Our Product Disclosure Statement (PDS)

Transcription

1 Our Product Disclosure Statement (PDS) Your HIF Hospital and Extras health cover in detail. Visit online to get a quote and join (or switch). Call hif.com.au Australia s first certified Carbon Neutral health fund.

2 What s inside? inside? A bit about us, this PDS and health insurance 2-3 HIF Hospital Cover Options 4 GoldVital Hospital 8 GoldStarter Hospital 12 GoldSaver Hospital 14 Gold Hospital 16 GoldStar Hospital 18 About our Extras cover 20 Ways to claim 22 Feedback, disputes and privacy 46 Frequently asked questions 48 Glossary 51 A bit about us, this PDS and health insurance At HIF, we aim to make choosing smart health insurance simple and painless. With that in mind, we ll keep this Product Disclosure Statement (PDS) as short and sweet as possible. No unnecessary information. Just the must-know stuff. We want you to be able to make the right health insurance choice but we don t want you to fall asleep. So here we go About us and you HIF is a not-for-profit private health insurer. That means we don t have shareholders, so any income we earn after paying for our members benefits and covering our operating expenses is available to pay bigger and better benefits. And that s a good thing. About this PDS You ll find lots of useful info about our health insurance in this brochure: what s and what isn t; details of different cover options; explanations about our services and the terminology we use. All the stuff you need to know when comparing, choosing and reviewing your health cover. Important Tip When you join HIF or change your level of cover, we will send you a Member Statement confirming your new level of cover. To avoid confusion, it s a good idea to keep your statement with this brochure. Keep Updated HIF is always reviewing and improving its services and benefits so to ensure you are claiming all possible benefits remember to regularly visit hif.com.au/domesticpds for an updated version of this PDS. About Australian private health insurance All Australian private health insurers, and residents and non-residents who pay tax in Australia, have potential responsibilities, obligations and entitlements under Australian health insurance laws. These laws include directions about services that can or must be, entitlement to the private health insurance rebate and obligations to pay the Medicare Levy Surcharge (MLS) and the Lifetime Health Cover (LHC) loading. The legislation or rules that affect your premiums, cover and membership obligations include: The Private Health Insurance Act 2007 (the PHI Act) Fairer Private Health Insurance Incentives Act 2012 Fairer Private Health Insurance Incentives (Medicare Levy Surcharge) Act 2012 Fairer Private Health Insurance Incentives (Medicare Levy Surcharge Fringe Benefits) Act 2012 Under the PHI Act, we are required to document our operating guidelines, known as Fund Rules or Business Rules. All private health funds have to do this. These rules detail our obligations as a private health insurer, as well as the obligations of our members. As such, when you become a HIF member, you agree to be bound by these rules. If you would like a copy of the rules, simply hello@hif.com.au or call us on Want more information? Visit hif.com.au to find out more about our not-for-profit health fund. Alternatively, if you would like to know more about us or the rules and regulations around health insurance, please hello@hif.com.au or call us on

3 HIF Hospital Cover Options Restrictions and exclusions Choice of Excess Cover for in-hospital procedures GoldStarter GoldSaver Gold GoldStar Product Restricted Excluded GoldStar Surgery by podiatrists Cosmetic services* Private Room Private room (maternity) (3 days) (5 days) (uned) Shared room Intensive Care Theatre Care Same-day Accommodation Same-day Theatre Appliances Prostheses Pharmacy Drugs AccessGap Palliative Care Restricted Restricted Cardio (heart)** Psychiatric Care & Treatment Joint Replacement Assisted Reproductive Technology (e.g. IVF) Eye Surgery (non-cosmetic) Gastric banding & Obesity surgery Restricted Some restrictions and exclusions may apply. Restricted Restricted Restricted Restricted Restricted Services not by Medicare* Gold Surgery by podiatrists Cosmetic services* GoldSaver GoldStarter Assisted reproductive technology Cardiac (heart) conditions, procedures or monitoring** Eye surgery Joint replacement Psychiatric Palliative care Rehabilitation Palliative care Psychiatric Rehabilitation Services not by Medicare* Gastric banding and obesity surgery Cosmetic services* Services not by Medicare* Surgery by podiatrists Gastric banding and obesity surgery Cardiac (heart) conditions, procedures or monitoring** Eye surgery Joint replacement Assisted reproductive technology Obstetrics (maternity) Cosmetic services* Services not by Medicare* Surgery by podiatrists For restricted services HIF will pay a basic benefit known as the public hospital rate, toward accommodation charges. All other charges raised by the hospital during the stay will be paid by the member. An excluded service means all charges raised during the stay will be paid by the member. * Where a service is deemed by Medicare to be cosmetic and/or does not attract a Medicare rebate, all charges raised in association with the hospital stay will not be eligible for payment. ** Some examples of cardiac (heart) procedures including medical treatment or surgical procedures for cardiac conditions, are arrhythmias, artery bypass grafts, coronary angioplasty, congenital defects, heart disease, heart transplants, pacemakers and defibrilators, stent insertion. 4 5

4 Things you need to know about our Hospital cover When selecting Hospital cover, it s important to ensure that you understand how each level of cover will apply to you, as well as being aware of details such as ations, restrictions or exclusions that might also apply to your chosen cover. AccessGap Cover AccessGap Cover applies to medical accounts for members undergoing in-patient hospital procedures. It s designed to reduce or eliminate out-of-pocket expenses by allowing doctors to use the scheme on a patient-bypatient basis. If a doctor uses the scheme, he/ she agrees to charge you a set fee for each item and will then receive a payment from HIF and Medicare combined, which is more than the Medicare Schedule Fee. To be eligible for AccessGap Cover, doctors must be willing to participate for your particular surgery and the account must be lodged directly with HIF (not Medicare). To find out more about specific payment amounts for upcoming procedures, or for your doctor to register for the scheme, please call us on Healthcare providers HIF covers extras, medical and hospital providers throughout Australia. To confirm if a provider is approved by HIF, go to hif.com.au, us at info@hif.com.au or call us on Ambulance services HIF is required under New South Wales and Australian Capital Territory legislation to financially contribute toward the cost of operating state or territory-provided emergency ambulance services on behalf of any person who is a permanent state or territory resident and holds any level of HIF Hospital cover. Under this arrangement, our members who are residents of NSW or ACT and hold HIF Hospital cover may submit their resident state or territory emergency ambulance invoice to HIF to claim a benefit toward the fees charged. Please note that ambulance benefits may not be claimable under a NSW or ACT HIF Hospital cover if the service was not provided by your local state-controlled ambulance service, or if the service was not deemed by the ambulance attendant to be an emergency (medically necessary). For more information about this, see page 24 or visit hif.com.au and visit the Ambulance Cover page within the Health section. Medical Gap Different medical providers may charge different prices for the same procedure. If you are planning a procedure, we recommend that you ask your medical provider and any associated health provider (e.g. anaesthetist or assistant) if they will participate in our AccessGap scheme to help you avoid or minimise your out-of-pocket expenses. If your health provider does not confirm your out-of-pocket expenses, we recommend you contact us with your provider s details, item numbers and charges and we will provide you with a benefit estimate. The Pre-existing Condition Rule This standard rule is applied across the health insurance industry. It is designed to ensure that long-term members are not financially disadvantaged by new members who join and claim benefits immediately for pre-existing conditions. A pre-existing condition is defined as an ailment or condition for which the signs or symptoms were evident or known at any time during the 6 months prior to when the member joins HIF, or upgrades to a higher level of cover or the same cover with a reduced or nil excess. HIF is not required to pay benefits for a pre-existing condition during the first 12 months of a new member s Hospital cover. Where an existing member upgrades to a higher level of cover or the same cover with a reduced or nil excess, any services related to the pre-existing condition will be paid out at the previous level of cover for the first 12 months. Restricted services Where services are noted as restricted in your Hospital cover, this means that if you receive them in a private hospital, you will only be at the basic public hospital benefit rate, which includes: The cost of a shared room in a public hospital A benefit towards the cost of surgically implanted prosthesis AccessGap for in-patient medical services No other benefits are payable for restricted services, unless specifically listed in the individual product description within this brochure. Workers Compensation and Dual Insurance Benefits cannot be claimed and are not payable by HIF where you have or can claim benefits or compensation (in full or in part) for treatment, goods or services from a third party including Workers Compensation or Public Liability sources, your employer or any other Insurance policy. Transferring and upgrading your cover New members who transfer Hospital cover from another Australian health fund to an equivalent level of HIF Hospital cover will not have any waiting periods applied for the services for which you were previously, providing these were served with the previous fund. New members who transfer Hospital cover from another Australian health fund to a higher level of Hospital cover, or equivalent level of cover with a reduced or nil excess, will have qualifying periods applied for the higher level of cover and/ or benefits. During these periods benefits will be payable at the equivalent level of cover to that of your previous fund. Current HIF members who transfer Hospital cover to a higher level of Hospital cover, or equivalent level of cover with a reduced or nil excess, will have qualifying periods applied for the higher level of cover and/or benefits. During these periods benefits will be payable at the lower level of cover. Any benefits paid by your previous private health insurer will be considered when determining rebates for your future claims. Benefits will not be paid for any hospital services provided outside Australia, or for services purchased or provided within Australia from a non-australian recognised provider. Excluded services Where services are noted as excluded in your Hospital cover, this means that you are 6 not and you must pay all costs. 7

5 GoldVital Hospital This is our entry-level option for young singles and couples who want cover for vital medical services. It covers treatment after an accident, intensive care and theatre fees, plus other essential services, including surgery to remove tonsils, adenoids, appendix and wisdom teeth. GoldVital Hospital Cover for emergency treatment in hospital resulting from an accidental injury* Surgical removal of wisdom teeth, tonsils, appendix and adenoids Minor gynaecological procedures^ Joint reconstruction and investigation Same-day accommodation and theatre fees for approved services No maternity cover Full cover for the cost of a shared or private room, theatre fees and charges in an HIF contracted hospital anywhere in Australia for approved services Full AccessGap Cover for inpatient medical procedures for approved services Includes an excess to reduce the premium Restrictions and exclusions apply Available for singles and couples only Hospital waiting periods Treatment received as the result of an accident one day General hospitalisation two months All treatment related to a pre-existing ailment or condition, but not including pre-existing conditions for psychiatric care, rehabilitation or palliative care 12 months Services GoldVital Hospital will cover the services outlined in the table on the following page in a public hospital or contracted private hospital facility, subject to any waiting periods which may apply and the Preexisting Ailment Rule. Benefits for noncontracted private hospitals are available from HIF. Check with us prior to admission to ensure that the hospital is an HIF contracted facility. HIF has negotiated contractual arrangements with most hospitals and day hospital facilities throughout Australia. The benefits listed in the table opposite are offered to members who are admitted to those hospitals. Exclusions As an entry-level option, GoldVital provides basic cover for a ed range of vital medical services and essential emergency treatment. As such, it only covers the services listed in the table on page 10 all other non-emergency and hospital care services are excluded. Assisted reproductive technology (eg IVF) Cardiac (Heart) procedures including medical treatment or surgical procedures for cardiac conditions such as, arrhythmias, artery bypass grafts, coronary angioplasty, congenital defects, heart disease, heart transplants, pacemakers and defibrillators, stent insertion. Eye Surgery (any procedure on the surface or within the structures of the eye) Dialysis Gastric banding and Obesity surgery including reversal and adjustment procedures Joint replacement Obstetrics related services Spinal fusion Sterility reversals Services deemed cosmetic by Medicare and service that do not attract a Medicare rebate Services not listed as include are excluded. Restricted services Benefits for the following services will include basic public hospital rate (only) for accommodation. However, full AccessGap coverage for inpatient medical procedures and benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a copayment by the patient: Psychiatric care or attention Palliative care Rehabilitation No benefits will be payable for other charges related to these services (e.g. theatre or some pharmaceutical costs), so significant out-of-pocket expenses may apply for these procedures if you are admitted as a private patient. Applicable excess A mandatory excess of $500 per person, per admission, per year (up to a maximum of $500 per year single policy or $1,000 per year couple policy) is applied to GoldVital Hospital cover to reduce premium costs. The excess applies to overnight and same day admissions * An accident is an unforeseen event, occurring by chance and caused by an external force or object which results in an injury to the body requiring immediate medical treatment in hospital within 24 hours of the accident. If further hospital treatment (as an admitted patient) is required, the patient must be re-admitted to a hospital within 90 days of the initial hospital treatment. 8 ^ Benefits will be paid for Same Day Procedures only for minor gynaecological procedures. 9

6 Description of charges and benefits Accommodation Charges Full cover in a shared or private room Full cover in a shared or private room Theatre Fees charges Charges are not raised for this service Full cover for theatre charges Pharmaceutical drugs (does not include discharge drugs) Charges are not raised for this service Charges vary between hospitals depending on the contract that s in place. Please check with the hospital or HIF. Benefits may not apply to, or be restricted for, non-tga* approved, experimental or high cost drugs, Prostheses and consumables Benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient. Prostheses items used in relation to relevant exclusion services are not. Outpatient theatre fees (not emergency department fees) Medical Gap For more details please refer to the AccessGap Cover section in this brochure, or info@hif.com.au or call us on Applicable Excess All hospitals and approved day care facilities Mandatory excess is applied to GoldVital hospital. Benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient. Benefits may not apply or be restricted for non hospital contract medical treatments or consumables. Prostheses items used in relation to relevant exclusion services are not. No charge raised Full cover for outpatient theatre fees Admitted patients are entitled to the difference between the Medicare rebate and the Commonwealth Medical Benefits Schedule fee for all medical services performed whilst the patient is admitted as an inpatient in hospital and may be entitled to a further refund of the AccessGap cover amount. Funds are not permitted to pay gap cover if the patient is treated as an outpatient or when the patient is not formally admitted to hospital. GoldVital - $500 per person in a calendar year to a max of $1000 per membership. Excess applies to overnight or same day admissions. This page has been left blank intentionally 10 11

7 GoldStarter Hospital This is our basic-level private Hospital insurance cover. Like GoldVital, it s great value and a smart choice if you re younger and less likely to require things like maternity and cardio procedures, but it also includes a broader range of nonemergency care. GoldStarter Hospital No maternity cover Restrictions and exclusions apply Full cover for the cost of a shared room, theatre fees and charges in a HIF contracted hospital anywhere in Australia for approved services Full AccessGap Cover for inpatient medical procedures for approved services Includes an excess to reduce the premium Hospital waiting periods General hospitalisation two months All treatment related to a pre-existing ailment or condition, but not including pre-existing conditions for psychiatric care, rehabilitation or palliative care 12 months Restricted services Benefits for the following services will include basic public hospital rate (only) for accommodation. However, full AccessGap coverage for inpatient medical procedures and benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient: Rehabilitation Surgery by podiatrists No benefits will be payable for other charges related to these services (e.g. theatre or some pharmaceutical costs), so significant out-of-pocket expenses may apply for these procedures if you are admitted as a private patient. Exclusions Benefits are not payable for any charges raised for the following services: Assisted reproductive technology (e.g. IVF) Cardio (e.g. conditions of the heart requiring surgery, monitoring or other procedures) Eye surgery (any procedure on the surface or within the structures of the eye) Gastric banding and obesity surgery Joint replacement Obstetrics Services deemed cosmetic by Medicare and services that do not attract a Medicare rebate Services GoldStarter Hospital will cover the following services in a public hospital or contracted private hospital facility, subject to any waiting periods which may apply and the Pre-existing Ailment Rule. Benefits for non-contracted private hospitals are available from HIF. Check with us prior to admission to ensure that the hospital is a HIF contracted facility. Accommodation charges including day patient, intensive care and neonatal care Full cover in a shared or private room. The full cost of a shared room. If you occupy a private room you will be up to the hospital charge for a shared room and you will be required to meet the balance of the accommodation charge. Theatre fee Charges are not raised for this service. Pharmaceutical drugs (does not include discharge drugs) Full cover for theatre charges. Charges are not raised for this service. Charges vary between hospitals depending on the contract that s in place. Please check with the hospital or HIF. Benefits may not apply to, or be restricted for, non-tga* approved, experimental or high cost drugs. Prostheses and consumables Benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient. Prostheses items used in relation to relevant exclusion services are not. Outpatient theatre fees (not emergency department fees) Medical Gap For more details, please refer to the AccessGap Cover section in this brochure, or info@hif.com.au or call us on All hospitals and approved day care facilities Benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient. Benefits may not apply or be restricted for non hospital contract medical treatments or consumables. Prostheses items used in relation to relevant exclusion services are not. No charge raised. Full cover for outpatient theatre fees. Admitted patients are entitled to the difference between the Medicare rebate and the Commonwealth Medical Benefits Schedule fee for all medical services performed whilst the patient is admitted as an inpatient in hospital and may be entitled to a further refund of the AccessGap cover amount. Funds are not permitted to pay gap cover if the patient is treated as an outpatient or when the patient is not formally admitted to hospital. HIF has negotiated contractual arrangements with most hospitals and day Applicable excess hospital facilities throughout Australia. The A mandatory excess is applied to GoldStarter Hospital cover to reduce premium costs: listed benefits are offered to members who GoldStarter $200 per person to a max of $400** Psychiatric care or attention are admitted to those hospitals. * Therapeutic Goods Administration ** Excesses are paid once per person per admission under the policy in a calendar year up to the maximum. 12 Palliative care Excesses apply to all hospital treatments. Some examples of cardiac (heart) procedures including medical treatment or surgical procedures for cardiac 13 conditions, are arrhythmias, artery bypass grafts, coronary angioplasty, congenital defects, heart disease, heart transplants, pacemakers and defibrilators, stent insertion.

8 GoldSaver Hospital This is our intermediate Hospital cover and is a step up from GoldStarter. It s great for young couples and families who are likely to need things like maternity cover but not services such as cardio and joint replacement surgery. GoldSaver Hospital Intermediate Hospital cover Includes maternity services Full cover for the cost of a shared room, theatre fees and labour ward charges in a HIF contracted hospital anywhere in Australia for approved services Private room for up to 3 days for management of labour and delivery of child Full AccessGap cover for inpatient medical procedures Includes an excess to reduce the premium Some restricted services human tissue) may be subject to a co-payment by the patient: Joint replacement Cardio (e.g. conditions of the heart requiring surgery, monitoring or other procedures) Eye surgery (any procedure on the surface or within the structures of the eye) Psychiatric care or attention Assisted reproductive technology (e.g IVF) Surgery by a podiatrist No benefits will be payable for other charges related to these services (e.g. theatre or some pharmaceutical costs), so significant out-of-pocket expenses may apply for these procedures if you are admitted as a private patient. Exclusions Benefits are not payable for any charges raised for the following services: Gastric banding and obesity surgery Services deemed cosmetic by Medicare and services that do not attract a Medicare rebate Some examples of cardiac (heart) procedures including medical treatment or surgical procedures for cardiac conditions, are arrhythmias, artery bypass grafts, coronary angioplasty, congenital defects, heart disease, heart transplants, pacemakers and defibrilators, stent insertion. Accommodation charges including day patient, intensive care and neonatal care Theatre fee and labour ward charges Pharmaceutical drugs (does not include discharge drugs) Full cover in a shared or private room. Full cover in a shared room. A private room will be fully for up to 3 days for maternity stays relating to the management of labour and delivery. If you occupy a private room for maternity stays greater than 3 days, for the fourth and additional days you will be up to the hospital charge for a shared room and you will be required to meet the balance of the accommodation charge. Charges are not raised for this service. Full cover for theatre and labour ward charges. Charges are not raised for this service. Charges vary between hospitals depending on the contract that s in place. Please check with the hospital or HIF. Benefits may not apply to, or be restricted for, non-tga* approved, experimental or high cost drugs. Prostheses and consumables Benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient. Prostheses items used in relation to relevant exclusion services are not. Benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient. Benefits may not apply or be restricted for non hospital contract medical treatments or consumables. Prostheses from excluded services not. Hospital waiting periods General hospitalisation 2 months All obstetric related services 12 months Services Outpatient theatre fees Full cost of the charge raised. GoldSaver Hospital will cover the following (not emergency department All treatment related to a pre-existing Full cover for outpatient theatre fees. services in a public hospital or contracted fees) ailment or condition, but not including private hospital facility, subject to any Medical Gap All hospitals and Admitted patients are entitled to the difference pre-existing conditions for psychiatric care, waiting periods which may apply and the For more details, please refer approved day care between the Medicare rebate and the rehabilitation or palliative care 12 months Pre-existing Ailment Rule. Benefits for noncontracted private hospitals are available section in this brochure, or for all medical services performed whilst the to the AccessGap Cover facilities Commonwealth Medical Benefits Schedule fee Restricted Services info@hif.com.au or call patient is admitted as an inpatient in hospital from HIF. Check prior to admission to ensure us on and may be entitled to a further refund of Benefits for the following services will that the hospital is a HIF contracted facility. the AccessGap cover amount. Funds are not include basic public hospital rate (only) for HIF has negotiated contractual permitted to pay gap cover if the patient is accommodation. However, full AccessGap arrangements with most hospitals and day treated as an outpatient or when the patient coverage for in-patient medical procedures hospital facilities throughout Australia. The is not formally admitted to hospital. and benefits will be paid towards prostheses listed benefits are offered to members who Applicable excess in accordance with the Commonwealth are admitted to those hospitals. Prostheses List. Items on the list (excluding A mandatory excess is applied to reduce premium costs: GoldSaver $200 per person to a max of $400** 14 * Therapeutic Goods Administration 15 ** Excesses are paid once per person per admission under the policy in a calendar year, up to the maximum. Excesses apply to all hospital treatments.

9 Gold Hospital This is our award-winning top shared room hospital insurance cover. You re fully for theatre fees, ward fees and all other services. It s especially great if you re planning on having a baby, because our maternity cover includes up to five days in a private room at no extra cost. Gold Hospital Top Hospital cover Comprehensive cover for all Medicare approved items Includes maternity services Private room for up to 5 days for management of labour and delivery of child Full cover for the cost of a shared room, theatre fees and labour ward charges in a HIF contracted hospital anywhere in Australia Full AccessGap Cover for inpatient medical procedures Choice of excesses to reduce cost Hospital waiting periods General hospitalisation 2 months All obstetric related services 12 months All treatment related to a pre-existing ailment or condition, but not including pre-existing conditions for psychiatric care, rehabilitation or palliative care 12 months Restrictions Surgery performed in a hospital by registered podiatrists is not eligible for Medicare rebates. However, under this level of cover HIF will pay ed benefits toward the podiatrist s charges. Hospital accommodation and theatre charges will also be ed. Exclusions No benefit is payable for services deemed as cosmetic by Medicare and/or services that do not attract a Medicare benefit. Services Gold Hospital will cover the following services in a public hospital or contracted private hospital facility, subject to any waiting periods which may apply and the Pre-existing Ailment Rule. Benefits for noncontracted private hospitals are available from HIF. Check prior to admission to ensure that the hospital is a HIF contracted facility. HIF has negotiated contractual arrangements with most hospitals and day hospital facilities throughout Australia. The listed benefits are offered to members who are admitted to those hospitals. Accommodation charges including day patient, intensive care and neonatal care Theatre fee and labour ward charges Pharmaceutical drugs (does not include discharge drugs) Prostheses and consumables Outpatient theatre fees (not emergency department fees) Medical Gap For more details, please refer to the AccessGap Cover section in this brochure, or info@hif.com.au or call us on All hospitals and approved day care facilities Full cover in a shared or private room. Excess options Optional excesses to reduce premium costs: Gold Excess 100/200 $100 per person to a max of $200** Gold Excess 200/400 $200 per person to a max of $400** Gold Excess 400/800 $400 per person to a max of $800** The full cost of a shared room. A private room will be fully for up to 5 days for maternity stays relating to the management of labour and delivery. If you occupy a private room for maternity stays greater than 5 days, for the sixth and additional days you will be up to the hospital charge for a shared room and you will be required to meet the balance of the accommodation charge. Charges are not raised for this service. Full cover for theatre and labour ward charges. Charges are not raised for this service. Charges vary between hospitals depending on the contract that s in place. Please check with the hospital or HIF. Benefits may not apply to, or be restricted for, non-tga* approved, experimental or high cost drugs. Benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient. Benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient. Benefits may not apply or be restricted for non hospital contract medical treatments or consumables. No charge raised. Full cover for outpatient theatre fees. Admitted patients are entitled to the difference between the Medicare rebate and the Commonwealth Medical Benefits Schedule fee for all medical services performed whilst the patient is admitted as an inpatient in hospital and may be entitled to a further refund of the AccessGap cover amount. Funds are not permitted to pay gap cover if the patient is treated as an outpatient or when the patient is not formally admitted to hospital. * Therapeutic Goods Administration ** Excesses are paid once per person per admission under the policy in a calendar year, up to the maximum. The excess is not applied to same-day surgery or to child dependants under the age of

10 GoldStar Hospital This is our premium hospital insurance cover, with all the bells and whistles. You re fully for everything, including a private room for all services, theatre fees and all ward fees. No worries. Just total peace of mind for you and your family. GoldStar Hospital Cover Top Hospital cover Comprehensive cover for all Medicare approved items Includes maternity services Full cover for the cost of a private room, theatre fees and labour ward charges in a HIF contracted hospital anywhere in Australia Full AccessGap Cover for inpatient medical procedures Choice of excesses to reduce cost Hospital waiting periods General hospitalisation 2 months All obstetric related services 12 months All treatment related to a pre-existing ailment or condition, but not including pre-existing conditions for psychiatric care, rehabilitation or palliative care 12 months Restrictions Surgery performed in a hospital by registered podiatrists is not eligible for Medicare rebates. However, under this level of cover HIF will pay ed benefits toward the podiatrist s charges. Hospital accommodation and theatre charges will also be ed. Exclusions No benefit is payable for services deemed as cosmetic by Medicare and/or services that do not attract a Medicare benefit. Services GoldStar Hospital will cover the following services provided in a public hospital or contracted private hospital facility, subject to any waiting periods which may apply and the Pre-existing Ailment Rule. Benefits for non-contracted private hospitals are available from HIF. Check prior to admission to ensure that the hospital is a HIF contracted facility. HIF has negotiated contractual arrangements with most hospitals and day hospital facilities throughout Australia. The listed benefits are offered to members who are admitted to those hospitals. Accommodation charges including day patient, intensive care and neonatal care Theatre fee and labour ward charges Pharmaceutical drugs (does not include discharge drugs) Prostheses and consumables Outpatient theatre fees (not emergency department fees) Medical Gap For more details, please refer to the AccessGap Cover section in this brochure, or info@hif.com.au or call us on All hospitals and approved day care facilities Full cover in a shared or private room. Full cover in a shared or private room. Charges are not raised for this service. Full cover for theatre and labour ward charges. Charges are not raised for this service. Charges vary between hospitals depending on the contract that s in place. Please check with the hospital or HIF. Benefits may not apply to, or be restricted for, non-tga* approved, experimental or high cost drugs. Benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient. Benefits will be paid towards prostheses in accordance with the Commonwealth Prostheses List. Items on the list (excluding human tissue) may be subject to a co-payment by the patient. Benefits may not apply or be restricted for non hospital contract medical treatments or consumables. No charge raised. Full cover for outpatient theatre fees. Admitted patients are entitled to the difference between the Medicare rebate and the Commonwealth Medical Benefits Schedule fee for all medical services performed whilst the patient is admitted as an inpatient in hospital and may be entitled to a further refund of the AccessGap Cover amount. Funds are not permitted to pay gap cover if the patient is treated as an outpatient or when the patient is not formally admitted to hospital. Excess options Optional excesses are available to reduce premium costs: GoldStar Excess 200/400 $200 per person to a max of $400** GoldStar Excess 400/800 $400 per person to a max of $800** GoldStar Excess 500/1000 $500 per person to a max of $1000** * Therapeutic Goods Administration ** Excesses are paid once per person per admission under the policy in a calendar year, up to the maximum. The excess is not applied to same-day surgery or to child dependants under the age of

11 Things you should know about our Extras cover Here at HIF, we pride ourselves on enabling member choice. So, unlike some health fund insurers who pay lower benefits if you don t go to their preferred providers, with HIF you re free to visit any Extras provider in Australia. Our only requirement is that members must visit healthcare providers who are legally qualified to practise in Australia and are therefore approved by HIF. So as long as your preferred doctor, dental provider, optical provider, physiotherapist, chiropractor or other type of healthcare provider is approved by HIF, you re free to use whichever one you want. Our Member Loyalty Program HIF recognises and rewards members who retain their Extras cover (excluding Vital Options) each year by providing increasing benefits or s. Our dental s increase every year from commencement until the maximum is available in your sixth year of membership. Benefits or s for services like optical, physiotherapy, occupational and speech therapy increase after 5 years and benefits or s increase for chiropractic, osteopathic and pharmacy after 3 years. Where a policy is upgraded to a higher level of Extras cover (excluding Vital Options), s and benefits will automatically move to the next highest loyalty benefit on the new level of cover and progress each year until all maximum benefits and s are reached. Annual s HIF Extras covers have an for most services, which means there is a on how much HIF will pay toward your claims. Most s are for the calendar year (January to December) but each January your benefit s will be refreshed, allowing you to claim benefits again for Extras services provided in the new year. Claiming timeframe ation Claims must be made within two years of the service being provided. Approved consultations Unless stated, to be eligible for HIF benefits all services must be provided by a HIF approved health provider at that provider s registered practice address in a face-toface setting, or as otherwise approved by HIF. Video, telephone or online facilitated services, with the exception of HIF approved Hospital Substitute treatment or Chronic Health Disease Management programs, are not approved consultations. Workers Compensation and Dual Insurance Benefits cannot be claimed and are not payable by HIF where you have or can claim benefits or compensation (in full or in part) for treatment, goods or services from a third party including Workers Compensation or Public Liability sources, your employer or any other Insurance policy. Transferring and upgrading your cover New members who transfer Extras cover from another Australian health fund to an equivalent level of HIF Extras cover will not have any waiting periods applied, providing these were served with the previous fund. New members who transfer Extras cover from another Australian health fund to a higher level of Extras cover, or equivalent level of cover with additional or higher benefits will have qualifying periods applied for the higher level of cover and/ or benefits. During these periods benefits will be payable at the equivalent level of cover to that of your previous fund. Vital Options Vital Options offers great value, entry-level Extras cover for singles and couples only (not available for families). What services are included? Chiropractic Dental (General) Emergency Ambulance Endodontic Periodontal Osteopathy Physiotherapy Please note: Benefits are only payable on the following dental items. There are some items within item code ranges for which HIF does not pay a benefit, or if they are performed with another item in the same course of treatment. If you are planning dental treatment in the future, please call HIF prior to treatment on to confirm that you will be. General dental: , , 121, , , , , , 926, Endodontic: Periodontal: Current HIF members who transfer Extras cover to a higher level of Extras cover, or equivalent level of cover with a reduced or nil excess, will have qualifying periods applied for the higher level of cover and/or benefits. During these periods benefits will be payable at the lower level of cover. Any benefits paid by your previous private health insurer will be considered when determining rebates for your future claims. How much can be claimed? With a combined of $800 per person per year, Vital Options gives complete choice as to how the is used. This could be used for a quick check-up at the dentist or visits to a chiropractor, for example. Each member can choose the services they d like to use and Vital Options will pay back 50% on each service claimed until the maximum annual of $800 is reached. For example, one member could claim up to $800 on dental services each year, while another member chooses to split the across more of the services by Vital Options. For instance, they could choose to use $250 on dental, $400 on osteopathy and $150 on chiropractic treatment. Emergency ambulance services are included. If urgent ambulance transport is needed, Vital Options cover will pay 50% of the bill up to the maximum of $800 per person. This can be a valuable benefit as Medicare doesn t cover urgent ambulance transport, which can cost over $

12 Ways to claim Electronic Claiming Providers with electronic claiming technology (HICAPS or IBA) can settle your account with you on the spot. Simply swipe your HIF membership card and pay any difference. SmartClaim for mobile Members who own an Apple or Android mobile device can now submit paid extras accounts of $700 or less by using their mobile s in-built camera to photograph receipts and invoices. To find out more, visit hif.com.au or download HIF SmartClaim now from the Apple App Store or the Android Market. Fast-Track e-claiming ( /fax) For paid Extras accounts of $700 or less, try our quick and easy Fast-Track option. Simply scan your completed HIF claim form and associated receipts and invoices, and a copy to claims@hif.com.au or fax a copy to (08) To find out more, visit hif.com.au Hospital and AccessGap Accounts Your doctor may send the accounts to HIF direct. If not, you can send the unpaid account to us for processing the HIF and Medicare benefits payable. We will then send the payment direct to your doctor or hospital on your behalf. Please call us before you go into hospital so we can assist you with your claims. By post Complete a claim form and post it to: HIF GPO Box X2221 Perth WA 6847 Claim forms can be downloaded from hif.com.au or mailed to you on request. For more information on the different ways to make a claim, check out the How to Claim page on hif.com.au Extras waiting benefits Type of service Vital Saver Special Super Premium Waiting Period Ambulance* 2 months Auxiliary Home Nursing 2 months Asthmatic Spacers 2 months Chiropractic 2 months Complementary Therapies 2 months Dental - General Uned Limited 2 months Diabetes Education 2 months Dietetics 2 months Healthy Lifestyle 2 months Occupational Therapy 2 months Optical 2 months Orthoptics (Eye Therapy) 2 months Osteopathy 2 months Peak-flow Meter 2 months Pharmacy Drugs 2 months Physiotherapy 2 months Podiatry Consultations 2 months Speech Therapy 2 months Dental - General Limited** Up to 12 months Blood Glucose/Pressure Monitor 12 months Dental - Major 12 months External Prosthesis/ Medical Appliances 12 months Nebuliser / Humidifier 12 months Orthotic Appliances 12 months Psychological Consultations Assisted Reproduction Drugs 12 months 36 months Hearing Aids 36 months From time to time we promote special offers for new members. Visit hif.com.au for more information and to view our current offers. * Does not include inter-hospital transfers or transport to home. ** Limited item numbers are, please contact HIF for more details 22 23

13 Ambulance benefits Benefit is paid on charges raised for approved ambulance services. On all our Extras cover except Vital Options, HIF fully covers the cost of emergency ambulance transport for cases classified by approved ambulance service providers as requiring urgent attention and where the patient is admitted to the emergency department of a hospital. A patient co-payment of $50 per service applies to non-emergency call-outs and transportation. Benefits are not payable for transportation from a hospital to your home, nursing home or other hospital, or for transportation for ongoing medical treatment. Benefits are not payable for off road or air ambulance. Vital Options cover will pay 50% of an emergency ambulance bill up to a maximum of $800 per person per calendar year. Where a member is eligible for a state or Federal government subsidy, HIF will pay a benefit, less this entitlement. e: Ambulance services, charges and levies vary significantly across Australian states and territories: QLD & TAS Residents are for uned emergency services provided by their respective state governments. Interstate ambulance service charges for these residents may not apply if reciprocal agreements are in place with the other states where the ambulance service was required. NSW and ACT Residents who hold HIF Hospital cover are for uned emergency ambulance services provided in their home state by their state government or territory ambulance service. Interstate emergency services may also be if under a reciprocal state agreement.* All other emergency services In all other locations and circumstances, emergency ambulance services may be claimable from HIF Options covers, subject to the services being provided by the recognised St John or state government controlled ambulance organisation and the service being deemed as medically necessary by the attending ambulance officer. Premium Options Super Options Special Options Saver Options Type of service Additional information Benefit Person Ambulance As above Emergency: 100% Benefit N/A N/A Emergency: 100% Person Benefit Person N/A N/A Emergency: 100% Benefit Person N/A N/A Emergency: 100% N/A N/A Nonemergency call-outs and transportation: 100% with a $50 co-payment Nonemergency call-outs and transportation: 100% with a $50 co-payment Nonemergency call-outs and transportation: 100% with a $50 co-payment Nonemergency call-outs and transportation: 100% with a $50 co-payment Interhospital transfers: No benefit Interhospital transfers: No benefit Interhospital transfers: No benefit Interhospital transfers: No benefit 24 25

14 26 27 Premium Options Type of service Additional information Benefit Person Asthmatic spacers Auxiliary Home Nursing Blood glucose or blood pressure monitor Chiropractic N/A $18 2 per person per year Benefits must be ordered by a medical practitioner. Contact us for conditions. A letter of recommendation from the patient s treating practitioner is required. Benefits are paid for spinal manipulation or spinal adjustments carried out by a registered chiropractor approved by HIF. $120 $1,800 per year 75% of cost 1 of either monitor every 3 years Spinal adjustment manipulation First visit: $30 Visits 2-10: $29 Visits 10+: $18 X-ray: $110 Max: $200 (chiropractic and osteopathic) Up to 3 years: $650 Over 3 years: $750 1 x-ray per year Special Options Type of service Additional information Benefit Person Asthmatic spacers Auxiliary Home Nursing Blood glucose or blood pressure monitor Chiropractic Super Options Benefit Person No $18 2 per person per year No $75 $1,800 per year No 75% of cost 1 of either monitor every 3 years (chiropractic and osteopathic) Up to 3 years: $1300 Over 3 years: $1500 Spinal adjustment manipulation First visit: $28 Visits 2-10: $23 Visits 10+: $14 X-ray: $85 Max: $200 (chiropractic and osteopathic) Up to 3 years: $550 Over 3 years: $650 1 x-ray per year No No No (chiropractic and osteopathic) Up to 3 years: $1100 Over 3 years: $1300 Saver Options Benefit Person N/A N/A N/A No N/A N/A No Benefits must be ordered by a medical practitioner. Contact us for conditions. A letter of recommendation from the patient s treating practitioner is required. Benefits are paid for spinal manipulation or spinal adjustments carried out by a registered chiropractor approved by HIF. N/A N/A No N/A N/A No N/A N/A No N/A N/A No Spinal adjustment manipulation First visit: $26 Visits 2-10: $21 Visits 10+: $10 X-ray: $70 osteopathic, physiotherapy, podiatry and therapies) $450 1 x-ray per year osteopathic, physiotherapy, podiatry and therapies) $900 Spinal adjustment - manipulation: First visit: $26 Visits 2-10: $21 Visits 10+: $10 X-ray: $65 dietetics, healthy lifestyle, pharmacy, osteopathic, physiotherapy and podiatry) $350 1 x-ray per year dietetics, healthy lifestyle, pharmacy, osteopathic, physiotherapy and podiatry) $700 Extras benefits

15 28 29 Premium Options Type of service Additional information Benefit Person Complementary therapies - Naturopathy - Homeopathy - Acupuncture - Traditional Chinese Medicine - Remedial massage therapy - Myotherapy Dental Diabetics education Dietetics Benefits are not payable on medicines provided by the practitioner. The treatment must be provided by a practitioner who is registered with HIF in the speciality for which the charge is raised. For consultations or information sessions held by Diabetes Association in relation to diabetes. consultations carried out by a registered dietician approved by HIF. Visits 1-6: $25 Visits 7+: $17 First visit: $36 $18 First visit: $40 $20 Group: $12 Special Options Up to 3 years: $500 Over 3 years: $600 Super Options Benefit Person No * Visits 1-6: $20 See page 44 for more details 6 visits per year Type of service Additional information Benefit Person Complementary therapies - Naturopathy - Homeopathy - Acupuncture - Traditional Chinese Medicine - Remedial massage therapy - Myotherapy Dental Diabetics education Dietetics Benefits are not payable on medicines provided by the practitioner. The treatment must be provided by a practitioner who is registered with HIF in the speciality for which the charge is raised. For consultations or information sessions held by Diabetes Association in relation to diabetes. consultations carried out by a registered dietician approved by HIF. Visits 1-6: $16 Visits 7+: $11 Visits 7+: $13 No First visit: $36 $18 $324 per year No First visit: $36 Up to 3 years: $100* Over 3 years: $200* $18 Group: $10 Saver Options Up to 3 years: $250 Over 3 years: $350 6 visits per year $324 per year Benefit Person $400* Visit 1-6: $15 Visits 7+: $10 See page 44 for more details $700 Up to 3 years: $50 # Over 3 years: $100 # No $200 # N/A N/A No N/A N/A No First visit: $36 $18 Group: $10 $252 per year No First visit: $36 $18 Group: $10 annual dietetics, healthy lifestyle, osteopathy, pharmacy, physiotherapy and podiatry) $350 * Subject to combined overall person of $450 and membership of $900 for chiropractic incl. 1 X-ray per year per person, osteopathic, physiotherapy and podiatry. # Subject to combined overall person of $350 and membership of $700 for chiropractic incl. 1 X-ray per year per person, dietetics, healthy lifestyle, pharmacy, osteopathic, physiotherapy, and podiatry. annual dietetics, healthy lifestyle, osteopathy, pharmacy, physiotherapy and podiatry) $700 Extras benefits

16 30 31 Premium Options Type of service Additional information Benefit Person External Prosthesis/ Medical Appliances Healthy Lifestyle - Health management program - Weight loss program - Quit smoking plan - Health assessments - Skin cancer screening HIF approved prosthetics items such as artificial limbs, wigs and external mammary prostheses and approved medical devices such as a Tens machine, Circulation Booster and Cam Walker. Conditions apply so please contact us for details prior to purchasing item. Benefits are payable for HIF approved programs delivered by registered providers only. Please contact us prior to commencing the program or paying subscriptions to ascertain if the program is eligible for a rebate. 75% of fee $1,500 per year. Single: $125 Family: $250 e: sub s apply depending upon item. Super Options Benefit Person No 75% of fee $1,500 per year. $125 Single: $100 Special Options Type of service Additional information Benefit Person External Prosthesis/ Medical Appliances Healthy Lifestyle - Health management program - Weight loss program - Quit smoking plan - Health assessments - Skin cancer screening HIF approved prosthetics items such as artificial limbs, wigs and external mammary prostheses and approved medical devices such as a Tens machine, Circulation Booster and Cam Walker. Conditions apply so please contact us for details prior to purchasing item. Benefits are payable for HIF approved programs delivered by registered providers only. Please contact us prior to commencing the program or paying subscriptions to ascertain if the program is eligible for a rebate. Family: $200 e: sub s apply depending upon item. $100 Saver Options Benefit Person No N/A N/A No N/A N/A No Single: $75 Family: $150 $75 Single: $50 Family: $100 $50 dietetics, healthy lifestyle, osteopathic, pharmacy, physiotherapy and podiatry) $700 Extras benefits

17 32 33 Premium Options Type of service Additional information Benefit Person Hearing aids Humidifier or nebuliser Occupational therapy Optical Orthotics replacement hearing aids after 5 years from date of supply. A letter of recommendation from the patient s treating practitioner is required. consultations carried out by a registered occupational therapist, approved by HIF. items carried out by a registered podiatrist or orthotic supplier, approved by HIF #. Up to 5 years: $550 5 to 10 years: $600 per ear 10+ years: $700 per ear Up to 5 years: 1 Over 5 years: 1 per ear 75% of cost 1 of either monitor every 3 years. Maximum $180. First Visit $60 Subsequent $27 Group $10 (orthoptics, physiotherapy and speech therapy) Up to 5 years: $1200 Over 5 years: $ % of cost $240 1 every 2 years from date of supply ^ Super Options Benefit Person No Up to 5 years: $ years: $550 per ear Up to 5 years: 1 Over 5 years: 1 per ear No 75% of cost 1 of either monitor every 3 years. Maximum $140. No First visit: $45 See page 40 for more details $25 Group: $10 (orthoptics, physiotherapy and speech therapy) Up to 5 years: $900 Over 5 years: $1100 No 75% of cost $200 1 every 2 years from date of supply ^ No No No No # e: benefits are not available for orthotics which are not specifically modified and fitted for the individual member s condition. ^ Orthotic includes associated services such as muscle testing, ROM testing and gait analysis. Special Options Type of service Additional information Benefit Person Hearing aids Humidifier or nebuliser Occupational therapy Optical Orthotics replacement hearing aids after 5 years from date of supply. A letter of recommendation from the patient s treating practitioner is required. consultations carried out by a registered occupational therapist, approved by HIF. items carried out by a registered podiatrist or orthotic supplier, approved by HIF #. Saver Options Benefit Person N/A N/A No N/A N/A No N/A N/A No N/A N/A No N/A N/A No N/A N/A No See page 40 for more details N/A N/A No N/A N/A No # e: benefits are not available for orthotics which are not specifically modified and fitted for the individual member s condition. Extras benefits

18 34 35 Premium Options Type of service Additional information Benefit Person Orthoptics (eye therapy) Osteopathic Peak Flow Meter items carried out by a registered orthoptics supplier, approved by HIF. items carried out by a registered osteopath, approved by HIF. Initial: $50 $25 First visit: $30 Visits 2-10: $29 Visits 10+: $18 with occupational physiotherapy and speech therapy Up to 5 years: $1200 Over 5 years: $1500 (chiropractic and osteopathic) Up to 3 years: $650 Over 3 years: $750 Super Options Benefit Person No Initial $50 (chiropractic and osteopathic) Up to 3 years: $1300 Over 3 years: $1500 Subsequent $25 First visit: $28 Visits 2-10: $23 Visits 10+: $17 with occupational physiotherapy and speech therapy Up to 5 years: $900 Over 5 years: $1100 (chiropractic and osteopathic) Up to 3 years: $550 Over 3 years: $650 No (chiropractic and osteopathic) Up to 3 years: $1100 Over 3 years: $1300 N/A $30 1 per year No $30 1 per year No Special Options Type of service Additional information Benefit Person Orthoptics (eye therapy) Osteopathic Peak Flow Meter items carried out by a registered orthoptics supplier, approved by HIF. items carried out by a registered osteopath, approved by HIF. Saver Options Benefit Person N/A N/A No N/A N/A No First visit: $26 Visits 2-10: $21 Visits 10+: $16 physiotherapy, osteopathic and podiatry) $450 physiotherapy, osteopathic and podiatry) $900 First visit: $26 Visits 2-10: $21 Visits 10+: $16 dietetics, healthy lifestyle, osteopathic, pharmacy, physiotherapy & podiatry) $350 N/A N/A N/A No N/A N/A No annual dietetics, healthy lifestyle, osteopathic, pharmacy, physiotherapy and podiatry) $700 Extras benefits

19 36 37 Premium Options Type of service Additional information Benefit Person Pharmacy Physiotherapy payable on contraceptives or NHS (PBS) prescriptions or over the counter items purchased with or without a prescription. Benefits are paid on items carried out by a registered physiotherapist, approved by HIF. Member pays PBS contribution. Benefit is 100% of balance up to $80 per script item. First visit: $45 Visits 2-10: $40 Visits 10+: $30 Hydrotherapy: $15 Antenatal: $15 Group: $15 Up to 3 years: $200 Over 3 years: $400 (occupational, orthoptics and speech therapy) Up to 5 years: $1200 Over 5 years: $1500 $600 sub for hydrotherapy, antenatal and group. Special Options Type of service Additional information Benefit Person Pharmacy Physiotherapy payable on contraceptives or NHS (PBS) prescriptions or over the counter items purchased with or without a prescription. Benefits are paid on items carried out by a registered physiotherapist, approved by HIF. Member pays PBS contribution. Benefit is 100% of balance up to $80 per script item. First visit: $32 Visits 2-10: $24 Visits 10+: $19 Hydrotherapy: $13 Antenatal: $13 Group: $8 Super Options Benefit Person No Member pays PBS contribution. Benefit is 100% of balance up to $80 per script item. No First visit: $35 Visits 2-10: $29 Visits 10+: $20 Hydrotherapy: $13 Antenatal: $13 Group: $13 Up to 3 years: $200 Over 3 years: $400 (occupational, orthoptics and speech therapy) Up to 5 years: $900 Over 5 years: $1100 $500 sub for hydrotherapy, antenatal and group. Saver Options Benefit Person $200 No Member pays PBS contribution. Benefit is 100% of balance up to $80 per script item. ( chiropractic, physiotherapy, osteopathic and podiatry) $450 $400 sub for hydrotherapy, antenatal and group. ( chiropractic, physiotherapy, osteopathic and podiatry) $900 First visit: $32 Visits 2-10: $24 Visits 10+: $19 Hydrotherapy: $13 Antenatal: $13 Group: $8 dietetics, healthy lifestyle, osteopathic, pharmacy, physiotherapy & podiatry) $350 dietetics, healthy lifestyle, osteopathic, pharmacy, physiotherapy and podiatry) $350 $300 sub for hydrotherapy, antenatal and group. No No dietetics, healthy lifestyle, osteopathic, pharmacy, physiotherapy and podiatry) $700 dietetics, healthy lifestyle, osteopathic, pharmacy, physiotherapy and podiatry) $700 Extras benefits

20 38 39 Premium Options Type of service Additional information Benefit Person Podiatry* Psychology Speech therapy consultations carried out by a registered podiatrist, approved by HIF. Maximum of 2 sessions will be paid on the same date if there is a minimum of 2 hours between sessions. consultations carried out by a registered psychologist, approved by HIF. items carried out by a registered speech therapist, approved by HIF. First visit: $32 $25 Consultations that are not performed in the podiatrist s registered practice: $12 First visit: $100 $55 Group: $30 per person to a max of $75 per session First visit: $75 $45 $382 includes podiatry surgery performed in the podiatrist s registered rooms only. $1,000 per year (occupational, orthoptics and physiotherapy) Up to 5 years: $1200 Over 5 years: $1500 Super Options Benefit Person No First visit: $32 $23 Consultations that are not performed in the podiatrist s registered practice: $12 No First visit: $75 $55 Group: $25 per person to a max of $75 per session No First visit: $75 $45 $354 includes podiatry surgery performed in the podiatrist s registered rooms only No $740 per year No (occupational, orthoptics and physiotherapy) Up to 5 years: $900 Over 5 years: $1100 * Benefits not payable when provided as part of treatment provided in, or arranged by a hospital (including surgery). Special Options Type of service Additional information Benefit Person Podiatry* Psychology Speech therapy consultations carried out by a registered podiatrist, approved by HIF. Maximum of 2 sessions will be paid on the same date if there is a minimum of 2 hours between sessions. consultations carried out by a registered psychologist, approved by HIF. items carried out by a registered speech therapist, approved by HIF. First visit: $32 $23 Consultations that are not performed in the podiatrist s registered practice: $12 physiotherapy, osteopathic and podiatry) $450 Saver Options Benefit Person physiotherapy, osteopathic and podiatry) $900 First visit: $32 $23 Consultations that are not performed in the podiatrist s registered practice: $12 dietetics, healthy lifestyle, osteopathic, pharmacy, physiotherapy & podiatry) $350 No : dietetics, healthy lifestyle, osteopathic, pharmacy, physiotherapy and podiatry) $700 N/A N/A No N/A N/A No N/A N/A No N/A N/A No * Benefits not payable when provided as part of treatment provided in or arranged by, a hospital (including surgery). Extras benefits