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.
- In the case where premiums would be significantly impacted, we have decreased cover.
- We’ve also addressed the issue of affordability by removing cover for insulin pumps, which has a costly impact on premiums each year.
- We’re required to include the new product tier in the name. As this product exceeds the minimum requirement for the ‘Basic’ tier, from now on we’ll refer to this product as ‘Basic Hospital (Basic Plus)’.
Upgrade without waiting periods
If the services that are 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 Mid Hospital (Basic 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.
Basic Hospital Basic +
Scope of cover
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.