Does HIF cover Gender Affirmation Surgery?

HIF covers Gender Affirmation Surgery and will pay a benefit in instances where benefits are also payable by Medicare. HIF’s eligibility to cover Gender Affirmation Surgery will therefore depend on the treatment involved and the MBS item codesused for the inpatient admission. 

For example, if the patient is taking out private hospital coverfor the first time and they’re eligible to receive benefits for Gender Affirmation Surgery, a 12 month waiting periodwill apply. However, if the patient already holds an equivalent level of cover with another fund and switchesto HIF, we’ll automatically honour their length of membership and honour any waiting periods already served for Gender Affirmation Surgery procedures. 

Please note:  

• 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.  

• HIF does not offer an open Complying Hospital Product that provides a higher benefit for Psychiatric Care other than as a restricted benefit, as a result any hospital inpatient psychiatric services may incur significant out of pocket expense.  

• If the patient chooses a surgeon who has opted in to HIF’s ‘AccessGap’ arrangement, then the benefits payable will be higher due to theAccessGapCover ensuring no out-of-pocket or a reduced out-of-pocket experience. A full list of providers who have opted in for AccessGap is available on this webpage.