Frequently Asked Questions

Frequently Asked Questions

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* Based on an Australian Government Rebate of %, % LHC loading, $ excess for a in . Please note that our prices will increase from 1 April

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What will happen to my current cover?

As always, our focus is what’s best for members and providing value for money health insurance.

We’re reviewing all our Hospital and Extras covers to make sure they align with the new rules. There are some changes that we’re required to implement, and we’re also working hard to ensure we can offset as many changes as we can with benefit improvements.


When will I know about changes to my cover?

We’ll be communicating any changes to members as soon as we can – you’ll receive an email or letter from us communicating any direct changes to your cover. Our website will also be regularly updated with all the latest information.


How will the changes affect my health insurance premium?

We know you want to find out as soon as possible, but we’re not able to calculate new premiums until they are approved by the Health Minister.

The premium review process is overseen by the Australian Government and all premium increases require approval from the Health Minister. Until these are approved, we can't notify members.

Even once we get approval, we will need to complete updates to our system and then wait until the new rebate is announced at the start of February, as this will impact the price you need to pay.

But rest assured, we’ll do our best to get your premiums to you as soon as we can.


What’s changing with Hospital covers?

There are two key changes that will impact members – standard clinical categories and Gold/Silver/Bronze/Basic product categories.

Standard Clinical Categories

To make it easier for members to understand their cover, the Government is introducing standard clinical categories on 1 April. Each clinical category has a defined scope of cover, and a list of treatments that are included.

View the categories here.

Gold, Silver, Bronze, Basic product categories

All hospital products will be classified into one of the following categories: Gold, Silver, Bronze or Basic. For each category, there are a minimum number of clinical categories that must be covered. This means that some current products will have to change to be able to fit into one of the prescribed categories. A significant majority of our members won’t be affected by this, but for those who are, we’ll inform them directly as soon as the changes are confirmed.

More information can be found here. 


What’s happening with Natural Therapies?

The outcome of a review by the Australian Government means that health insurers can no longer pay a benefit for some natural therapies from 1 April 2019.

The positive news is that we can still cover remedial massage, myotherapy, Chinese herbal medicine consultations and acupuncture, which are the most common services that members claim for.

The list of excluded therapies is:

  • Alexander technique
  • Aromatherapy
  • Bowen Therapy
  • Butekyo
  • Feldenkrais
  • Western herbalism
  • Homeopathy
  • Iridology
  • Kinesiology
  • Naturopathy
  • Pilates
  • Reflexology
  • Rolfing
  • Shiatsu
  • Tai chi
  • Yoga

While only a small percentage of our members claim for these services, that still matters to us. So we’re doing what we can to give back to you – we’re investing any savings from the removal of these therapies into benefit improvements.

Read more about the removal of some natural therapies here.


Will you offer travel and accommodation benefits as part of your hospital cover?

Members on Top Extras cover can already claim a travel benefit (for medically necessary trips over 200km return).

In addition, members in remote and rural areas may be eligible for a Government subsidy:


Patient Transport Assistance Contacts

ACT Interstate Patients’ Travel Assistance Scheme (iptas)
Phone: 02 6205 5868

NSW Isolated Patients’ Travel and Accommodation Scheme (iptaas)
Phone: 1800 478 227

Northern Territory Escorts for Patient Travel (pats)
Phone: 08 8922 8235

Queensland Patient Travel Subsidy Scheme (ptss)
Phone: 13 43 25 84

SA Patient Assistance Transport Scheme (pats)
Phone: 1800 188 115

Tasmanian Patient Travel Assistance Scheme (ptas)
Royal Hobart Hospital Phone: 03 6222 8225
Launceston General Hospital Phone: 03 6348 7249
North West Regional Hospital Phone: 03 6430 3673

Victorian Patient Transport Assistance Scheme (vptas)
Phone: 1300 737 073