Certain Hospital and Extras benefits have changed from 1 January 2024. You can learn more about the Benefit Changes and how they may apply to you here.

How do I know if I’m covered for my procedure?

One of the most important things to do before booking in your procedure is to confirm whether or not it’s covered in your hospital policy. All hospital procedures are defined by their Medicare Benefit Schedule Item number, which are sorted into Clinical Categories. The Clinical Category simply refers to grouping similar types of hospital treatments together. These categories are standard across all private health insurers and each product tier (Gold, Silver, Bronze and Basic) has specific Clinical Categories that must be included, making it clear what is and isn’t included. If you need to find out what you’re covered for, check your policy summary – it contains everything you need to know.

Still not sure? We’re here to help. Give our team a call on 1300 937 838 and we’ll be able check for you. Don't have time to call? Email us.