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Each person is permitted to be admitted as a private patient in a private hospital for up to 5 separate day procedures within a financial year (July to June). No theatre fees are covered in the case of an overnight admission; admission in a non-contracted hospital; or after the fifth day procedure. In these circumstances, government default benefits will apply. Please ask the hospital in regards to the current rates and please note no theatre fees are covered by default benefits’. Combining Public Basic+ Hospital with Budget Extras allows you to have a simple level of extras cover for non-hospital related services such as dental and optical.
Hospital
| Services | |
|---|---|
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Cancer 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Treatment for accidents 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Cardiac + cardiac related services 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Tonsils + adenoids 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Appendicitis 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Wisdom teeth (Hospital benefits only) 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Arthroscopy + colonoscopy 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Pregnancy + pregnancy related services 12 month waiting period |
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Covered as a private patient in a public hospital only. |
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Assisted Reproductive services (IVF, etc.) 12 month waiting period |
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Covered as a private patient in a public hospital only. |
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Spinal surgery 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Shoulder surgery 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Knee reconstruction 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Psychiatric services 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Rehabilitation 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Palliative care 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Major eye surgery 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Dental surgery 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Kidney dialysis 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Bariatric surgery 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Hip + knee replacement 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Other joint replacement 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Prosthetic appliances 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Early release home nursing 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Podiatry surgery 2 month waiting period |
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Covered as a private patient in a public hospital only. Limited benefits are available when Podiatric Surgery is performed in a contracted hospital by an Australian Government Accredited Podiatrist. |
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Non-cosmetic surgery/plastic surgery 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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Ambulance cover 2 month waiting period |
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100% of the cost of ambulance services within Australia provided that the service is from a State/Territory registered ambulance service and deemed medically necessary. |
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All other services recognised by Medicare 2 month waiting period |
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Covered as a private patient in a public hospital only. |
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| Services | |
|---|---|
| Cosmetic surgery |
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Not Covered. |
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| Services where Medicare does not pay a benefit |
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|
Not Covered. |
|
| Category | Annual Limit | |
|---|---|---|
|
General & Major Dental 12 month waiting period |
$500 |
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Covers dental items listed by the Australian Dental Association (ADA) up to a set rebate. General Dental Includes restorations/fillings & Occlusal Therapy General Dental services are not subjected to an individual category maximum however, benefits paid towards these procedures do form part of the overall annual benefit limitation. Major Dental Periodontics Set benefits are payable for individual dental services and may not attract the full major dental annual sub-limit.
(2 months waiting period for General Dental and 12 months waiting period for Major Dental.) |
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Optical 6 month waiting period |
$170 |
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100% of the fee up to the annual limit |
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Physiotherapy 2 month waiting period |
$300 |
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Includes Telehealth Services. |
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Chiropractic and Osteopathy 2 month waiting period |
$300 |
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$600 per family limit |
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Non-PBS Pharmacy 2 month waiting period |
$200 |
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Per Prescription up to $50 |
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Natural Therapies 2 month waiting period |
$200 |
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$400 per family limit |
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Ambulance Services 2 month waiting period |
unlimited |
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100% of the cost of ambulance services within Australia provided that the service is from a State/Territory registered ambulance service and deemed medically necessary. |
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© Navy Health Ltd All Rights Reserved 2023
