(before any rebate, loading or discount)
Covers only one person
Available in NSW & ACT
# 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.
Employees/Members of organisations with arrangements with this health insurer
This policy exempts you from the Medicare Levy Surcharge.
This policy does not provide accident cover or benefits for travel and accommodation (outside of hospital).
| Assisted reproductive services | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Back, neck and spine | Gastrointestinal endoscopy | Pain management |
| Blood | Gynaecology | Pain management with device |
| Bone, joint and muscle | Heart and vascular system | Palliative care |
| Brain and nervous system | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Hospital psychiatric services | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Cataracts | Implantation of hearing devices | Pregnancy and birth |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Joint replacements | Sleep studies |
| Dialysis for chronic kidney failure | Kidney and bladder | Tonsils, adenoids and grommets |
| Digestive system | Lung and chest | Weight loss surgery |
| Ear, nose and throat | Male 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.
Excess: No excess
Co-payments: No co-payments
Waiting periods:
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.
Top Gold Hospital covers you at the hospital of your choice, as well as providing benefits on Midwifery and Special Nursing. Home support services and programs: This program allows you to leave hospital early and continue to receive expert in-home care, so you can recover in the comfort of your own home.
This health insurer does not operate a preferred provider scheme.
| Note, for items marked with an asterisk *: Pharmaceutical benefits paid for items with an official pharmacy receipt, after you pay a sum equal to the Australian Government’s highest current PBS co-payment. The Major Dental limit increases by $175 per year up to $1,500 and Optical limit increases by $25 per year up to $300. Hearing Aids are limited to one appliance per person every five years. Health Management benefits paid for services and treatment of $20 or more. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental | 0 | $1,000 per policy | Periodic oral examination - 80% of charge Scale & clean - 80% of charge Fluoride treatment - 80% of charge Surgical tooth extraction - 80% of charge |
| Major dental | 12 | $800 per policy (combined limit for major dental, endodontic, orthodontic & other services) $1,500 lifetime limit for Orthodontic | Full crown veneered - 80% of charge |
| Endodontic | 12 | Filling of one root canal - 80% of charge | |
| Orthodontic | 12 | Braces for upper & lower teeth, including removal plus fitting of retainer - 80% of charge | |
| Optical* | 0 | $200 per policy | Single vision lenses & frames - 80% of charge Multi-focal lenses & frames - 80% of charge |
| Non PBS pharmaceuticals* | 0 | $500 per policy | Per eligible prescription - 100% of charge |
| Physiotherapy | 0 | $600 per policy (combined limit for physiotherapy, ante-natal/post-natal classes, eye therapy (orthoptics), occupational therapy, speech therapy & other services) | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Chiropractic | 0 | $500 per policy (combined limit for chiropractic, psychology, acupuncture, remedial massage, chinese medicine, dietetics/dietary advice, exercise physiology, osteopathy & other services) | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Podiatry | 0 | $300 per policy | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Psychology | 0 | Combined limit - see Chiropractic | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Acupuncture | 0 | Combined limit - see Chiropractic | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Remedial massage | 0 | Combined limit - see Chiropractic | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Hearing aids* | 12 | $500 per policy 1 appliance(s) every 5 years | Hearing aid - 80% of charge |
| Blood glucose monitors | 12 | $500 per policy (combined limit for blood glucose monitors, orthotics (podiatric orthoses) & other services) | Per monitor - 80% of charge |
| Audiology | 0 | $200 per policy | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Ante-natal/Post-natal classes | 0 | Combined limit - see Physiotherapy | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Chinese medicine | 0 | Combined limit - see Chiropractic | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Dietetics/dietary advice | 0 | Combined limit - see Chiropractic | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Exercise physiology | 0 | Combined limit - see Chiropractic | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Eye therapy (orthoptics) | 0 | Combined limit - see Physiotherapy | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Health management / Healthy lifestyle* | 6 | No annual limit | Health management - 80% of charge |
| Occupational therapy | 0 | Combined limit - see Physiotherapy | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Orthotics (podiatric orthoses) | 12 | Combined limit - see Blood glucose monitors | Orthotics supply & fit - 80% of charge |
| Osteopathy | 0 | Combined limit - see Chiropractic | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Speech therapy | 0 | Combined limit - see Physiotherapy | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Other treatments - check with your insurer |
Travel and accommodation: Covers a patient and attendant for essential medical travel, to the nearest hospital or medical centre for round trips exceeding 200 kms
In NSW & ACT this policy provides:
Emergency: Unlimited with no waiting period.
Call-out fees: will not be paid.
https://www.guhealth.com.au/forms-and-publications/fact-sheets
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.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
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.
These categories are not covered by this policy.