Overseas Visitors Health Cover

If you are admitted to a Members First, Participating Private hospital or public hospital, you will receive full cover for hospital expenses, for as long as medically necessary.

Hospital expenses are charges for in-hospital services, which include:

Accommodation fees for overnight or same-day hospital stays
Operating theatre and intensive care fees
Supplied pharmaceuticals approved by the Pharmaceutical Benefits Scheme (PBS) and provided as part of your in-hospital treatment
Allied services including physiotherapy, occupational therapy and dietetics
No Gap prostheses that are surgically implanted and Government-recognised

Cover for prostheses

You are also covered for surgically implanted Government-recognised No Gap prostheses. If your doctor chooses a No Gap prosthesis, you will not have any out-of-pocket expense where the prosthesis item is implanted as part of the hospital treatment covered. If the prosthesis item used is listed as a Gap prosthesis you will have to pay any gap charged by the hospital. You can ask your specialist to choose a No Gap prosthesis as there is one available for every surgical requirement.

Medical expenses

Cover for your medical expenses

We cover you for up to 100% of the Government Schedule fee for services provided by doctors including surgeons, anaesthetists, pathologists or radiologists whilst in hospital. You?ll also receive medical cover for up to 85% of the Government Schedule fee as a hospital outpatient or when treated by a doctor or specialist in private practice

Cover for the 'gap'

Ezyclaim is a direct billing system your specialist can use to eliminate or reduce the gap. An Ezyclaim specialist bills us directly. So in most cases, you don't pay any out-of-pocket expenses, or even receive a bill. And if there is a gap, you will be told about the amount before your treatment. Simply ask your specialist about Ezyclaim.

Additional features and benefits

Ambulance services	Full ambulance cover On top of your hospital cover you will receive full cover for ambulance transportation services or on-the-spot treatment anywhere in Australia. If you do not have an ambulance subscription with your state ambulance service and need to make a claim for ambulance services covered on top of your hospital cover, please complete and return to us the Particulars of Ambulance Transportation form.

What is not covered?

Full costs at non-participating private hospitals	If you choose to be treated at a private hospital that is not in our Participating private hospital network, you may incur large out-of-pocket expenses. To get the most value from your cover, we recommend you use a Participating hospital.
During a Waiting Period	A waiting period starts from the date you join. During a waiting period you are not covered and will not receive any benefits for the types of treatment affected by the waiting period. Once the waiting period is over, you will receive the full benefits listed under your level of cover for that treatment type. All hospital covers have 12 month waiting periods for pre-existing conditions and pregnancy (childbirth), where applicable. If you transfer to HBA from another health fund on an equivalent level of cover we will honour all the waiting periods you have already served when we receive confirmation of your previous membership and level of cover, but you will need to join within one month of leaving the other fund. When you upgrade to a higher level of cover, the benefits from your previous level of cover apply during waiting periods.
Restricted Benefits	If a service is covered as a Restricted Benefit, this means you will be covered with your choice of doctor for shared room accommodation in a public hospital only. If you go to a private hospital for a specific service which has Restricted Benefits, it is likely to result in large out-of-pocket expenses. Restricted Benefits are an amount set by the Government and are generally not enough to cover accommodation costs in a private hospital. Some hospital covers give Restricted Benefits for specific services for the duration of that cover. If Restricted Benefits apply for other treatments under this level of cover, they will be listed below.
Exclusions	Some covers exclude specific services. This means you will not be covered for that specified service or treatment whilst on that level of cover. For the duration on this level of cover you will not receive cover for: Any treatment outside of Australia Services not covered by Medicare Cosmetic surgery or sterilisation reversal Medical costs for surgical procedures performed in hospital by a dentist or podiatrist. However some Dental costs can be covered by our extensive range of extras covers Expenses relating to medical examinations, X-rays, inoculations or vaccinations or other treatments related to acquiring a visa or permanent residency.
Services and situations not covered by health funds	There are some hospital services that are generally not covered under a health fund's hospital cover: A person who has been in hospital for more than 35 days and is classified as a nursing home type patient (as defined in the Health Insurance Act) may receive limited benefits. In such cases patients are required by law to make a personal contribution towards their care. Benefits are not payable for pharmaceuticals supplied on discharge from hospital, unless covered under your extras benefits. Benefits are not payable where compensation, damages or benefits may be claimed from another source (eg. Workers' Compensation, Compulsory Third Party Insurance, Common Law Damages, Government Programs/Agencies, Travel Insurance, Sports Insurance etc) in relation to a condition, injury or ailment. We reserve the right to recover any benefits paid in this regard.

Are there any restrictions or exclusions?

Hospital	Waiting Period
Heart or artery-related services	Restricted benefits apply for the first year
Assisted reproductive services (including IVF)	Restricted benefits apply for the first two years
Hip or knee replacement	Restricted benefits apply for the first two years
Psychiatric treatment	Restricted benefits apply for the first two years
Rehabilitation	Restricted benefits apply for the first two years
Cataract surgery	Restricted benefits apply for the first two years
Cosmetic surgery, sterilisation reversal & surgical podiatry	Restricted benefits apply for the duration of cover

What are the waiting periods?

Hospital	Waiting Period
Pregnancy (childbirth)	1 Year
Pre-existing ailments, illnesses or conditions for hospital services	1 Year

What does it cost?

Cover	Current Price	Price from 1 April
Single	$46.70 per week ^†	$49.60 per week ^†
Couple	$93.40 per week ^†	$99.15 per week ^†
Family	$93.40 per week ^†	$99.15 per week ^†

Prices are for stated memberships only.