Top

Smart Starter hospital cover

For getting started in health insurance

Choose quality Smart Starter hospital cover, from under $3.00 per person per day* 

  • Designed for singles and couples getting started in health insurance
  • Covers you for the things you're likely to need, and nothing you don't (such as hip replacements or cataracts)
  • Includes national cover for emergency and medically necessary ambulance services, including transfers between hospitals
  • Covers all costs of accommodation in a contracted private hospital or day-only facility, or a public hospital as a private patient, once any excess has been paid
  •    
    *Under $3.00 per person per day is based on the 25.934% rebate being claimed upfront for a single person or couple residing in NSW, for Smart Starter hospital cover with a $500 excess.
   
    Get quality health cover now, from the only health fund in Australia created by doctors, for doctors.        

Quick Quote

I am...

I live in...

  • Please select...
  • ACT
  • NSW
  • NT
  • QLD
  • SA
  • TAS
  • VIC
  • WA

What is included:

Excess

Singles $500 per calendar year.

Couples $1,000 per calendar year.

$500 of excess is paid per admission until the full amount of excess is paid for the year. The total excess amount applies to the entire membership not for each person covered by the membership.

Co-payments

 
None

Waiting Periods and pre-existing conditions

The benefits available under this product are only payable for services received after serving the relevant waiting period. Waiting periods apply when you’re new to private health insurance or you purchase cover with better benefits or conditions. More information.

None for accidents

12 months for pre-existing conditions

2 months for psychiatric, rehabilitation and palliative care (whether or not for a pre-existing condition), and all other treatments

Exclusions

No benefits are paid for:
  • Pregnancy related services
  • Assisted reproductive services
  • Sterilisation and reversal of sterilisation
  • Hip and knee replacements and revisions
  • Cataract and glaucoma treatment
  • Gastric banding and obesity surgery
  • Services that are not eligible for Medicare benefits
  • Hearing loss related services
  • Diabetes related services
  • Spinal surgery not related to an accident

Benefit restrictions

  • Cardiothoracic surgery limited to delivery as a private patient in a public hospital.
  • Psychiatric services are limited to all days delivered as a private patient in a public hospital shared ward.
  • Dialysis for chronic renal failure is limited to delivery as a private patient in a public hospital shared ward.
  • Rehabilitation services following cardio thoracic, psychiatric, hip and knee replacement and revisions is limited to delivery as a private patient in a public hospital shared ward.

Ambulance

National cover for emergency and medically necessary ambulance services when
  • an ambulance is called to attend you but you are not subsequently taken to hospital
  • it is medically necessary for you to be transported by an ambulance to be admitted to hospital
  • you need immediate medical attention at a hospital or other approved facility
  • you are an admitted patient and need to be transferred to another hospital

Accommodation

In a contracted private hospital or day-only facility, or a public hospital as a private patient all costs of accommodation are covered after the excess is paid. In non-contract hospitals or day-only facilities the lowest contracted benefit is paid and you can expect to have out-of-pocket expenses.

Hospital services

After the excess is paid all costs are covered for theatre services while you are an in-patient.

Medical services

gap cover

The cost of doctors' services delivered while you are an admitted patient can be covered by the Access Gap Cover scheme which reduces or eliminates your medical services out-of-pocket expenses. When your doctor agrees to participate in the Access Gap Cover scheme the Fund covers the scheme's scheduled amount for your treatment. The doctor may choose to charge you a payment above the scheme's scheduled amount. This may be no more than $400 per service. Most pathology and radiology providers have contracts with us, so while you are an admitted patient most of these services will have no out-of-pocket expense. Claims using this gap scheme should be submitted directly to the Fund. Check that your doctors have marked any bills sent to you as Access Gap cover accounts. To find doctors who participate in this gap scheme use the Doctor Search facility on this website.

Pharmaceuticals

In a contracted private hospital or day-only facility, or a public hospital as a private patient, all costs of PBS pharmaceuticals related to the condition being treated are covered, and the cost of non-PBS items related to the condition being treated are covered as per the contract with the hospital. In non-contract hospitals and day-only facilities the lowest contracted benefit is paid and you can expect to have out-of-pocket expenses.

Prostheses

Covers 100% of the minimum cost specified for government approved prostheses.

Other

Up to $70 per day for travel and accommodation where a doctor certifies the need for a parent, spouse or child to be with a member in hospital more than 200 kms from home. An annual limit of $500 applies.

Examples of what you can expect to be out of pocket for if you go to hospital

Your excess For personal items such as newspapers and television hire. The difference between the Medicare Schedule fee and your doctor’s fee. From 1 August 2007 this will only apply if your doctor does not wish to participate in the Access Gap Scheme.

 

Looking for Extras Cover as well?

You can add Extras cover to your Hospital Cover

View Extras Options