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Emergency ambulance Emergency ambulance refers to the cost of emergency ambulance transport and emergency treatment by paramedics. Benefit: 100% for one emergency ambulance service per person Annual Limit per person: Unlimited Annual Limit per policy: Unlimited Waiting Period: 1 day Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat). | Included | Included | Included | Included | Included | Included |
Non-emergency ambulance Non-emergency ambulance refers to the cost of non-emergency ambulance transport and treatment by paramedics. Benefit: 100% of the fee for each non-emergency ambulance service. A $50 per trip co-payment (to be paid by the member) will apply. Annual Limit per person: Unlimited Annual Limit per policy: Unlimited Waiting Period: 30 days Not covered:
- Transportation from a hospital to your home, nursing home or other hospital.
- Transportation for ongoing medical treatment.
- Off road or air ambulance (e.g. plane, helicopter or boat). | Included | Included | Included | Included | Included | Included |
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Public hospital - shared room This provides cover for the cost of a shared room in a public hospital anywhere in Australia. | Included | Included | Included | Included | Included | Included |
Private hospital - shared room This provides cover for the cost of a shared room in an HIF-contracted private hospital anywhere in Australia. | Included | Included | Included | Included | Included | Included |
Private hospital - private room This provides cover for the cost of a private room in an HIF-contracted private hospital anywhere in Australia. (Subject to availability of private room) | Included | Included | Included | Included | Included | Included |
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Rehabilitation Hospital treatment for physical rehabilitation for a patient related to surgery or illness.
For example: inpatient and admitted day patient rehabilitation, stroke recovery, cardiac rehabilitation. Waiting Period: 2 months | Restricted | Restricted | Restricted | Included | Included | Included |
Hospital psychiatric services Hospital treatment for the treatment and care of patients with psychiatric, mental, addiction or behavioural disorders.
For example: psychoses such as schizophrenia, mood disorders such as depression, eating disorders and addiction therapy. Waiting Period: 2 months | Restricted | Restricted | Restricted | Restricted | Restricted | Included |
Palliative care Hospital treatment for care where the intent is primarily providing quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain. Waiting Period: 2 months | Restricted | Restricted | Restricted | Included | Included | Included |
Brain and nervous system Hospital treatment for the investigation and treatment of the brain, brain-related conditions, spinal cord and peripheral nervous system.
For example: stroke, brain or spinal cord tumours, head injuries, epilepsy and Parkinson’s disease.
Treatment of spinal column (back bone) conditions is listed separately under Back, neck and spine.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Eye (not cataracts) Hospital treatment for the investigation and treatment of the eye and the contents of the eye socket.
For example: retinal detachment, tear duct conditions, eye infections and medically managed trauma to the eye.
Cataract procedures are listed separately under Cataracts.
Eyelid procedures are listed separately under Plastic and reconstructive surgery.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Ear, nose and throat Hospital treatment for the investigation and treatment of the ear, nose, throat, middle ear, thyroid, parathyroid, larynx, lymph nodes and related areas of the head and neck.
For example: damaged ear drum, sinus surgery, removal of foreign bodies, stapedectomy and throat cancer.
Tonsils, adenoids and grommets are listed separately under Tonsils, adenoids and grommets.
The implantation of a hearing device is listed separately under Implantation of hearing devices.
Orthopaedic neck conditions are listed separately under Back, neck and spine.
Sleep studies are listed separately under Sleep studies
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Tonsils, adenoids and grommets Hospital treatment of the tonsils, adenoids and insertion or removal of grommets. Waiting Period: 2 months (12 months for pre-existing conditions) | Included | Included | Included | Included | Included | Included |
Bone, joint and muscle Hospital treatment for the investigation and treatment of diseases, disorders and injuries of the musculoskeletal system.
For example: carpal tunnel, fractures, hand surgery, joint fusion, bone spurs, osteomyelitis and bone cancer.
Chest surgery is listed separately under Lung and chest.
Spinal cord conditions are listed separately under Brain and nervous system.
Spinal column conditions are listed separately under Back, neck and spine.
Joint reconstructions are listed separately under Joint reconstructions.
Joint replacements are listed separately under Joint replacements.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).
Management of back pain is listed separately under Pain management. Pain management that requires a device is listed separately under Pain management with device.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Joint reconstructions Hospital treatment for surgery for joint reconstructions.
For example: torn tendons, rotator cuff tears and damaged ligaments.
Joint replacements are listed separately under Joint replacements.
Bone fractures are listed separately under Bone, joint and muscle.
Procedures to the spinal column are listed separately under Back, neck and spine.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon). Waiting Period: 2 months (12 months for pre-existing conditions) | Included | Included | Included | Included | Included | Included |
Kidney and bladder Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.
For example: kidney stones, adrenal gland tumour and incontinence.
Dialysis is listed separately under Dialysis for chronic kidney failure.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Male reproductive system Hospital treatment for the investigation and treatment of the male reproductive system including the prostate.
For example: male sterilisation, circumcision and prostate cancer.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Digestive system Hospital treatment for the investigation and treatment of the digestive system, including the oesophagus, stomach, gall bladder, pancreas, spleen, liver and bowel.
For example: oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids.
Endoscopy is listed separately under Gastrointestinal endoscopy.
Hernia and appendicectomy procedures are listed separately under Hernia and appendix.
Bariatric surgery is listed separately under Weight loss surgery.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Hernia and appendix Hospital treatment for the investigation and treatment of a hernia or appendicitis.
Digestive conditions are listed separately under Digestive system. Waiting Period: 2 months (12 months for pre-existing conditions) | Included | Included | Included | Included | Included | Included |
Gastrointestinal endoscopy Hospital treatment for the diagnosis, investigation and treatment of the internal parts of the gastrointestinal system using an endoscope.
For example: colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP).
Non-endoscopic procedures for the digestive system are listed separately under Digestive system. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Gynaecology Hospital treatment for the investigation and treatment of the female reproductive system.
For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.
Fertility treatments are listed separately under Assisted reproductive services.
Pregnancy and birth-related conditions are listed separately under Pregnancy and birth.
Miscarriage or termination of pregnancy is listed separately under Miscarriage and termination of pregnancy.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Miscarriage and termination of pregnancy Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Chemotherapy, radiotherapy and immunotherapy for cancer Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours. Surgical treatment of cancer is listed separately under each body system. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Pain management Hospital treatment for pain management that does not require the insertion or surgical management of a device.
For example: treatment of nerve pain and chest pain due to cancer by injection of a nerve block.
Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under Pain management with device. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Skin Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included.
For example: melanoma, minor wound repair and abscesses.
Removal of excess skin due to weight loss is listed separately under Weight loss surgery.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Breast surgery (medically necessary) Hospital treatment for the investigation and treatment of breast disorders and associated lymph nodes, and reconstruction and/or reduction following breast surgery or a preventative mastectomy.
For example: breast lesions, breast tumours, asymmetry due to breast cancer surgery, and gynecomastia.
This clinical category does not require benefits to be paid for cosmetic breast surgery that is not medically necessary.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Diabetes management (excluding insulin pumps) Hospital treatment for the investigation and management of diabetes.
For example: stabilisation of hypo- or hyper- glycaemia, contour problems due to insulin injections.
Treatment for diabetes-related conditions is listed separately under each body system affected. For example, treatment for diabetes-related eye conditions is listed separately under Eye.
Treatment for ulcers is listed separately under Skin.
Provision and replacement of insulin pumps is listed separately under Insulin pumps. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Included | Included | Included | Included | Included |
Heart and vascular system Hospital treatment for the investigation and treatment of the heart, heart-related conditions and vascular system.
For example: heart failure and heart attack, monitoring of heart conditions, varicose veins and removal of plaque from arterial walls.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Included | Included | Included |
Lung and chest Hospital treatment for the investigation and treatment of the lungs, lung-related conditions, mediastinum and chest.
For example: lung cancer, respiratory disorders such as asthma, pneumonia, and treatment of trauma to the chest.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Included | Included | Included | Included |
Blood Hospital treatment for the investigation and treatment of blood and blood-related conditions.
For example: blood clotting disorders and bone marrow transplants.
Treatment for cancers of the blood is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Included | Included | Included | Included |
Back, neck and spine Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion.
For example: sciatica, prolapsed or herniated disc, and spine curvature disorders such as scoliosis, kyphosis and lordosis.
Joint replacements are listed separately under Joint replacements.
Joint fusions are listed separately under Bone, joint and muscle.
Spinal cord conditions are listed separately under Brain and nervous system.
Management of back pain is listed separately under Pain management. Pain management that requires a device is listed separately under Pain management with device.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Included | Included | Included |
Plastic and reconstructive surgery (medically necessary) Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or accident or congenital.
For example: burns requiring a graft, cleft palate, club foot and angioma.
Plastic surgery that is medically necessary relating to the treatment of a skin-related condition is listed separately under Skin.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Included | Included | Included |
Dental surgery Hospital treatment for surgery to the teeth and gums. For example: surgery to remove wisdom teeth, and dental implant surgery.
Waiting Period: 2 months (12 months for pre-existing conditions) Please note: If you undergo surgery by a recognised dentist in a hospital, you may be able to claim benefits for theatre, accommodation and anaesthetist costs. Benefits towards your dentist's fees will only be paid if you also hold a suitable Extras product and have served all relevant waiting periods in addition to your Hospital cover. | Not Included | Not Included | Included | Included | Included | Included |
Podiatric surgery Hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon, but limited to cover for: - accommodation; and
- the cost of a prosthesis as listed in the prostheses list set out in the Private Health Insurance (Prostheses) Rules, as in force from time to time.
Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Included | Included | Included | Included |
Implantation of hearing devices Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.
Stapedectomy is listed separately under Ear, nose and throat. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Included | Included | Included | Included |
Cataracts Hospital treatment for surgery to remove a cataract and replace with an artificial lens. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Not Included | Included | Included |
Joint replacements Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of prostheses.
For example: replacement of shoulder, wrist, finger, hip, knee, ankle, or toe joint, spinal disc replacement.
Joint fusions are listed separately under Bone, joint and muscle.
Spinal fusions are listed separately under Back, neck and spine
Joint reconstructions are listed separately under Joint reconstructions.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon). Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Not Included | Included | Included |
Dialysis for chronic kidney failure Hospital treatment for dialysis treatment for chronic kidney failure.
For example: peritoneal dialysis and haemodialysis. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Not Included | Included | Included |
Pregnancy and birth Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth. Treatment for the baby is covered under the clinical category relevant to their condition.
For example, respiratory conditions are covered under Lung and chest.
Female reproductive conditions are listed separately under Gynaecology.
Fertility treatments are listed separately under Assisted reproductive services.
Miscarriage and termination of pregnancy is listed separately under Miscarriage and termination of pregnancy. Waiting Period: 12 months | Not Included | Not Included | Not Included | Not Included | Not Included | Included |
Assisted reproductive services Hospital treatment for fertility treatments or procedures.
For example: retrieval of eggs or sperm, In vitro Fertilisation (IVF), and Gamete Intra-fallopian Transfer (GIFT).
Treatment of the female reproductive system is listed separately under Gynaecology.
Pregnancy and birth-related services are listed separately under Pregnancy and birth. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Not Included | Not Included | Included |
Weight loss surgery Hospital treatment for surgery that is designed to reduce a person’s weight, remove excess skin due to weight loss and reversal of a bariatric procedure.
For example: gastric banding, gastric bypass, sleeve gastrectomy. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Not Included | Not Included | Included |
Insulin pumps Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Not Included | Included | Included |
Pain management with device Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain.
For example: treatment of nerve pain, back pain, and pain caused by coronary heart disease with a device (for example an infusion pump or neurostimulator).
Treatment of pain that does not require a device is listed separately under Pain management. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Not Included | Included | Included |
Sleep studies Hospital treatment for the investigation of sleep patterns and anomalies.
For example: sleep apnoea and snoring. Waiting Period: 2 months (12 months for pre-existing conditions) | Not Included | Not Included | Not Included | Included | Included | Included |
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Choice of hospital excess On all Hospital covers, members can select from a range of excess options to reduce their premium. Please refer to the individual product factsheets for more details on the excesses that apply. | Included | Included | Included | Included | Included | Included |
HIF Second Opinion HIF Second Opinion is a service for HIF members with Silver Plus or Gold Top Hospital and/or Top Extras cover. It gives you access to the Teladoc Health network of the world's leading medical specialists, enabling you to get a second opinion on any diagnosis, condition or treatment. Plus, eligible HIF members get access to the Teladoc Health online medical advice portal, giving you the opportunity to submit questions to a panel of experienced Australian GPs, access expert insights and use their online symptom checker. | Not Included | Not Included | Not Included | Not Included | Included | Included |
AccessGap Cover Did you know... doctors can charge more than the Medicare Benefits Schedule (MBS)? And if they do, their patients will incur an out of pocket expense for the difference between the fee charged and the MBS. The good news is that HIF’s medical gap cover arrangement, AccessGap, is designed to minimise or eliminate these out of pocket expenses for inpatient medical services in a registered overnight hospital or day facility. | Included | Included | Included | Included | Included | Included |
Mental Health Navigator Mental Health Navigator is a discreet, quick and confidential service (for HIF members 18 years and over) that provides an expert review of your mental health diagnosis plus and ongoing treatment plan with support. It provides access to a network of leading Australian-based clinical psychologists, psychiatrists and mental health nurses who will review your current condition (and when needed) modify your diagnosis. | Included | Included | Included | Included | Included | Included |