1. What's included in this product?
Shared room in a private or public hospital
What is AccessGap Cover?
Doctors can charge more than the Medicare Benefits Schedule (MBS). And if they do, their patients without gap cover insurance will incur an out-of-pocket expense for the difference between the fee charged and the MBS. The good news is that AccessGap Cover, our medical gap arrangement, minimises or even eliminates these out-of-pocket expenses for medical services you receive as an in-patient in a registered overnight hospital or day facility. That said, you need to bear in mind that Australian doctors can nominate to opt in or out of AccessGap, so it makes sense to check in advance. View our online list of registered participating AccessGap specialists, or simply ask your doctor or specialist if they will treat you under the AccessGap Cover arrangement.
2. What’s excluded from this product?
- Obstetrics (maternity)
- Assisted reproductive technology (e.g. IVF)
- Gastric banding and obesity surgery
- Cardiac (heart) conditions, procedures or monitoring*
- Eye surgery
- Joint replacement
- Cosmetic services^
- Out-patient services
- Services not covered by Medicare
- Ambulance (except for emergency services applicable under NSW & ACT legislation).
* This includes things like heart bypass surgery, angiograms and coronary care.
^ ‘Cosmetic Services’ refers to any treatment that’s deemed to be cosmetic by Medicare
3. What excess applies for GoldStarter?
An excess is the amount you pay towards your eligible hospital treatment, after which we take care of the rest.
For GoldStarter, there’s a standard $200 excess per person per admission (up to a maximum of $400 per year).
4. Are there any restrictions?
With GoldStarter, we pay a basic benefit (known as the public hospital rate) towards accommodation charges* for the following services:
- Palliative care
- Psychiatric treatment
Important, please note: If you’re admitted to hospital and a private room is the only option available, a co-payment per night may apply. This charge will be the difference between your chosen hospital’s shared room and private room rate. To confirm the applicable co-payment (if any), please contact your hospital prior to admission.
*All other charges raised by the hospital during the stay will be paid by the member.
5. What about waiting periods and the pre-existing condition rule?
All health funds have to enforce waiting periods. It’s the only way we can protect our members from people who simply join our fund to claim large amounts and then leave. However, we try to keep waiting periods to a minimum. That’s why, if you switch to HIF from another health fund, we’ll honour your full length of membership with your previous fund, (meaning you won’t have to re-serve any unnecessary waiting periods).
If you aren’t switching from another fund, the waiting periods with GoldStarter are:
2 months for general hospitalisation claims
12 months for all treatments related to a pre-existing ailment or condition