If your Doctor or Specialist deems your weight loss surgery to be medically necessary, you may be eligible to claim a benefit from HIF. If it's classified as cosmetic however, benefits won't be payable.
In order for us to provide confirmation, please ensure that you meet the requirements outlined below and also complete our Medical Estimate Form so a member of our team can check your eligibility
Eligibility requirements for weight loss surgery:
- You must hold one of our Gold Hospital Covers.
- Medicare must deem your surgery to be medically necessary, in which case an Medicare Benefit Schedule item number will apply
- You must be treated as an inpatient. Please note, out of pockets may apply if treated in a HIF non-contracted hospital.
Please note: 2-month waiting period applies for new conditions and 12 months for pre-existing conditions. If you're switching from another health fund and 'Weight Loss Surgery' was included on your level of cover, any waiting periods you've already served will be honored. Continuity in cover will not be offered if the financial date paid to with the previous health insurer is greater than 2 months from the commencement date with HIF.
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