Private Health Information Statement - Combined policy

Gold Hospital & Top Extras

Monthly Premium

$883.73 #

(before any rebate, loading or discount)

Covers two adults & dependants, including persons with a disability* (3 or more people, only 2 of whom are adults)

Available in Tasmania

Closed to new members

# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading or an insurer discount. Check with your insurer for details.

This policy covers children, students up to and including the age of 31 and non-students up to and including the age of 31, as well as persons with a disability.

* Participants in the National Disability Insurance Scheme(NDIS) are considered persons with a disability. Insurers may have a broader definition of persons with a disability. Check with the insurer for details.

Hospital cover

This policy exempts you from the Medicare Levy Surcharge.

This policy provides benefits for travel or accommodation (outside of hospital) - check with your insurer for details.

This policy does not provide accident cover.

This policy includes cover for

Hospital Cover Legend
Assisted reproductive servicesEye (not cataracts)Miscarriage and termination of pregnancy
Back, neck and spineGastrointestinal endoscopyPain management
BloodGynaecologyPain management with device
Bone, joint and muscleHeart and vascular systemPalliative care
Brain and nervous systemHernia and appendixPlastic and reconstructive surgery (medically necessary)
Breast surgery (medically necessary)Hospital psychiatric servicesPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
CataractsImplantation of hearing devicesPregnancy and birth
Chemotherapy, radiotherapy and immunotherapy for cancerInsulin pumpsRehabilitation
Dental surgeryJoint reconstructionsSkin
Diabetes management (excluding insulin pumps)Joint replacementsSleep studies
Dialysis for chronic kidney failureKidney and bladderTonsils, adenoids and grommets
Digestive systemLung and chestWeight loss surgery
Ear, nose and throatMale reproductive system

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess on admission. This is limited to a maximum of $500 per person and $1000 per policy per year.

Excess payments do not apply to hospital admissions for day surgery.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product.

The Medical Costs Finder lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Comprehensive, top hospital cover for complete peace of mind. HCi will waive any applicable excess for same-day hospital treatments. We also waive any applicable excess on dependants under 18 years of age.

For further information about this policy see

https://www.hciltd.com.au/hospital-cover/

General Treatment Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

General treatment legend
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental2$1,650 per person up to $4,950 per policyPeriodic oral examination - $45.00
Scale & clean - $80.00
Fluoride treatment - $30.00
Surgical tooth extraction - $160.00
Major dental12$1,650 per person up to $4,950 per policy
(combined limit for major dental, endodontic & orthodontic - Sub-limits apply)
Full crown veneered - $800.00
Endodontic12Filling of one root canal - $160.00
Orthodontic12Braces for upper & lower teeth, including removal plus fitting of retainer - 100% of charge
Optical6$300 per person up to $900 per policySingle vision lenses & frames - $300.00
Multi-focal lenses & frames - $300.00
Non PBS pharmaceuticals2$1,000 per person up to $3,000 per policy
(Sub-limits apply)
Per eligible prescription - $100.00
Physiotherapy2$750 per person up to $2,250 per policy
(combined limit for physiotherapy & exercise physiology)
Initial visit - $60.00
Subsequent visit - $60.00
Chiropractic2$500 per person up to $1,500 per policy
(combined limit for chiropractic, acupuncture, remedial massage, chinese medicine & osteopathy)
Initial visit - $40.00
Subsequent visit - $40.00
Podiatry2$1,000 per person up to $3,000 per policy
(combined limit for podiatry, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses) & speech therapy - Sub-limits apply)
Initial visit - $40.00
Subsequent visit - $40.00
Psychology2$300 per person up to $900 per policyInitial visit - $70.00
Subsequent visit - $70.00
Acupuncture2Combined limit - see ChiropracticInitial visit - $40.00
Subsequent visit - $40.00
Remedial massage2Combined limit - see ChiropracticInitial visit - $40.00
Subsequent visit - $40.00
Hearing aids36$2,000 per person up to $6,000 per policy
2 appliance(s) every 3 years
(Sub-limits apply)
Hearing aid - $1,000.00
Blood glucose monitors12$500 per person
1 appliance(s) every 3 years
Per monitor - $500.00
Audiology2$250 per person up to $750 per policyInitial visit - $50.00
Subsequent visit - $50.00
Chinese medicine2Combined limit - see ChiropracticInitial visit - $40.00
Subsequent visit - $40.00
Dietetics/dietary advice2Combined limit - see PodiatryInitial visit - $40.00
Subsequent visit - $40.00
Exercise physiology2Combined limit - see PhysiotherapyInitial visit - $60.00
Subsequent visit - $60.00
Eye therapy (orthoptics)2Combined limit - see PodiatryInitial visit - $40.00
Subsequent visit - $40.00
Health management / Healthy lifestyle2$350 per person up to $1,050 per policy
(Sub-limits apply)
Health management - $200.00
Home nursing2$500 per person up to $1,500 per policyInitial visit - $50.00
Subsequent visit - $50.00
Occupational therapy2Combined limit - see PodiatryInitial visit - $40.00
Subsequent visit - $40.00
Orthotics (podiatric orthoses)2Combined limit - see PodiatryOrthotics supply & fit - $250.00
Osteopathy2Combined limit - see ChiropracticInitial visit - $40.00
Subsequent visit - $40.00
Speech therapy2Combined limit - see PodiatryInitial visit - $40.00
Subsequent visit - $40.00
Vaccinations2$250 per person up to $750 per policy
(Sub-limits apply)
Per service - $25.00
Flu vaccination 1 per calendar year $25 per service. Other eligible vaccines $100 per service. For eligible medicinal cannabis prescriptions a 12 month waiting period applies.

This policy does not include General treatment (Extras) cover for

General treatment legend
Other treatments - check with your insurer

Other features of this general treatment cover

Policy limits or caps may apply.

For further information about this policy see

https://www.hciltd.com.au/hospital-cover/

Ambulance cover

Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.

For further information about this policy see

https://www.hciltd.com.au/hospital-cover/

Disclaimer

The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.

Not Covered

These categories are not covered by this policy.