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133 423

Product Change FAQs

Product Change FAQs

Find out why products are changing, what is changing, whether it affects you and what your options are.

What is changing?

From 1 July we are making changes to select hospital products (including packages that cover hospital). Extras products will not be affected.

Depending on the hospital product you have, you may experience one or a combination of the following changes:

The addition of a day excess (an upfront payment) means from 1 July onwards, whether you go into hospital for a day or overnight procedure, you will pay an excess.

You only have to pay an excess once per person, per calendar year regardless of whether it’s for day surgery or an overnight stay.

Healthy Saver Hospital and Smart Saver Twin Pack will have an excess of $250.

You will still be able to get cover for these services on higher levels of cover, e.g. Top Hospital. It’s just some low to mid-level hospital products that will have select services excluded or restricted.

While there are a number of services that will be excluded or restricted, the products affected will still cover thousands of medical procedures.

What services will be impacted by exclusions or restrictions?

Surgical weight loss, otherwise known as bariatric surgery, is weight loss surgery focused on the stomach and/or intestines.

From 1 July, weight loss surgery will be excluded (not covered) on select hospital products.

You can check whether your hospital product will exclude weight loss surgery by referencing the table below, or viewing your policy.

A cochlear implant is a device surgically inserted into a part of the ear to improve hearing.

From 1 July, cochlear implants will be excluded (not covered) on select hospital products.

You can check whether your hospital product will exclude cochlear implants by referencing the table below, or viewing your policy.

Dialysis is a surgical process that involves removing waste products and excess fluid from the body. It’s a necessary procedure when the kidneys can’t effectively filter blood.

From 1 July, dialysis will be excluded (not covered) on select hospital products.

You can check whether your hospital product will exclude dialysis by referencing the table below, or viewing your policy.

An insulin pump is a device that delivers insulin to the body. It’s used by some people with diabetes.

From 1 July, insulin pumps will be excluded (not covered) on select hospital products.

You can check whether your hospital product will exclude insulin pumps by referencing the table below, or viewing your policy.

Sterility reversal is a procedure that restores fertility in men or women after they’ve had a tubal ligation (fallopian tubes severed) or a vasectomy.

From 1 July, sterility reversal will be excluded (not covered) on select hospital products.

You can check whether your hospital product will exclude sterility reversal by referencing the table below, or viewing your policy.

Psychiatric care involves the medical diagnosis, prevention, study and treatment of mental disorders.

From 1 July, benefits for psychiatric care will be restricted (covered, but only to a limited extent) on select hospital products. If psychiatric care is restricted on your product, you can still claim but it’s likely you’ll have a large out-of-pocket.

You can check whether your hospital product will restrict psychiatric care by referencing the table below, or viewing your policy.

Do these changes affect me?

Not all products will be affected by these changes. If you only have Extras insurance, you are not affected by any changes.

You will receive a letter from us between 12 March – 20 April detailing changes to your product and your options moving forward if you are affected by the changes.

If you have Hospital insurance or a package that includes cover for hospital, here’s how to tell if you’re affected:

Check to see if your policy has an excess, or if it will have an excess when the changes come into effect. You can do this by logging into myHBF and viewing your policy document.

If you have a hospital product with an excess, or will have an excess when the changes come into effect, a day excess will apply from 1 July onwards. That means if you go into hospital, whether it’s just for the day or involves an overnight stay, you will pay an excess.

You only have to pay this excess once per person, per calendar year regardless of if you go in during the day or for an overnight stay.

To check if your product is affected by any exclusions or restrictions, you can either login to myHBF and view your policy or you can check the table below.

If your product doesn’t appear below, you aren’t affected by any change in exclusions or restrictions. You might still have a day excess apply from 1 July.

From 1 July 2018 onwards, the following products will cover:

Surgical weight loss, cochlear implants, dialysis, insulin pumps and sterility reversal will be excluded on this product. Benefits for psychiatric care are already restricted on this product, so there is no change to this service.

Surgical weight loss, cochlear implants, dialysis, insulin pumps and sterility reversal will be excluded on this product. Benefits for psychiatric care are already restricted on this product, so there is no change to this service.

Surgical weight loss, cochlear implants, dialysis, insulin pumps and sterility reversal will be excluded on this product. Benefits for psychiatric care are already restricted on this product, so there is no change to this service.

Surgical weight loss, cochlear implants, dialysis and insulin pumps will be excluded on this product. Benefits for psychiatric care are already restricted on this product, so there is no change to this service.

Surgical weight loss, cochlear implants, dialysis and insulin pumps will be excluded on this product. Benefits for psychiatric care are already restricted on this product, so there is no change to this service.

Surgical weight loss, cochlear implants, dialysis and insulin pumps will be excluded on this product. Benefits for psychiatric care are already restricted on this product, so there is no change to this service.

Surgical weight loss and dialysis will be excluded on this product. Benefits for psychiatric care will be restricted.

Surgical weight loss and dialysis will be excluded on this product. Benefits for psychiatric care will be restricted.

Surgical weight loss and dialysis will be excluded on this product. Benefits for psychiatric care will be restricted.

Dialysis will be excluded on this product. Benefits for psychiatric care will be restricted. Surgical weight loss is already excluded on this product, so there is no change in benefits to this service.

Surgical Weight Loss Cochlear Implants Dialysis Insulin Pumps Sterility Reversal Psychiatric Benefits
Young Saver Hospital Restricted*
Young Single Saver Twin Pack Restricted*
GMF Lite Hospital Restricted*
Healthy Saver Hospital Restricted*
Healthy Saver Twin Pack Restricted*
Smart Saver Twin Pack Restricted*
GMF Mid Hospital Restricted
GMF Mid No Maternity Restricted
Mid Hospital Restricted
Mid Family Cover ** Restricted

*Psychiatric benefits were already restricted on this product. There is no change in benefits for psychiatric care on this product.

**Surgical weight loss was already excluded on this product. There is no change in benefits for surgical weight loss on this product.

When do the changes come into effect?

The changes come into effect on 1 July 2018.

These changes affect me — what can I do about it?

We understand the impact these changes have and want to make sure you aren’t left without options.

Contact us and we’ll walk you through the changes and what you can do. If you’d like to make any changes to your policy, you can do this at your local branch, over the phone, or via email.

We’ve also made special arrangements for you:

If you upgrade to a higher level of cover before 1 September, you won’t have to re-serve the waiting period for services affected by the change in exclusions or restrictions on your lower-level product.

If you’re in the middle of a waiting period, when you upgrade you’ll just serve out the remainder of that waiting period.

If you are undertaking a course of treatment when the change takes effect, your benefits will not be impacted unless the course continues beyond 31 December 2018. This only applies to treatment that commences before 1 July 2018.

If you think you’ll require follow-up treatment, it’s a good idea to upgrade before 1 September so you don’t have to re-serve waiting periods for that treatment.

If you book your treatment before 1 May 2018 or you’ve already received a benefit quote from us, you will still be covered for your treatment even if it falls after the changes come into effect on 1 July.

So long as you’ve got your booking sorted before 1 May 2018, the procedure itself can be after 1 July and you won’t be affected by the changes.

Just be sure to let us know if you have a treatment pre-booked.

If you think you’ll require follow-up treatment, it’s a good idea to upgrade before 1 September so you don’t have to re-serve waiting periods for that treatment.

Why are these changes happening?

We’re making these changes so we can continue to provide high quality health insurance at an affordable price.

Analysis of our products reveal we currently cover high-cost services on some low and mid-range products. A small proportion of members on these products account for a large proportion of high-cost claims. This trend is driving up premium prices for everyone else on these products.

To keep these products affordable, instead of increasing premiums we felt it would be fairer to ask members who need to claim for select services to move to a higher level of cover that better reflects the cost of those services.

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