Explore Essential Silver Hospital
Inclusions
An inclusion is a treatment, service or good that we will pay a benefit towards. Essential Silver Hospital includes cover for the following 29 services:
- Rehabilitation
- Palliative care
- Tonsils, adenoids and grommets
- Joint reconstructions
- Hernia and appendix
- Gynaecology
- Ear, nose and throat
- Bone, joint and muscle
- Kidney and bladder
- Male reproductive system
- Digestive system
- Gastrointestinal endoscopy
- Miscarriage and termination of pregnancy
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Skin
- Brain and nervous system
- Eye (not cataracts)
- Pain management
- Breast surgery (medically necessary)
- Diabetes management (excluding insulin pumps)
- Blood
- Dental surgery
- Lung and chest
- Sleep studies
- Back, neck and spine
- Plastic and reconstructive surgery (medically necessary)
- Heart and vascular system
- Podiatric surgery (provided by a registered podiatric surgeon)
- Implantation of hearing devices
Added hospital features
- Urgent ambulance
- Private room coverage*
If you need cover for any of the excluded services or higher benefits for the restricted services, you may want to compare our higher levels of hospital cover.
Restrictions
For restricted services, benefits payable are limited to the Minimum Default Benefit. If a service is restricted, you’ll generally have a large out-of-pocket cost if you receive treatment at a private hospital.
Essential Silver Hospital includes cover for 1 restricted service:
- Hospital psychiatric services
If you need higher benefits for any of the restricted services, you may want to compare our higher levels of hospital cover.
Exclusions
An exclusion is a treatment or service which is not included on your cover. No benefits are payable towards excluded treatments or services. If you choose to be treated for an exclusion as a private patient, you may incur significant out-of-pocket costs.
Essential Silver Hospital excludes cover for the following services:
- Assisted reproductive services
- Pain management with device
- Insulin pumps
- Cataracts
- Dialysis for chronic kidney failure
- Joint replacements
- Pregnancy and birth
- Weight loss surgery
If you need cover for any of the excluded services, you may want to compare our higher levels of hospital cover.
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Frequently asked questions
What is hospital insurance?
Also known as hospital cover, hospital insurance helps cover costs when you're admitted to hospital. It covers things like your doctors' fees, accommodation and theatre fees.
When can I start using my hospital insurance?
When you buy hospital insurance for the first time or after not having it for a long time, or you upgrade to include a new service, there will generally be a waiting period you need to serve before you can claim.
At HBF, waiting periods for hospital insurance are as follows
What is a hospital excess?
An excess is a sum of money you pay upfront before you receive hospital treatment. Generally, the higher your excess, the lower your premium.
An excess is paid once per member, per calendar year (to a maximum of twice per couple or family policy) no matter how many times you may be hospitalised. Excess applies for day and overnight admissions.
You won’t be required to pay an excess for any dependant children on your single parent or family policy*.
How much will I get back when I make a hospital insurance claim?
Where your treatment is an included service on your hospital cover, your hospital costs will either be fully or partially covered depending on the type of agreement your health fund has with your specialists and hospital.
With HBF, when you’re admitted to hospital for treatment you will get 100% back for the cost of your hospital accommodation and specialists so long as you choose providers that have ‘no-gap’ (otherwise known as ‘fully covered’) agreements with HBF. Just be aware of out-of-pocket costs, which can include excess or co-payments. Please note, outpatient services are not covered under hospital insurance.
Before you book hospital treatments, contact us and we’ll help you understand what you can claim, how much you can claim, and if any excess, co-payments or waiting periods apply. To ensure we give you accurate advice, please have a written cost estimate from your provider on-hand.
What does hospital insurance cover?
Hospital insurance helps cover the cost of 'inpatient' services — these are treatments you receive when you're admitted to hospital for care (e.g. for surgery). Hospital insurance helps cover your medical specialists' fees, as well as accommodation, approved prostheses and theatre fees.
The specific hospital treatments and services you're covered for (e.g. chemotherapy, a colonoscopy, tonsil removal, knee reconstructions etc.) depend on the level of hospital cover you choose.
