Yes, we absolutely pay benefits towards a vasectomy. Whether it’s something you’re considering for personal or medical reasons, this service is included on our Bronze, Bronze Plus, Silver, Gold and GoldStar Hospital Cover policies.
Who covers what?
Provided you’re treated as an inpatient at a contracted day facility or hospital you would certainly be entitled to claim a benefit from both HIF and Medicare. If you’re treated as an outpatient however, then a benefit from Medicare would only apply.
How much is covered?
The benefit that HIF is allowed to pay towards a vasectomy and any other type of surgery/treatment is based on the Government’s Medicare Benefit Schedule (MBS). Medicare will pay 75% of the doctors’ fee up to their pre-defined limit, then we would cover the remaining 25%. So, any out-of-pocket expenses would depend on how much your specialist is charging for their services.
That’s why, we always advise our Members to provide HIF with an itemised medical estimate prior to any treatment. That way, we'll be able to confirm how much you can claim back and ensure any out-of-pockets are kept to a minimum. To obtain a medical estimate, simply ask your doctor or specialist prior to proceeding with any treatment.
Are there any waiting periods?
We always try to keep waiting periods to an absolute minimum. So, if you join us from another health fund, we’ll take your previous policy into account, so you won’t have to re-serve any waiting periods already served.
If you’re new to private health insurance the following waiting periods apply for a vasectomy:
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