The following services are not covered under our Extras cover policies:
- Any purported Extras (general treatment) service or circumstances of provision which does not meet the requirements or standards legislated under the Private Health Insurance Act (2007).
- Any treatment or service which is not specifically listed as "included" in an Extras policy
- Any treatment or service provided outside Australia
- Any treatment or service where a patient has the right to claim costs from a third party (e.g., another private health insurer, workers compensation or motor vehicle insurance)
- Treatment or services by a provider who is not recognised by HIF.
When will benefits for covered services not be paid?
Benefits will not be paid in the following situations:
- Your policy is not financial (e.g., in arrears and or suspended) when benefit is claimed
- The claim is for a service provided more than two years ago
- The provider of the treatment or service is not recognised such as trainee providers
- Any treatment, service or item which is not listed as Included on a policy
- Any amount in excess of the maximum claimable limit or sub-limit for that service and applicable per policy or person covered
- Any treatment, service or item provided within a Waiting Period or prior to joining HIF (e.g., Orthodontic treatment)
- The service has already been claimed from another insurer or where another insurer or 3rd party has a liability to cover that service.