
Accommodation – shared and private room (where available)
Current
Theatre fees, intensive care fees
Current
Labour ward fees
Current
Shared room
Current
Private room (where available)
Current

Restricted Services

It’s important to understand what it means when a service is listed as ‘restricted’. Here is an overview of what we’ll pay for and what you you’ll have to pay for if going to hospital for treatment for a service that’s restricted:

In a public hospital:

  • We pay – accommodation in a shared room (as long as the hospital doesn’t charge above the default rate set out by the Federal Government), and medical costs.
  • You pay – any excess (if applicable), and any gap if your hospital charges above the default rate.

In a private hospital:

  • We pay – accommodation as if staying in a shared room (at the default rate set out by the Federal Government), and medical costs.
  • You pay – any excess (if applicable) and the balance of accommodation costs, plus any theatre costs. This could be costly, so ensure the hospital provides you with the potential costs upfront.

Either way, the hospital should let you know about any out-of-pocket expenses you’ll need to pay. This is called informed financial consent.

 

Waiting Periods

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