1

A policy that includes cover for hospital‑substitute treatment.

Hospital treatment for the same types of treatment covered by the policy for hospital‑substitute treatment.

2

A policy under which a person is covered, wholly or partly, for hospital treatment where:

(a) the treatment includes the provision of a prosthesis of a kind listed in the Private Health Insurance (Prostheses) Rules made under the Act; and

(b) either:

(i) a medicare benefit is payable in respect of the professional service associated with the provision of the prosthesis; or

(ii) the provision of the prosthesis is associated with podiatric treatment by a registered podiatric surgeon; or

(iii) for a prosthesis that is an insulin infusion pump:

(A) the insulin infusion pump is provided during a professional service for which a medicare benefit is payable; and

(B) the professional service is a professional attendance by a consultant physician in the practice of his or her specialty; and

(C) the professional service is provided as a certified Type C procedure or certified overnight Type C procedure; and

(D) the insulin infusion pump is provided for the purpose of administering insulin.

The provision of the prosthesis.

3

A policy under which a person is covered, wholly or partly, for hospital‑substitute treatment where:

(a) the treatment includes the provision of a prosthesis of a kind listed in the Private Health Insurance (Prostheses) Rules made under the Act; and

(b) a medicare benefit is payable in respect of the professional service associated with the provision of the prosthesis.

The provision of the prosthesis.

18 or older, but under 41

the person’s base percentage

41

the person’s base percentage minus 2 percentage points

42

the person’s base percentage minus 4 percentage points

43

the person’s base percentage minus 6 percentage points

44

the person’s base percentage minus 8 percentage points

45 or older

zero

18 or older, but under 26

10%

26

8%

27

6%

28

4%

29

2%

1

Policy name

The name of the policy.

Note: See rules 11H and 11J for rules governing the naming of policies that cover hospital treatment and the naming of policies that cover general treatment.

2

Name of private health insurer

The trading or brand name of the private health insurer in the State in which the policy is being made available, together with any associated branding that the insurer elects to include.

3

Disclaimer for restricted access insurers

If the policy is offered by a restricted access insurer—the following statement:

“Membership of this insurer is restricted to”

followed by the details.

4

Contact details

A contact phone number and website address of the private health insurer.

5

State/s available in

The States in which the product is available, expressed as either:

  (a) if:

 (i) the product is offered in all States; and

 (ii) every feature of the product (including the monthly premium referred to in item 6) is the same in each State;

   “All States”; or

  (b) otherwise—the State or States in which the product is available, expressed as whichever of the following is applicable:

 (i) “NSW & ACT”;

 (ii) “Northern Territory”;

 (iii) “Queensland”;

 (iv) “South Australia”;

 (v) “Tasmania”;

 (vi) “Victoria”;

 (vii) “Western Australia”.

6

Monthly premium

The total monthly premium payable before any rebate, loading or discount is applied.

The following words must be inserted before or following the premium amount: “before any rebate, loading or discount”.

Note: This item does not limit the information that a private health insurer may give to an insured person with regard to the premium payable after any rebate, loading and/or discount is applied.

7

Corporate products

If the policy is part of a corporate product—a statement to that effect, indicating either of the following, with the bracketed text replaced with the appropriate information:

  (a) “Employees/members of [Company/Organisation]”;

  (b) “Employees/members of organisations with arrangements with this health insurer”.

8

Closed products

If the policy is closed so that it is no longer available to anyone except those persons who, at the time of closing, were insured under the policy—the following words:

“This policy is closed to new members.”.

9

Who is covered

The insured groups that may be covered, expressed as whichever of the following is applicable:

  (a) “only one person”;

  (b) “2 adults (and no‑one else)”;

  (c) “2 or more people, none of whom is an adult”;

  (d) “2 or more people, only one of whom is an adult”;

  (e) “3 or more people, only 2 of whom are adults”;

  (f) “3 or more people, at least 3 of whom are adults”.

Note 1: The insured groups are set out in rule 5 of these Rules.

Note 2: This item does not limit the information that a private health insurer may give to an insured person with regard to the name/s of person/s covered by the policy.

10

Ambulance cover

The following information:

  (a) whether ambulance cover is included;

  (b) if so:

 (i) the waiting period (if any); and

 (ii) whether the cover is:

 (A) emergency only; or

 (B) emergency and non‑emergency; and

 (iii) any limits on cover (dollar amount or service); and

 (iv) any call‑out fees (if applicable);

  (c) for each State in which:

 (i) the product is available; and

 (ii) ambulance cover is not included;

   the following information:

 (iii) whether free ambulance services are available in that State;

 (iv) if so—whether they are limited to services in that State;

  (d) if ambulance cover were to be provided by a person other than the private health insurer who prepared the statement—whether the policy would provide a benefit for that cover.

11

Date available

If, and only if, the policy is not yet available—the date from which the policy will be available.

12

Date statement issued or updated

The date on which the content of the statement was issued or updated, in the following format, with the bracketed text replaced with the appropriate information:

“Date statement [issued/updated]: [dd]/[month in words]/[yyyy]”

13

Unique identifier

The unique identifier for the private health information statement that is generated by the privatehealth.gov.au system.

1

Information relating to policies that are available only with a general treatment policy

If the policy is available only with a policy that covers general treatment—whichever of the following is applicable:

  (a) if the policy may be purchased with any policy that covers general treatment offered by the insurer—the statement “must be purchased with a general treatment policy”;

  (b) if there is a set range of policies that cover general treatment with which the policy may be combined—the statement “must be purchased with certain general treatment policies”.

2

Whether the policy exempts holders from the Medicare Levy Surcharge

Whichever of the following is applicable:

  (a) “This policy exempts you from the Medicare Levy Surcharge”;

  (b) “This policy does not exempt you from the Medicare Levy Surcharge”.

3

What’s included and what’s not included in the policy

An indication of:

  (a) treatments that are covered by the policy, consisting of the words:

“This policy includes cover for”; and

  (b) treatments that are not covered by the policy, consisting of the words:

“This policy does not include cover for”;

followed, in each case, by:

  (c) the relevant clinical categories; and

  (d) whichever of the following (if any) is appropriate:

 (i) accident cover;

 (ii) benefits for travel or accommodation.

4

Restrictions

A list of all clinical categories (if any) that have restricted cover.

5

Waiting periods for new and upgrading members

The waiting periods that apply under the policy before a policy holder can claim, expressed either:

  (a) in the following format, with the bracketed text replaced with the appropriate figures:

 (i) “[the number of months (up to 2)] months for palliative care, rehabilitation and psychiatric treatments”;

 (ii) “[the number of months (up to 12)] months for pre‑existing conditions”;

 (iii) if, and only if, the policy covers pregnancy and birth (obstetrics)—“[the number of months (up to 12)] months for pregnancy and birth (obstetrics)”;

 (iv) “[the number of months (up to 2)] months for all other treatments”; or

  (b) if shown in a table—for all clinical categories covered by the policy, the appropriate figure for the relevant waiting period.

Note 1: This item does not limit the information that a private health insurer may provide with regard to an individual’s policy.

Note 2: The obstetrics waiting period of up to 12 months does not apply to treatment for neonatal care.

6

Excess

Whichever of the following is appropriate:

  (a) if there is no excess—the words “No excess”;

  (b) if there is an excess:

 (i) whichever of the following is appropriate, with the bracketed text replaced with the appropriate figure, and where the dollar amount for excess per admission is the excess for an overnight admission, if this is different from the excess for day surgery:

 (A) “You will have to pay an excess of $[number] per admission.”;

 (B) “You will have to pay an excess of $[number] per admission. This is limited to a maximum of $[number] per year.”;

 (C) “You will have to pay an excess on admission. This is limited to a maximum of $[number] per year.”;

 (D) “You will have to pay an excess of $[number] per admission. This is limited to a maximum of $[number] per person per year.”;

 (E) “You will have to pay an excess on admission. This is limited to a maximum of $[number] per person and $[number] per policy per year.”;

 (F) “You will have to pay an excess of $[number] per admission. This is limited to a maximum of $[number] per person and $[number] per policy per year.”;

 (G) “You will have to pay an excess on admission. This is limited to a maximum of $[number] per policy per year.”; and

 (ii) if applicable—“Excess payments do not apply to hospital admissions for accidents, of dependent persons, or for day surgery”, with any of “accidents”, “dependent persons” and “day surgery” that do not apply deleted, but with the order of those terms otherwise unchanged.

7

Extra cost per day (co‑payments)

If there are no co‑payments—the statement “No co‑payments”.

If there are co‑payments:

  (a) the statement “Every time you go to hospital you will have to pay”, followed by (with the bracketed text replaced with the appropriate figures):

 (i) either:

 (A) the statement “$[number] per day for overnight admissions”; or

 (B) the statements:

 “$[number] per day for a shared room for overnight admissions”; and

 if the policy covers accommodation in a private room—“$[number] per day for a private room for overnight admissions”; and

 (ii) as applicable, either:

 (A) the statement “$[number] for day surgery (no overnight stay)”; or

 (B) the statement “No co‑payment for day surgery (no overnight stay)”; and

 (iii) the statement “­– up to $[number] per hospital stay”, placed, if applicable, and if the insurer so chooses, directly after the statements referred to in subparagraph (i); and

  (b) if applicable—the statement “The maximum co‑payment is $[number] per year” (with the bracketed text replaced with the appropriate figures).

8

Note on out of pocket costs/doctors’ fees

The following statement:

“Under this policy, you may have to pay out‑of‑pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out‑of‑pocket costs that may apply to you.”.

9

Note on information relating to contracts between hospitals and insurers

The following statement:

“The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer.”.

10

Other features

A statement that indicates any other features of the policy that the insurer wishes to draw attention to.

The statement must consist of at most 100 words.

Example: Benefits for travel or accommodation, or aged‑based or other discounts.

Note: This statement (if included) is in addition to the statement (if included) that is referred to in item 9 of Schedule 3.

1

Information relating to policies that are available only with a hospital policy

If the policy is available only with a policy that covers hospital  treatment—whichever of the following is applicable:

  (a) if the policy may be purchased with any policy that covers hospital treatment offered by the insurer—the statement “must be purchased with a hospital policy”;

  (b) if there is a set range of policies that cover hospital treatment with which the policy may be combined—the statement “must be purchased with certain hospital policies”.

2

Preferred service provider arrangements

Whichever of the following is appropriate:

  (a) if the private health insurer has preferred service provider arrangements—either:

 (i) a brief outline of the appropriate arrangements; or

 (ii) the following statement, with the bracketed text replaced with the appropriate text: “By using [insert name of insurer]’s ‘preferred providers’ you may have lower out of pocket costs on [insert services or use “many allied health”] treatments and have access to more ‘no gap’ treatments. A list of ‘preferred providers’ is available from [insert name of insurer].”;

  (b) otherwise—the following statement, with the bracketed text replaced with the appropriate text: “[Insert name of insurer] does not operate a preferred provider scheme.”.

3

Treatments covered by the policy

A complete list of treatments that are covered by the policy, expressed in terms of the following:

  (a) general dental;

  (b) major dental;

  (c) endodontic;

  (d) orthodontic;

  (e) optical;

  (f) non PBS pharmaceuticals;

  (g) physiotherapy;

  (h) chiropractic;

  (i) podiatry;

  (j) psychology;

  (k) acupuncture;

  (l) remedial massage;

  (m) hearing aids;

  (n) blood glucose monitors;

  (o) for any treatment that cannot be classified as any of the above—the name of the treatment.

Note: Insurers may cover additional treatments, for example, exercise physiology and occupational therapy.

4

Treatments not covered by the policy

A list of treatments that are not covered by the policy, expressed in terms of the treatments listed in item 3.

5

Waiting period (months)

For each treatment that is covered by the policy—whichever of the following is applicable, with the bracketed text replaced with the appropriate text:

  (a) if there is a waiting period—“[Number] months”;

  (b) if there is no waiting period for the treatment—“None”.

Note: If an insured person has already served all applicable waiting periods, this item does not limit the information that a private health insurer may provide with regard to the individual’s policy.

6

Benefit limits (per 12 months)

For each treatment that is covered by the policy—if there is no annual limit on the benefits that can be paid, the statement “No annual limit”.

Otherwise—the following statements, as applicable, with the bracketed text replaced with the appropriate figures or text:

  (a) either:

 (i) any of the following statements:

 (A) “$[number] per person”;

 (B) “$[number] per treatment”;

 (C) “$[number] per policy”; or

 (ii) any combination of the statements set out in subparagraph (a) (i), linked by the words “up to”;

  (b) if there is a limit on claims per specified number of years—whichever of the following is applicable:

 (i) “[number] appliance(s) every [specified number] years”;

 (ii) “[number] service(s) every [specified number] years”;

  (c) in the case of combined limits:

 (i) for the treatment against which the combined limit is listed— “(combined limit for [list treatments listed in item 3 in relation to which limit is combined])”; and

 (ii) for the other treatments in relation to which the limit is combined—“(combined limit – see [treatment against which the combined limit is listed])”;

  (d) in the case of limits for individually grouped treatments—whichever of the following statements is applicable:

 (i) “$[number] per person (combined limit for [whichever of general dental, major dental, endodontic & orthodontic is applicable])”;

 (ii) “$[number] lifetime limit for [whichever of general dental, major dental, endodontic & orthodontic is applicable]”;

  (e) if a sub‑limit applies on any treatment—the statement “Sub‑limits apply” (in bold font);

  (f) if:

 (i) there is a limit on general dental; but

 (ii) there is no limit on preventative dental;

   the statement “(no limit on preventative dental)”;

  (g) if none of paragraphs (a) to (f) apply—a brief outline of the applicable limits.

Note 1: If an insured person has used a portion of lifetime limits, this item does not limit the information that a private health insurer may provide with regard to the individual’s usage of lifetime limit amounts.

Note 2: This item does not limit the information that a private health insurer may give to an insured person. For example, if limits apply to the policy other than those listed in this item, private health insurers may provide information about those other benefit limits to insured persons.

7

Examples of maximum benefits—general dental, major dental, endodontic and orthodontic

For each treatment listed in paragraphs (a) to (d) of item 3 (whether or not covered by the policy):

  (a) the following treatments, broken down into the following dental item numbers:

 (i) for general dental:

 (A) “Periodic oral examination”—012; and

 (B) “Scale & clean”—114; and

 (C) “Fluoride treatment”—121; and

 (D) if covered under general dental—“Surgical tooth extraction”—322;

 (ii) for major dental treatment:

 (A) if covered under major dental—“Surgical tooth extraction”—322; and

 (B) “Full crown veneered”—615;

 (iii) for endodontic treatment—“Filling of one root canal”—417;

 (iv) for orthodontic treatment—“Braces for upper and lower teeth, including removal plus fitting of retainer”—881; and

  (b) if the dental item number is covered by the policy—an example of the maximum benefit that is payable when an insured person visits a practitioner who is not a preferred service provider, expressed using whichever of the following is applicable:

 (i) “$[number]”, with the bracketed text replaced by the appropriate figure, if:

 (A) the benefit is a dollar figure; or

 (B) the insurer pays a benefit that is a percentage of the charge up to a dollar limit that is specified for the item separately from an annual limit;

 (ii) if the only benefit limit for the item is an annual limit— “[number]% of charge”, with the bracketed text replaced by the appropriate figure; and

  (c) if the dental item number is not covered by the policy—the statement “n/a”.

For paragraph (b) of this item:

  (d) if:

 (i) the dental item number is provided by orthodontists and general dentists; and

 (ii) different benefits are offered for orthodontists and general dentists;

   the lower of:

 (iii) the benefit for the orthodontist; and

 (iv) the benefit for the general dentist;

   must be used; and

  (e) if examples are given for initial and subsequent visits, examples must be for individual sessions.

8

Examples of maximum benefits—other

For each treatment covered by the policy, other than the treatments covered by item 7—examples of the maximum benefits that are payable when an insured person visits a practitioner who is not a preferred service provider, expressed using whichever of subparagraphs (b)(i) and (ii) of item 7 is applicable.

For this item:

  (a) if examples are given for initial and subsequent visits, examples must be for individual sessions; and

  (b) if:

 (i) optical treatment is covered; and

 (ii) benefits for frames and lenses are paid separately;

   the example must be expressed as the sum of the benefit for each component.

Note 1: If treatments are listed for the purposes of paragraph (o) of item 3, examples of maximum benefits for those treatments must be given.

Note 2: This item does not limit the information that a private health insurer may give to an insured person.

Note 3: The insurer may provide information about the benefits that apply if treatment is through a preferred provider.

9

Other features

A statement that indicates any other features of the policy that the insurer wishes to draw attention to.

The statement must consist of at most 100 words.

Example: Benefits for travel or accommodation, or discounts.

Note: This statement (if included) is in addition to the statement (if included) that is referred to in item 10 of Schedule 2.

Rehabilitation

R

R

R



Hospital psychiatric services

R

R

R



Palliative care

R

R

R



Brain and nervous system

RCP







Eye (not cataracts)

RCP







Ear, nose and throat

RCP







Tonsils, adenoids and grommets

RCP







Bone, joint and muscle

RCP







Joint reconstructions

RCP







Kidney and bladder

RCP







Male reproductive system

RCP







Digestive system

RCP







Hernia and appendix

RCP







Gastrointestinal endoscopy

RCP







Gynaecology

RCP







Miscarriage and termination of pregnancy

RCP







Chemotherapy, radiotherapy and immunotherapy for cancer

RCP







Pain management

RCP







Skin

RCP







Breast surgery (medically necessary)

RCP







Diabetes management (excluding insulin pumps)

RCP







Heart and vascular system

RCP





Lung and chest

RCP





Blood

RCP





Back, neck and spine

RCP





Plastic and reconstructive surgery (medically necessary)

RCP





Dental surgery

RCP





Podiatric surgery (provided by a registered podiatric surgeon)

RCP





Implantation of hearing devices

RCP





Cataracts

RCP



Joint replacements

RCP



Dialysis for chronic kidney failure

RCP



Pregnancy and birth

RCP



Assisted reproductive services

RCP



Weight loss surgery

RCP



Insulin pumps

RCP



Pain management with device

RCP



Sleep studies

RCP





Indicates the clinical category is a minimum requirement of the product tier.  The clinical category must be covered on an unrestricted basis.

R

Indicates the clinical category is a minimum requirement of the product tier.  The clinical category may be offered on a restricted cover basis in Basic, Bronze and Silver product tiers only.

RCP

Restricted cover permitted: indicates the clinical category is not a minimum requirement of the product tier. Insurers may choose to offer these as additional clinical categories on a restricted or unrestricted basis.

A blank cell indicates that the clinical category is not a minimum requirement of the product tier. Insurers may choose to offer these as additional clinical categories; however it must be on an unrestricted basis.

Clinical categories table

Column 1

Column 2

Column 3

Clinical category

Scope of cover

(see Note 1)

Treatments to be covered (MBS Items)

(see Notes 1, 2 and 3)

Rehabilitation

Hospital treatment for physical rehabilitation for a patient related to surgery or illness.

For example: inpatient and admitted day patient rehabilitation, stroke recovery, cardiac rehabilitation.

Hospital psychiatric services

Hospital treatment for the treatment and care of patients with psychiatric, mental, addiction or behavioural disorders.

For example: psychoses such as schizophrenia, mood disorders such as depression, eating disorders and addiction therapy.

170, 171, 172, 289, 297, 320, 322, 324, 326, 328, 342, 344, 346, 348, 350, 352, 855, 857, 858, 861, 864, 866, 2700, 2701, 2712, 2713, 2715, 2717, 2721, 2723, 2725, 2727, 6018, 6019, 6023, 6024, 6028, 6029, 6031, 6032, 6034, 6035, 6037, 6038, 6042, 14216, 14217, 14219, 14220, 14224, 80005, 80015, 80020, 80101, 80105, 80115, 80120, 80130, 80140, 80145, 80155, 80165, 80170, 90250, 90251, 90252, 90253, 90254, 90255, 90256, 90257, 90264, 90265, 90272, 90274, 90276, 90278, 93300, 93303, 93306, 93309

Palliative care

Hospital treatment for care where the intent is primarily providing quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain.

3005, 3010, 3014, 3018, 3023, 3028, 3032, 3040, 3044, 3051, 3055, 3062, 3069, 3074, 3078, 3083, 3088, 3093

Assisted reproductive services

Hospital treatment for fertility treatments or procedures.

For example: retrieval of eggs or sperm, In vitro Fertilisation (IVF), and Gamete Intra-fallopian Transfer (GIFT).

Treatment of the female reproductive system is listed separately under Gynaecology.

Pregnancy and birth-related services are listed separately under Pregnancy and birth.

13200, 13201, 13202, 13203, 13209, 13212, 13215, 13218, 13221, 13241, 13251, 13260, 13290, 14203, 14206, 37605, 37606

Back, neck and spine

Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion.

For example: sciatica, prolapsed or herniated disc, spinal disc replacement and spine curvature disorders such as scoliosis, kyphosis and lordosis.

Joint replacements are listed separately under Joint replacements.

Joint fusions are listed separately under Bone, joint and muscle.

Spinal cord conditions are listed separately under Brain and nervous system.

Management of back pain is listed separately under Pain management. Pain management that requires a device is listed separately under Pain management with device.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

30672, 35401, 44133, 50600, 50604, 50608, 50612, 50616, 50620, 50624, 50628, 50632, 50636, 50640, 50644, 51020, 51021, 51022, 51023, 51024, 51025, 51026, 51031, 51032, 51033, 51034, 51035, 51036, 51041, 51042, 51043, 51044, 51045, 51051, 51052, 51053, 51054, 51055, 51056, 51057, 51058, 51059, 51061, 51062, 51063, 51064, 51065, 51066, 51071, 51072, 51073, 51102, 51103, 51110, 51111, 51112, 51113, 51114, 51115, 51120, 51130, 51131, 51140, 51141, 51145, 51150, 51160, 51165, 51170, 51171

Blood

Hospital treatment for the investigation and treatment of blood and blood-related conditions.

For example: blood clotting disorders and bone marrow transplants.

Treatment for cancers of the blood is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

13700

Bone, joint and muscle

Hospital treatment for the investigation and treatment of diseases, disorders and injuries of the musculoskeletal system.

For example: carpal tunnel, fractures, hand surgery, joint fusion, bone spurs, osteomyelitis and bone cancer.

Chest surgery is listed separately under Lung and chest.

Spinal cord conditions are listed separately under Brain and nervous system.

Spinal column conditions are listed separately under Back, neck and spine.

Joint reconstructions are listed separately under Joint reconstructions.

Joint replacements are listed separately under Joint replacements.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).

Management of back pain is listed separately under Pain management. Pain management that requires a device is listed separately under Pain management with device.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

18350, 18351, 18353, 18354, 18360, 18361, 18365, 30103, 30107, 30226, 30229, 30232, 30235, 30238, 30241, 30244, 32036, 39331, 39332, 39336, 39339, 39342, 39345, 43521, 43527, 43530, 43533, 43876, 43879, 44325, 44328, 44331, 44334, 44338, 44342, 44346, 44350, 44354, 44358, 44359, 44361, 44364, 44367, 44370, 44373, 44376, 45605, 45788, 45851, 45855, 45857, 45859, 45861, 45863, 45867, 45869, 45871, 45873, 45875, 45945, 45978, 45981, 45987, 45993, 45996, 46300, 46303, 46308, 46330, 46333, 46335, 46336, 46339, 46340, 46341, 46342, 46348, 46351, 46354, 46357, 46360, 46363, 46365, 46367, 46370, 46372, 46375, 46378, 46379, 46380, 46381, 46384, 46387, 46390, 46393, 46394, 46395, 46399, 46401, 46464, 46465, 46468, 46471, 46474, 46477, 46480, 46483, 46493, 47000, 47003, 47007, 47009, 47012, 47015, 47018, 47021, 47024, 47027, 47030, 47033, 47042, 47045, 47047, 47049, 47052, 47053, 47054, 47057, 47060, 47063, 47066, 47069, 47301, 47304, 47307, 47310, 47313, 47316, 47319, 47348, 47351, 47354, 47357, 47361, 47362, 47364, 47367, 47370, 47373, 47381, 47384, 47385, 47386, 47387, 47390, 47393, 47396, 47399, 47402, 47405, 47408, 47411, 47414, 47417, 47420, 47423, 47426, 47429, 47432, 47435, 47438, 47441, 47444, 47447, 47450, 47451, 47453, 47456, 47459, 47462, 47465, 47466, 47467, 47468, 47471, 47474, 47477, 47480, 47483, 47486, 47489, 47491, 47495, 47498, 47501, 47511, 47514, 47516, 47519, 47528, 47531, 47534, 47537, 47540, 47543, 47546, 47549, 47552, 47555, 47558, 47559, 47561, 47565, 47566, 47568, 47570, 47573, 47579, 47582, 47585, 47588, 47591, 47595, 47597, 47600, 47603, 47612, 47615, 47618, 47621, 47624, 47630, 47637, 47639, 47648, 47657, 47663, 47666, 47672, 47678, 47753, 47756, 47762, 47765, 47768, 47771, 47774, 47777, 47780, 47783, 47786, 47789, 47790, 47791, 47900, 47903, 47921, 47924, 47927, 47929, 47953, 47954, 47955, 47956, 47960, 47964, 47967, 47975, 47978, 47981, 47982, 47983, 47984, 48245, 48248, 48251, 48254, 48257, 48400, 48403, 48406, 48409, 48412, 48415, 48419, 48420, 48421, 48422, 48423, 48424, 48426, 48427, 48430, 48433, 48435, 48507, 48509, 48512, 48942, 48945, 48954, 48972, 48980, 48983, 48986, 49100, 49106, 49109, 49118, 49124, 49200, 49203, 49206, 49212, 49213, 49218, 49219, 49220, 49239, 49300, 49303, 49306, 49309, 49360, 49363, 49366, 49500, 49509, 49512, 49569, 49590, 49712, 49718, 49724, 49727, 49728, 49730, 49732, 49734, 49736, 49738, 49740, 49742, 49744, 49760, 49761, 49762, 49763, 49764, 49765, 49766, 49767, 49768, 49769, 49770, 49771, 49772, 49773, 49774, 49775, 49776, 49777, 49778, 49779, 49780, 49781, 49783, 49784, 49785, 49786, 49787, 49788, 49789, 49790, 49791, 49792, 49793, 49794, 49795, 49796, 49797, 49798, 49800, 49803, 49806, 49809, 49812, 49814, 49815, 49818, 49821, 49824, 49827, 49830, 49833, 49836, 49837, 49838, 49845, 49851, 49854, 49860, 49866, 49878, 49881, 49884, 49887, 49890, 50107, 50112, 50115, 50118, 50130, 50200, 50201, 50203, 50206, 50209, 50212, 50215, 50218, 50221, 50224, 50233, 50236, 50239, 50242, 50245, 50300, 50303, 50306, 50309, 50310, 50312, 50321, 50324, 50330, 50335, 50336, 50339, 50345, 50348, 50351, 50352, 50354, 50357, 50360, 50369, 50372, 50375, 50378, 50381, 50384, 50390, 50393, 50394, 50395, 50396, 50399, 50426, 50428, 50450, 50451, 50455, 50456, 50460, 50461, 50465, 50466, 50470, 50471, 50475, 50476, 50508, 50512, 50524, 50528, 50532, 50536, 50540, 50544, 50548, 50552, 50556, 50560, 50564, 50568, 50572, 50576, 50580, 50584, 50588, 50592, 50596, 50654, 52056, 52057, 52058, 52059, 52060, 52061, 52062, 52063, 52064, 52066, 52069, 52072, 52073, 52075, 52078, 52081, 52084, 52087, 52090, 52092, 52094, 52095, 52096, 52097, 52098, 52099, 52102, 52105, 52114, 52126, 52129, 52130, 52131, 52180, 52182, 52184, 52186, 53200, 53203, 53206, 53209, 53212, 53215, 53218, 53220, 53221, 53224, 53225, 53226, 53227, 53230, 53233, 53236, 53239, 53400, 53403, 53406, 53409, 53410, 53411, 53412, 53413, 53414, 53415, 53416, 53418, 53419, 53422, 53423, 53424, 53425, 53427, 53429, 53439

Brain and nervous system

Hospital treatment for the investigation and treatment of the brain, brain-related conditions, spinal cord and peripheral nervous system.

For example: stroke, brain or spinal cord tumours, head injuries, epilepsy and Parkinson’s disease.

Treatment of spinal column (back bone) conditions is listed separately under Back, neck and spine.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

6007, 6009, 6011, 6013, 6015, 14227, 14234, 14237, 18377, 35000, 35003, 35006, 35009, 35012, 35412, 35414, 39007, 39015, 39018, 39113, 39300, 39303, 39306, 39307, 39309, 39312, 39315, 39318, 39319, 39321, 39324, 39327, 39328, 39329, 39330, 39333, 39503, 39604, 39610, 39612, 39615, 39638, 39639, 39641, 39651, 39654, 39656, 39700, 39703, 39710, 39712, 39715, 39718, 39720, 39801, 39803, 39815, 39818, 39821, 39900, 39903, 39906, 40004, 40012, 40018, 40104, 40106, 40109, 40112, 40119, 40600, 40700, 40701, 40702, 40703, 40704, 40705, 40706, 40707, 40708, 40709, 40712, 40801, 40803, 40850, 40851, 40852, 40854, 40856, 40858, 40860, 40862, 40863, 40905, 43987, 46364, 51011, 51012, 51013, 51014, 51015, 52800, 52803, 52806, 52809, 52812, 52815, 52818, 52821, 52824, 52826, 52828, 52830, 52832

Breast surgery (medically necessary)

Hospital treatment for the investigation and treatment of breast disorders and associated lymph nodes, and reconstruction and/or reduction following breast surgery or a preventative mastectomy.

For example: breast lesions, breast tumours, asymmetry due to breast cancer surgery, and gynecomastia.

This clinical category does not require benefits to be paid for cosmetic breast surgery that is not medically necessary.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

30299, 30300, 30302, 30303, 31500, 31503, 31506, 31509, 31512, 31515, 31516, 31519, 31524, 31525, 31530, 31533, 31536, 31548, 31551, 31554, 31557, 31560, 31563, 31566, 45060, 45061, 45062, 45520, 45522, 45523, 45524, 45527, 45528, 45530, 45533, 45534, 45535, 45536, 45539, 45542, 45545, 45546, 45548, 45551, 45553, 45554, 45556, 45558

Cataracts

Hospital treatment for surgery to remove a cataract and replace with an artificial lens.

42698, 42701, 42702, 42703, 42704, 42705, 42707, 42710, 42713, 42716

Chemotherapy, radiotherapy and immunotherapy for cancer

Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours.

Surgical treatment of cancer is listed separately under each body system.

13760, 13950, 14221, 14245, 14247, 14249, 15000, 15003, 15006, 15009, 15012, 15100, 15103, 15106, 15109, 15112, 15115, 15211, 15214, 15215, 15218, 15221, 15224, 15227, 15230, 15233, 15236, 15239, 15242, 15245, 15248, 15251, 15254, 15257, 15260, 15263, 15266, 15269, 15272, 15275, 15303, 15304, 15307, 15308, 15311, 15312, 15315, 15316, 15319, 15320, 15323, 15324, 15327, 15328, 15331, 15332, 15335, 15336, 15338, 15339, 15342, 15345, 15348, 15351, 15354, 15357, 15500, 15503, 15506, 15509, 15512, 15513, 15515, 15518, 15521, 15524, 15527, 15530, 15533, 15536, 15539, 15550, 15553, 15555, 15556, 15559, 15562, 15565, 15600, 15700, 15705, 15710, 15715, 15800, 15850, 15900, 16003, 16006, 16009, 16012, 16015, 16018, 30400, 34521, 34524, 34527, 34528, 34529, 34530, 34533, 34534, 34539, 34540, 35404, 35406, 35408, 50950, 50952

Dental surgery

Hospital treatment for surgery to the teeth and gums.

For example: surgery to remove wisdom teeth, and dental implant surgery.

75006, 75030, 75033, 75034, 75036, 75037, 75039, 75042, 75045, 75048, 75049, 75050, 75051, 75156, 75200, 75203, 75206, 75400, 75403, 75406, 75409, 75412, 75415, 75600, 75603, 75606, 75609, 75612, 75615, 75618, 75621, 75800, 75803, 75806, 75809, 75812, 75815, 75818, 75821, 75824, 75827, 75830, 75833, 75836, 75839, 75842, 75845, 75848, 75851, 75854

Diabetes management

(excluding insulin pumps)

Hospital treatment for the investigation and management of diabetes.

For example: stabilisation of hypo- or hyper- glycaemia, contour problems due to insulin injections.

Treatment for diabetes-related conditions is listed separately under each body system affected. For example, treatment for diabetes-related eye conditions is listed separately under Eye.

Treatment for ulcers is listed separately under Skin.

Provision and replacement of insulin pumps is listed separately under Insulin pumps.

31346

Dialysis for chronic kidney failure

Hospital treatment for dialysis treatment for chronic kidney failure.

For example: peritoneal dialysis and haemodialysis.

13100, 13103, 13104, 13106, 13109, 13110

Digestive system

Hospital treatment for the investigation and treatment of the digestive system, including the oesophagus, stomach, gall bladder, pancreas, spleen, liver and bowel.

For example: oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids.

Endoscopy is listed separately under Gastrointestinal endoscopy.

Hernia and appendicectomy procedures are listed separately under Hernia and appendix.

Bariatric surgery is listed separately under Weight loss surgery.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

11800, 11801, 11810, 13506, 14212, 30382, 30384, 30385, 30387, 30388, 30390, 30392, 30396, 30397, 30399, 30406, 30408, 30409, 30411, 30412, 30414, 30415, 30416, 30417, 30418, 30419, 30421, 30422, 30425, 30427, 30428, 30430, 30431, 30433, 30439, 30440, 30441, 30442, 30443, 30445, 30448, 30449, 30450, 30451, 30452, 30454, 30455, 30457, 30458, 30460, 30461, 30463, 30464, 30469, 30472, 30481, 30482, 30483, 30492, 30495, 30515, 30517, 30518, 30520, 30521, 30526, 30529, 30530, 30532, 30533, 30559, 30560, 30562, 30563, 30565, 30577, 30583, 30584, 30589, 30590, 30593, 30594, 30596, 30599, 30600, 30601, 30606, 30608, 30619, 30621, 30622, 30623, 30626, 30627, 30636, 30637, 30639, 30655, 30657, 30721, 30722, 30723, 30724, 30725, 30730, 30750, 30751, 30752, 30753, 30754, 30755, 30756, 30760, 30761, 30762, 30763, 30770, 30771, 30780, 30790, 30791, 30792, 30800, 30810, 31454, 31456, 31458, 31460, 31462, 31466, 31468, 31472, 32000, 32003, 32004, 32005, 32006, 32009, 32012, 32015, 32018, 32021, 32024, 32025, 32026, 32028, 32030, 32033, 32039, 32042, 32045, 32046, 32047, 32051, 32054, 32057, 32060, 32063, 32066, 32069, 32096, 32105, 32106, 32108, 32117, 32118, 32123, 32129, 32131, 32135, 32139, 32147, 32150, 32156, 32159, 32162, 32165, 32166, 32171, 32174, 32175, 32183, 32186, 32212, 32213, 32215, 32216, 32218, 32221, 32231, 32232, 32233, 32234, 32235, 32236, 32237, 41816, 41822, 41825, 41828, 41831, 41832, 43801, 43804, 43807, 43810, 43813, 43816, 43819, 43822, 43825, 43828, 43831, 43834, 43840, 43843, 43846, 43849, 43852, 43855, 43858, 43864, 43867, 43870, 43873, 43900, 43903, 43906, 43930, 43933, 43936, 43942, 43945, 43948, 43951, 43954, 43957, 43960, 43963, 43966, 43969, 43972, 43975, 43978, 43990, 43993, 43996, 43999, 44101, 44102, 44104, 44105

Ear, nose and throat

Hospital treatment for the investigation and treatment of the ear, nose, throat, middle ear, thyroid, parathyroid, larynx, lymph nodes and related areas of the head and neck.

For example: damaged ear drum, sinus surgery, removal of foreign bodies, stapedectomy and throat cancer.

Tonsils, adenoids and grommets are listed separately under Tonsils, adenoids and grommets.

The implantation of a hearing device is listed separately under Implantation of hearing devices.

Orthopaedic neck conditions are listed separately under Back, neck and spine.

Sleep studies are listed separately under Sleep studies.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

11300, 18368, 30104, 30105, 30246, 30247, 30250, 30251, 30253, 30255, 30256, 30259, 30262, 30266, 30269, 30272, 30275, 30278, 30281, 30283, 30286, 30287, 30289, 30293, 30294, 30296, 30297, 30306, 30310, 30314, 30315, 30317, 30318, 30320, 30326, 30618, 30820, 31400, 31403, 31406, 31409, 31412, 31423, 31426, 31429, 31432, 31435, 31438, 38419, 38420, 38422, 38423, 38425, 38426, 38428, 41500, 41501, 41503, 41506, 41509, 41512, 41515, 41518, 41521, 41524, 41527, 41530, 41533, 41536, 41539, 41542, 41545, 41548, 41551, 41554, 41557, 41560, 41563, 41564, 41566, 41569, 41572, 41575, 41576, 41578, 41579, 41581, 41584, 41587, 41590, 41593, 41596, 41599, 41608, 41611, 41614, 41615, 41620, 41623, 41626, 41629, 41635, 41638, 41641, 41644, 41647, 41650, 41653, 41656, 41659, 41662, 41668, 41671, 41672, 41674, 41677, 41683, 41686, 41689, 41692, 41698, 41701, 41704, 41707, 41710, 41713, 41716, 41719, 41722, 41725, 41728, 41729, 41731, 41734, 41737, 41740, 41743, 41746, 41749, 41752, 41755, 41764, 41767, 41770, 41773, 41776, 41779, 41782, 41785, 41786, 41787, 41804, 41807, 41810, 41813, 41834, 41837, 41840, 41843, 41855, 41858, 41861, 41864, 41867, 41868, 41870, 41873, 41876, 41879, 41880, 41881, 41884, 41885, 41886, 41907, 41910, 43832, 45645, 45646, 47735, 47738, 47741, 51900, 51902, 52021, 52024, 52025, 52027, 52030, 52033, 52034, 52035, 52055, 52132, 52133, 52135, 52138, 52141, 52147, 52148, 52158, 53000, 53003, 53004, 53006, 53009, 53012, 53015, 53016, 53017, 53019, 53052, 53054, 53056, 53058, 53060, 53062, 53064, 53068, 53070, 53458, 53459, 53460

Eye (not cataracts)

Hospital treatment for the investigation and treatment of the eye and the contents of the eye socket.

For example: retinal detachment, tear duct conditions, eye infections and medically managed trauma to the eye.

Cataract procedures are listed separately under Cataracts.

Eyelid procedures are listed separately under Plastic and reconstructive surgery.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

18366, 18369, 18370, 18372, 18374, 42503, 42504, 42505, 42506, 42509, 42510, 42512, 42515, 42518, 42521, 42524, 42527, 42530, 42533, 42536, 42539, 42542, 42543, 42545, 42548, 42551, 42554, 42557, 42563, 42569, 42572, 42573, 42574, 42575, 42576, 42581, 42584, 42587, 42588, 42590, 42593, 42596, 42599, 42602, 42605, 42608, 42610, 42611, 42614, 42615, 42617, 42620, 42622, 42623, 42626, 42629, 42632, 42635, 42638, 42641, 42644, 42647, 42650, 42651, 42652, 42653, 42656, 42662, 42665, 42667, 42668, 42672, 42673, 42676, 42677, 42680, 42683, 42686, 42689, 42692, 42695, 42719, 42725, 42731, 42734, 42738, 42739, 42740, 42741, 42743, 42744, 42746, 42749, 42752, 42755, 42758, 42761, 42764, 42767, 42770, 42773, 42776, 42779, 42782, 42785, 42788, 42791, 42794, 42801, 42802, 42805, 42806, 42807, 42808, 42809, 42810, 42811, 42812, 42815, 42818, 42821, 42824, 42833, 42836, 42839, 42842, 42845, 42848, 42851, 42854, 42857, 42869, 43021, 43022, 43023

Gastrointestinal endoscopy

Hospital treatment for the diagnosis, investigation and treatment of the internal parts of the gastrointestinal system using an endoscope.

For example: colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP).

Non-endoscopic procedures for the digestive system are listed separately under Digestive system.

11820, 11823, 30473, 30475, 30478, 30479, 30484, 30485, 30488, 30490, 30491, 30494, 30680, 30682, 30684, 30686, 30687, 30688, 30690, 30692, 30694, 30731, 32023, 32072, 32075, 32084, 32087, 32094, 32095, 32222, 32223, 32224, 32225, 32226, 32227, 32228, 32229, 32230

Gynaecology

Hospital treatment for the investigation and treatment of the female reproductive system.

For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.

Fertility treatments are listed separately under Assisted reproductive services.

Pregnancy and birth-related conditions are listed separately under Pregnancy and birth.

Miscarriage or termination of pregnancy is listed separately under Miscarriage and termination of pregnancy.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

30062, 35410, 35500, 35503, 35506, 35507, 35508, 35509, 35513, 35517, 35518, 35527, 35533, 35534, 35536, 35539, 35545, 35548, 35554, 35557, 35560, 35561, 35562, 35564, 35565, 35566, 35568, 35569, 35570, 35571, 35573, 35577, 35578, 35581, 35582, 35585, 35591, 35592, 35595, 35596, 35597, 35599, 35608, 35609, 35610, 35611, 35612, 35614, 35615, 35616, 35620, 35622, 35623, 35626, 35630, 35631, 35632, 35633, 35635, 35636, 35637, 35641, 35644, 35645, 35647, 35648, 35649, 35653, 35657, 35658, 35661, 35667, 35668, 35669, 35671, 35673, 35680, 35691, 35694, 35697, 35700, 35703, 35717, 35720, 35721, 35723, 35724, 35726, 35729, 35730, 35750, 35751, 35753, 35754, 35756, 35759

Heart and vascular system

Hospital treatment for the investigation and treatment of the heart, heart-related conditions and vascular system.

For example: heart failure and heart attack, monitoring of heart conditions, varicose veins and removal of plaque from arterial walls.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

6080, 6081, 6082, 6084, 11607, 13400, 32500, 32504, 32507, 32508, 32511, 32514, 32517, 32520, 32522, 32523, 32526, 32528, 32529, 32700, 32703, 32708, 32710, 32711, 32712, 32715, 32718, 32721, 32724, 32730, 32733, 32736, 32739, 32742, 32745, 32748, 32751, 32754, 32757, 32760, 32763, 32766, 32769, 33050, 33055, 33070, 33075, 33080, 33100, 33103, 33109, 33112, 33115, 33116, 33118, 33119, 33121, 33124, 33127, 33130, 33133, 33136, 33139, 33142, 33145, 33148, 33151, 33154, 33157, 33160, 33163, 33166, 33169, 33172, 33175, 33178, 33181, 33500, 33506, 33509, 33512, 33515, 33518, 33521, 33524, 33527, 33530, 33533, 33536, 33539, 33542, 33545, 33548, 33551, 33554, 33800, 33803, 33806, 33810, 33811, 33812, 33815, 33818, 33821, 33824, 33827, 33830, 33833, 33836, 33839, 33842, 33845, 33848, 34100, 34103, 34106, 34109, 34112, 34115, 34118, 34121, 34124, 34127, 34130, 34142, 34145, 34148, 34151, 34154, 34157, 34160, 34163, 34166, 34169, 34172, 34175, 34500, 34503, 34506, 34509, 34512, 34515, 34518, 34800, 34803, 34806, 34809, 34812, 34815, 34818, 34821, 34824, 34827, 34830, 34833, 35100, 35103, 35200, 35202, 35300, 35303, 35306, 35307, 35309, 35312, 35315, 35317, 35319, 35320, 35321, 35324, 35327, 35330, 35331, 35360, 35361, 35362, 35363, 38200, 38203, 38206, 38209, 38212, 38213, 38241, 38244, 38247, 38248, 38249, 38251, 38252, 38254, 38256, 38270, 38272, 38273, 38274, 38275, 38276, 38285, 38286, 38287, 38288, 38290, 38293, 38307, 38308, 38309, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322, 38323, 38350, 38353, 38356, 38358, 38359, 38362, 38365, 38368, 38447, 38449, 38450, 38452, 38461, 38463, 38467, 38471, 38472, 38474, 38477, 38484, 38485, 38487, 38490, 38493, 38495, 38499, 38502, 38508, 38509, 38510, 38511, 38512, 38513, 38514, 38515, 38516, 38517, 38518, 38519, 38522, 38523, 38550, 38553, 38554, 38555, 38556, 38557, 38558, 38568, 38571, 38572, 38600, 38603, 38609, 38612, 38615, 38618, 38621, 38624, 38627, 38637, 38653, 38670, 38673, 38677, 38680, 38700, 38703, 38706, 38709, 38715, 38718, 38721, 38724, 38727, 38730, 38733, 38736, 38739, 38742, 38745, 38748, 38751, 38754, 38757, 38760, 38764, 38766, 90300

Hernia and appendix

Hospital treatment for the investigation and treatment of a hernia or appendicitis.

Digestive conditions are listed separately under Digestive system.

30574, 30615, 30640, 30645, 30646, 30648, 30720, 43805, 43835, 43837, 43838, 43841, 43939, 44108, 44111, 44114

Implantation of hearing devices

Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.

Stapedectomy is listed separately under Ear, nose and throat.

41603, 41604, 41617, 41618

Insulin pumps

Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.

Joint reconstructions

Hospital treatment for surgery for joint reconstructions.

For example: torn tendons, rotator cuff tears and damaged ligaments.

Joint replacements are listed separately under Joint replacements.

Bone fractures are listed separately under Bone, joint and muscle.

Procedures to the spinal column are listed separately under Back, neck and spine.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).

46324, 46325, 46345, 46408, 46411, 46414, 46417, 46420, 46423, 46426, 46432, 46434, 46438, 46441, 46442, 46444, 46450, 46453, 46456, 46492, 46495, 46498, 46500, 46501, 46502, 46503, 46504, 46507, 46510, 46522, 47592, 47593, 47792, 48900, 48903, 48906, 48909, 48939, 48948, 48951, 48958, 48960, 49104, 49105, 49121, 49215, 49221, 49224, 49227, 49230, 49233, 49236, 49503, 49506, 49536, 49542, 49544, 49548, 49551, 49564, 49565, 49570, 49572, 49574, 49576, 49578, 49580, 49582, 49584, 49586, 49703, 49706, 49709, 50333

Joint replacements

Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of prostheses.

For example: replacement of shoulder, wrist, finger, hip, knee, ankle and toe joints.

Joint fusions are listed separately under Bone, joint and muscle.

Spinal fusions are listed separately under Back, neck and spine.

Joint reconstructions are listed separately under Joint reconstructions.

Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).

46309, 46312, 46315, 46318, 46321, 46322, 48915, 48918, 48921, 48924, 48927, 49112, 49115, 49116, 49117, 49209, 49210, 49315, 49318, 49319, 49321, 49372, 49374, 49376, 49378, 49380, 49382, 49384, 49386, 49388, 49390, 49392, 49394, 49396, 49398, 49515, 49516, 49517, 49518, 49519, 49521, 49524, 49525, 49527, 49530, 49533, 49534, 49554, 49715, 49716, 49717, 49782, 49839, 49857

Kidney and bladder

Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.

For example: kidney stones, adrenal gland tumour and incontinence.

Dialysis is listed separately under Dialysis for chronic kidney failure.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

11900, 11912, 11917, 11919, 12524, 12527, 18375, 18379, 30324, 36503, 36504, 36505, 36506, 36507, 36508, 36509, 36516, 36519, 36522, 36525, 36528, 36529, 36530, 36531, 36532, 36533, 36537, 36543, 36546, 36549, 36552, 36558, 36561, 36564, 36567, 36570, 36573, 36576, 36579, 36585, 36588, 36591, 36594, 36597, 36600, 36603, 36604, 36606, 36607, 36608, 36609, 36610, 36611, 36612, 36615, 36618, 36621, 36624, 36627, 36633, 36636, 36639, 36645, 36649, 36650, 36652, 36654, 36656, 36663, 36664, 36665, 36666, 36667, 36668, 36671, 36672, 36673, 36800, 36803, 36806, 36809, 36811, 36812, 36815, 36818, 36821, 36822, 36823, 36824, 36827, 36830, 36833, 36836, 36840, 36842, 36845, 36848, 36851, 36854, 36860, 36863, 37000, 37004, 37008, 37011, 37014, 37015, 37016, 37018, 37019, 37020, 37021, 37023, 37026, 37029, 37038, 37039, 37040, 37041, 37042, 37044, 37045, 37046, 37047, 37048, 37050, 37053, 37300, 37303, 37306, 37309, 37318, 37321, 37324, 37327, 37330, 37333, 37336, 37338, 37339, 37340, 37341, 37342, 37343, 37344, 37345, 37348, 37351, 37354, 37369, 37372, 37375, 37381, 37384, 37387, 37388, 37390, 37800, 37801, 37842, 37845, 37848, 37851, 37854, 43981, 43984

Lung and chest

Hospital treatment for the investigation and treatment of the lungs, lung-related conditions, mediastinum and chest.

For example: lung cancer, respiratory disorders such as asthma, pneumonia, and treatment of trauma to the chest.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

30090, 34133, 34136, 34139, 38415, 38416, 38417, 38418, 38421, 38424, 38427, 38430, 38436, 38438, 38440, 38441, 38446, 38448, 38453, 38455, 38460, 38462, 38464, 38466, 38468, 38469, 38643, 38656, 38800, 38803, 38806, 38809, 38812, 43861, 43909, 43912

Male reproductive system

Hospital treatment for the investigation and treatment of the male reproductive system including the prostate.

For example: male sterilisation, circumcision and prostate cancer.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

30628, 30629, 30630, 30631, 30635, 30641, 30642, 30643, 30644, 30649, 30654, 30658, 30661, 30662, 30663, 30666, 37200, 37201, 37202, 37203, 37206, 37207, 37208, 37209, 37210, 37211, 37213, 37214, 37215, 37216, 37217, 37218, 37219, 37220, 37221, 37223, 37224, 37226, 37227, 37230, 37233, 37245, 37393, 37396, 37402, 37405, 37408, 37411, 37415, 37417, 37418, 37423, 37426, 37429, 37432, 37435, 37438, 37601, 37604, 37607, 37610, 37613, 37616, 37619, 37623, 37803, 37804, 37806, 37807, 37809, 37810, 37812, 37813, 37815, 37816, 37818, 37819, 37821, 37822, 37824, 37825, 37827, 37828, 37830, 37831, 37833, 37834, 37836, 37839

Miscarriage and termination of pregnancy

Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy

.

16530, 16531, 35640, 35643, 35674

Pain management

Hospital treatment for pain management that does not require the insertion or surgical management of a device.

For example: treatment of nerve pain and chest pain due to cancer by injection of a nerve block.

Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under Pain management with device.

18280, 39013, 39014, 39100, 39109, 39110, 39111, 39116, 39117, 39118, 39119, 39121, 39124, 39140, 39323, 45939

Pain management with device

Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain.

For example: treatment of nerve pain, back pain, and pain caused by coronary heart disease with a device (for example an infusion pump or neurostimulator).

Treatment of pain that does not require a device is listed separately under Pain management.

14218, 39125, 39126, 39127, 39128, 39129, 39130, 39131, 39133, 39134, 39135, 39136, 39137, 39138, 39139, 39141

Plastic and reconstructive surgery

(medically necessary)

Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or accident, or congenital.

For example: burns requiring a graft, cleft palate, club foot and angioma.

Plastic surgery that is medically necessary relating to the treatment of a skin-related condition is listed separately under Skin.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

30003, 30006, 30010, 30014, 30017, 30020, 30175, 30176, 38457, 38458, 42860, 42863, 42866, 42872, 43882, 45000, 45003, 45006, 45009, 45012, 45015, 45018, 45019, 45021, 45024, 45025, 45026, 45027, 45030, 45033, 45035, 45036, 45039, 45042, 45045, 45048, 45051, 45054, 45200, 45201, 45202, 45203, 45206, 45207, 45209, 45212, 45215, 45218, 45221, 45224, 45227, 45230, 45233, 45236, 45239, 45240, 45400, 45403, 45406, 45409, 45412, 45415, 45418, 45439, 45442, 45445, 45448, 45451, 45460, 45461, 45462, 45464, 45465, 45466, 45468, 45469, 45471, 45472, 45474, 45475, 45477, 45478, 45480, 45481, 45483, 45484, 45485, 45486, 45487, 45488, 45489, 45490, 45491, 45492, 45493, 45494, 45496, 45497, 45498, 45499, 45500, 45501, 45502, 45503, 45504, 45505, 45506, 45512, 45515, 45518, 45519, 45560, 45561, 45562, 45563, 45564, 45565, 45566, 45568, 45569, 45570, 45572, 45575, 45578, 45581, 45584, 45585, 45587, 45588, 45589, 45590, 45593, 45596, 45597, 45599, 45602, 45608, 45611, 45614, 45617, 45620, 45623, 45624, 45625, 45626, 45627, 45629, 45632, 45635, 45641, 45644, 45647, 45650, 45652, 45653, 45656, 45658, 45659, 45660, 45661, 45662, 45665, 45668, 45669, 45671, 45674, 45675, 45676, 45677, 45680, 45683, 45686, 45689, 45692, 45695, 45698, 45701, 45704, 45707, 45710, 45713, 45714, 45716, 45720, 45723, 45726, 45729, 45731, 45732, 45735, 45738, 45741, 45744, 45747, 45752, 45753, 45754, 45755, 45758, 45761, 45767, 45770, 45773, 45776, 45779, 45782, 45785, 45791, 45794, 45797, 45799, 45801, 45803, 45805, 45807, 45809, 45811, 45813, 45815, 45817, 45819, 45821, 45823, 45825, 45827, 45829, 45831, 45833, 45835, 45837, 45839, 45841, 45843, 45845, 45847, 45849, 45853, 45865, 45877, 45879, 45882, 45885, 45888, 45891, 45894, 45897, 45900, 45975, 45984, 45990, 50411, 50414, 50417, 50420, 50423, 51904, 51906, 52010, 52036, 52045, 52048, 52106, 52108, 52111, 52117, 52120, 52122, 52123, 52300, 52303, 52306, 52309, 52312, 52315, 52318, 52319, 52321, 52324, 52327, 52330, 52333, 52336, 52337, 52339, 52342, 52345, 52348, 52351, 52354, 52357, 52360, 52363, 52366, 52369, 52372, 52375, 52378, 52379, 52380, 52382, 52420, 52424, 52430, 52440, 52442, 52444, 52446, 52450, 52452, 52456, 52458, 52460, 52480, 52482, 52484, 52600, 52603, 52606, 52609, 52612, 52615, 52618, 52621, 52624, 52626, 52627, 52630, 52633, 52636, 53242, 53453, 53455, 75024, 75027

Podiatric surgery

(provided by a registered podiatric surgeon)

Hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon, but limited to cover for:

• accommodation; and
• the cost of a prosthesis as listed in the prostheses list set out in the Private Health Insurance (Prostheses) Rules, as in force from time to time.

Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.

(No items listed)

Pregnancy and birth

Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.

Treatment for the baby is covered under the clinical category relevant to their condition. For example, respiratory conditions are covered under Lung and chest.

Female reproductive conditions are listed separately under Gynaecology.

Fertility treatments are listed separately under Assisted reproductive services.

Miscarriage and termination of pregnancy is listed separately under Miscarriage and termination of pregnancy.

16400, 16401, 16404, 16406, 16407, 16408, 16500, 16501, 16502, 16505, 16508, 16509, 16511, 16512, 16514, 16515, 16518, 16519, 16520, 16522, 16527, 16528, 16533, 16534, 16564, 16567, 16570, 16571, 16573, 16590, 16591, 16600, 16603, 16606, 16609, 16612, 16615, 16618, 16621, 16624, 16627, 82100, 82105, 82110, 82115, 82116, 82118, 82120, 82123, 82125, 82127

Skin

Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included.

For example: melanoma, minor wound repair and abscesses.

Removal of excess skin due to weight loss is listed separately under Weight loss surgery.

Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

12012, 12017, 12021, 12022, 12024, 14050, 14100, 14106, 14115, 14118, 14124, 18362, 30023, 30024, 30026, 30029, 30032, 30035, 30038, 30042, 30045, 30049, 30052, 30055, 30064, 30071, 30099, 30180, 30183, 30187, 30189, 30190, 30191, 30192, 30196, 30202, 30207, 30210, 30216, 30219, 30223, 30311, 30676, 30679, 31000, 31001, 31002, 31003, 31004, 31005, 31206, 31211, 31216, 31220, 31221, 31225, 31245, 31250, 31340, 31345, 31356, 31357, 31358, 31359, 31360, 31361, 31362, 31363, 31364, 31365, 31366, 31367, 31368, 31369, 31370, 31371, 31372, 31373, 31374, 31375, 31376, 31377, 31378, 31379, 31380, 31381, 31382, 31383, 44136, 46486, 46489, 46513, 46528, 46531, 46534, 47904, 47906, 47915, 47916, 47918, 52000, 52003, 52006, 52009, 52039, 52042, 52051, 52054

Sleep studies

Hospital treatment for the investigation of sleep patterns and anomalies.

For example: sleep apnoea and snoring.

12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12250, 12254, 12258, 12261, 12265, 12268, 12272

Tonsils, adenoids and grommets

Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.

41632, 41789, 41793, 41797, 41801

Weight loss surgery

Hospital treatment for surgery that is designed to reduce a person’s weight, remove excess skin due to weight loss and reversal of a bariatric procedure.

For example: gastric banding, gastric bypass, sleeve gastrectomy.

30165, 30168, 30171, 30172, 30177, 30179, 31569, 31572, 31575, 31578, 31581, 31584, 31585, 31587, 31590

3, 4, 23, 24, 36, 37, 44, 47, 52, 53, 54, 57, 58, 59, 60, 65, 104, 105, 106, 107, 108, 109, 110, 111, 115, 116, 117, 119, 120, 122, 128, 131, 132, 133, 135, 137, 141, 143, 145, 147, 160, 161, 162, 163, 164, 193, 195, 197, 199, 214, 215, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228, 229, 230, 231, 232, 233, 235, 236, 237, 238, 239, 240, 243, 244, 272, 276, 277, 279, 281, 282, 285, 287, 291, 293, 296, 299, 300, 302, 304, 306, 308, 310, 312, 314, 316, 318, 319, 330, 332, 334, 336, 338, 385, 386, 387, 388, 410, 411, 412, 413, 414, 415, 416, 417, 585, 588, 591, 594, 599, 600, 701, 703, 705, 707, 715, 721, 723, 729, 731, 732, 733, 735, 737, 739, 743, 747, 750, 758, 820, 822, 823, 825, 826, 828, 830, 832, 834, 835, 837, 838, 871, 872, 880, 900, 903, 2801, 2806, 2814, 2824, 2832, 2840, 2946, 2949, 2954, 2958, 2972, 2974, 2978, 2984, 2988, 2992, 2996, 3000, 4001, 5000, 5001, 5003, 5004, 5010, 5011, 5012, 5013, 5014, 5016, 5017, 5019, 5020, 5021, 5022, 5023, 5027, 5028, 5030, 5031, 5032, 5033, 5035, 5036, 5039, 5040, 5041, 5042, 5043, 5044, 5049, 5060, 5063, 5067, 5200, 5203, 5207, 5208, 5220, 5223, 5227, 5228, 5260, 5263, 5265, 5267, 6051, 6052, 6057, 6058, 6062, 6063, 6064, 6065, 6067, 6068, 6071, 6072, 6074, 6075, 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915, 10916, 10918, 10921, 10922, 10923, 10924, 10925, 10926, 10927, 10928, 10929, 10930, 10945, 10946, 11830, 11833, 12000, 12001, 12002, 12003, 12004, 12005, 13015, 13020, 13025, 13030, 13757, 13761, 13762, 13870, 13873, 14201, 14202, 17615, 17620, 17625, 17640, 17645, 17650, 17655, 18216, 18219, 18264, 18282, 18284, 18286, 18290, 18292, 18294, 18296, 18298, 30058, 30061, 30068, 30072, 30075, 30078, 30081, 30084, 30087, 30093, 30094, 30097, 30224, 30225, 30323, 30329, 30330, 30332, 30335, 30336, 30611, 30651, 30652, 30732, 31350, 31355, 34538, 35551, 35552, 36502, 38456, 39000, 43915, 44130, 46519, 46525, 51700, 51703, 52012, 52015, 52018, 52144, 75001, 75004, 75150, 75153, 82130, 82135, 82140, 82200, 82205, 82210, 82215

10801, 10802, 10803, 10804, 10805, 10806, 10807, 10808, 10809, 10816, 10931, 10932, 10933, 10940, 10941, 10942, 10943, 10944, 11000, 11003, 11004, 11005, 11009, 11012, 11015, 11018, 11021, 11024, 11027, 11200, 11204, 11205, 11210, 11211, 11215, 11218, 11219, 11220, 11221, 11224, 11235, 11237, 11240, 11241, 11242, 11243, 11244, 11303, 11304, 11306, 11309, 11312, 11315, 11318, 11324, 11327, 11330, 11332, 11333, 11336, 11339, 11503, 11505, 11506, 11507, 11508, 11512, 11600, 11602, 11604, 11605, 11610, 11611, 11612, 11614, 11615, 11627, 11705, 11713, 11719, 11720, 11721, 11724, 11725, 11726, 11727, 11728, 11729, 11730, 11731, 12200, 12201, 12306, 12312, 12315, 12320, 12321, 12322, 12325, 12326, 12500, 12533, 13207, 13300, 13303, 13306, 13309, 13312, 13318, 13319, 13703, 13706, 13750, 13755, 13815, 13818, 13830, 13832, 13834, 13835, 13837, 13838, 13839, 13840, 13842, 13848, 13851, 13854, 13857, 13876, 13881, 13882, 13885, 13888, 13899, 14255, 14256, 14257, 14258, 14259, 14260, 14263, 14264, 14265, 14266, 14270, 14272, 14277, 14278, 14280, 14283, 14285, 14288, 17610, 17680, 17690, 18213, 18222, 18225, 18226, 18227, 18228, 18230, 18232, 18233, 18234, 18236, 18238, 18240, 18242, 18244, 18248, 18250, 18252, 18254, 18256, 18258, 18260, 18262, 18266, 18268, 18270, 18272, 18276, 18278, 18288, 18297, 20100, 20102, 20104, 20120, 20124, 20140, 20142, 20143, 20144, 20145, 20146, 20147, 20148, 20160, 20162, 20164, 20170, 20172, 20174, 20176, 20190, 20192, 20210, 20212, 20214, 20216, 20220, 20222, 20225, 20230, 20300, 20305, 20320, 20321, 20330, 20350, 20352, 20355, 20400, 20401, 20402, 20403, 20404, 20405, 20406, 20410, 20420, 20440, 20450, 20452, 20470, 20472, 20474, 20475, 20500, 20520, 20522, 20524, 20526, 20528, 20540, 20542, 20546, 20548, 20560, 20600, 20604, 20620, 20622, 20630, 20632, 20634, 20670, 20680, 20690, 20700, 20702, 20703, 20704, 20706, 20730, 20740, 20745, 20750, 20752, 20754, 20756, 20770, 20790, 20791, 20792, 20793, 20794, 20798, 20799, 20800, 20802, 20803, 20804, 20806, 20810, 20815, 20820, 20830, 20832, 20840, 20841, 20842, 20844, 20845, 20846, 20847, 20848, 20850, 20855, 20860, 20862, 20863, 20864, 20866, 20867, 20868, 20880, 20882, 20884, 20886, 20900, 20902, 20904, 20905, 20906, 20910, 20911, 20912, 20914, 20916, 20920, 20924, 20926, 20928, 20930, 20932, 20934, 20936, 20938, 20940, 20942, 20943, 20944, 20946, 20948, 20950, 20952, 20954, 20956, 20958, 20960, 21100, 21110, 21112, 21114, 21116, 21120, 21130, 21140, 21150, 21155, 21160, 21170, 21195, 21199, 21200, 21202, 21210, 21212, 21214, 21215, 21216, 21220, 21230, 21232, 21234, 21260, 21270, 21272, 21274, 21275, 21280, 21300, 21321, 21340, 21360, 21380, 21382, 21390, 21392, 21400, 21402, 21403, 21404, 21420, 21430, 21432, 21440, 21445, 21460, 21461, 21462, 21464, 21472, 21474, 21480, 21482, 21484, 21486, 21490, 21500, 21502, 21520, 21522, 21530, 21532, 21535, 21600, 21610, 21620, 21622, 21630, 21632, 21634, 21636, 21638, 21650, 21652, 21654, 21656, 21670, 21680, 21682, 21685, 21700, 21710, 21712, 21714, 21716, 21730, 21732, 21740, 21756, 21760, 21770, 21772, 21780, 21785, 21790, 21800, 21810, 21820, 21830, 21832, 21834, 21840, 21842, 21850, 21860, 21865, 21870, 21872, 21878, 21879, 21880, 21881, 21882, 21883, 21884, 21885, 21886, 21887, 21900, 21906, 21908, 21910, 21912, 21914, 21915, 21916, 21918, 21922, 21925, 21926, 21930, 21935, 21936, 21939, 21941, 21942, 21943, 21945, 21949, 21952, 21955, 21959, 21962, 21965, 21969, 21970, 21973, 21976, 21980, 21990, 21992, 21997, 22002, 22007, 22008, 22012, 22014, 22015, 22020, 22025, 22031, 22036, 22041, 22042, 22051, 22055, 22060, 22065, 22075, 22900, 22905, 23010, 23025, 23035, 23045, 23055, 23065, 23075, 23085, 23091, 23101, 23111, 23112, 23113, 23114, 23115, 23116, 23117, 23118, 23119, 23121, 23170, 23180, 23190, 23200, 23210, 23220, 23230, 23240, 23250, 23260, 23270, 23280, 23290, 23300, 23310, 23320, 23330, 23340, 23350, 23360, 23370, 23380, 23390, 23400, 23410, 23420, 23430, 23440, 23450, 23460, 23470, 23480, 23490, 23500, 23510, 23520, 23530, 23540, 23550, 23560, 23570, 23580, 23590, 23600, 23610, 23620, 23630, 23640, 23650, 23660, 23670, 23680, 23690, 23700, 23710, 23720, 23730, 23740, 23750, 23760, 23770, 23780, 23790, 23800, 23810, 23820, 23830, 23840, 23850, 23860, 23870, 23880, 23890, 23900, 23910, 23920, 23930, 23940, 23950, 23960, 23970, 23980, 23990, 24100, 24101, 24102, 24103, 24104, 24105, 24106, 24107, 24108, 24109, 24110, 24111, 24112, 24113, 24114, 24115, 24116, 24117, 24118, 24119, 24120, 24121, 24122, 24123, 24124, 24125, 24126, 24127, 24128, 24129, 24130, 24131, 24132, 24133, 24134, 24135, 24136, 25000, 25005, 25010, 25013, 25014, 25020, 25025, 25030, 25050, 25200, 25205, 30001, 51300, 51303, 51306, 51309, 51312, 51315, 51318, 51800, 51803, 53700, 53702, 53704, 53706, 57364, 57506, 75009, 75012, 75015, 75018, 75021, 75023, 10950, 10951, 10952, 10953, 10954, 10956, 10958, 10960, 10962, 10964, 10966, 10968, 10970, 10988, 10989, 81000, 81005, 81010

ad = added or inserted

o = order(s)

am = amended

Ord = Ordinance

amdt = amendment

orig = original

c = clause(s)

par = paragraph(s)/subparagraph(s)

C[x] = Compilation No. x

/sub‑subparagraph(s)

Ch = Chapter(s)

pres = present

def = definition(s)

prev = previous

Dict = Dictionary

(prev…) = previously

disallowed = disallowed by Parliament

Pt = Part(s)

Div = Division(s)

r = regulation(s)/rule(s)

ed = editorial change

reloc = relocated

exp = expires/expired or ceases/ceased to have

renum = renumbered

effect

rep = repealed

F = Federal Register of Legislation

rs = repealed and substituted

gaz = gazette

s = section(s)/subsection(s)

LA = Legislation Act 2003

Sch = Schedule(s)

LIA = Legislative Instruments Act 2003

Sdiv = Subdivision(s)

(md) = misdescribed amendment can be given

SLI = Select Legislative Instrument

effect

SR = Statutory Rules

(md not incorp) = misdescribed amendment

Sub‑Ch = Sub‑Chapter(s)

cannot be given effect

SubPt = Subpart(s)

mod = modified/modification

underlining = whole or part not

No. = Number(s)

commenced or to be commenced

Private Health Insurance (Complying Product) Rules 2015

30 June 2015 (F2015L01021)

1 July 2015 (r 2)

Private Health Insurance (Complying Product) Amendment Rules 2015 (No.3)

17 September 2015 (F2015L01449)

20 September 2015

—

Private Health Insurance (Complying Product) Amendment Rules 2016 (No.1)

18 March 2016 (F2016L00353)

20 March 2016

—

Private Health Insurance (Complying Product) Amendment Rules 2016 (No.2)

2 June 2016 (F2016L00985)

2 June 2016

—

Private Health Insurance (Complying Product) Amendment Rules 2016 (No.3)

29 June 2016 (F2016L01102)

1 July 2016

—

Private Health Insurance (Complying Product) Amendment Rules 2016 (No.4)

16 September 2016 (F2016L01447)

20 September 2016

—

Private Health Insurance (Complying Product) Amendment Rules 2016 (No.5)

20 September 2016 (F2016L01464)

20 September 2016

—

Private Health Insurance (Complying Product) Amendment Rules 2016 (No.6)

22 November 2016 (F2016L01790)

23 November 2016

—

Private Health Insurance (Complying Product) Amendment Rules 2017 (No.1)

17 March 2017 (F2017L00243)

20 March 2017

—

Private Health Insurance (Complying Product) Amendment Rules 2017 (No.2)

28 June 2017 (F2017L00776)

1 July 2017

—

Private Health Insurance (Complying Product) Amendment Rules 2017 (No.3)

28 June 2017 (F2017L01219)

20 September 2017

—

Private Health Insurance (Complying Product) Amendment Rules 2018 (No.1)

19 March 2018 (F2018L00314)

20 March 2018

—

Private Health Insurance (Complying Product) Amendment (Psychiatric Care) Rules 2018

26 March 2018 (F2018L00393)

1 April 2018

—

Private Health Insurance (Complying Product) (ACT Nursing Home Type Patient) Amendment Rules 2018

28 June 2018 (F2018L00918)

1 July 2018 (s 2)

—

Private Health Insurance (Complying Product) Amendment (Terminating Products) Rules 2018

17 Sept 2018 (F2018L01304)

Sch 1: 22 Sept 2018 (s 2(1) item 2)

—

Private Health Insurance (Complying Product) Amendment Rules 2018 (No. 5)

19 Sept 2018 (F2018L01316)

20 Sept 2018 (s 2)

—

Private Health Insurance (Reforms) Amendment Rules 2018

11 Oct 2018 (F2018L01414)

Sch 1, Sch 2 (items 6–15) and Sch 3 (items 1–4): 1 Apr 2019 (s 2(1) items 2, 4, 6)
Sch 2 (items 1–5): 1 Jan 2019 (s 2(1) item 3)
Sch 2 (items 16–20) and Sch 3 (items 5–9): 1 Apr 2020 (s 2(1) items 5, 7)
Sch 7 (items 1–3): 12 Oct 2018 (s 2(1) item 11)

—

as amended by

Private Health Insurance (Reforms) Amendment Rules (No. 2) 2018

30 Oct 2018 (F2018L01504)

1 Nov 2018 (s 2(1))

—

Private Health Insurance (Reforms) Amendment Rules (No. 3) 2018

19 Dec 2018 (F2018L01795)

Sch 1: 1 Jan 2019 (s 2(1) item 2)

—

Private Health Insurance (Complying Product) Amendment Rules (No. 2) 2019

20 Mar 2019 (F2019L00328)

Sch 2: 1 July 2019 (s 2(1) item 3)
Remainder: 20 Mar 2019 (s 2(1) items 1, 2)

—

as amended by

Private Health Insurance Legislation Amendment Rules (No. 1) 2019

29 Apr 2019 (F2019L00639)

Sch 4: 30 Apr 2019 (s 2(1) item 5)

—

Private Health Insurance (Complying Product) Amendment Rules (No. 1 ) 2019

29 Mar 2019 (F2019L00464)

30 Mar 2019 (s 2(1) item 1)

—

Private Health Insurance (Complying Product) Amendment Rules (No. 3) 2019

29 Mar 2019 (F2019L00481)

1 Apr 2019 (s 2(1) item 2)

—

Private Health Insurance Legislation Amendment Rules (No. 1) 2019

29 Apr 2019 (F2019L00639)

Sch 3: 1 May 2019 (s 2(1) item 4)

—

Private Health Insurance Legislation Amendment (No. 2) Rules 2019

28 June 2019 (F2019L00925)

Sch 2: 1 July 2019 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment (No. 3) Rules 2019

19 Sept 2019 (F2019L01221)

Sch 2: 20 Sept 2019 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 4) 2019

30 Oct 2019 (F2019L01384)

Sch 2: 1 Nov 2019 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 1) 2020

28 Feb 2020 (F2020L00190)

Sch 2: 1 Mar 2020 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 2) 2020

19 Mar 2020 (F2020L00272)

Sch 2: 20 Mar 2020 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 3) 2020

30 Apr 2020 (F2020L00539)

Sch 2: 1 May 2020 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 4) 2020

30 June 2020 (F2020L00862)

Sch 2 and 3: 1 July 2020 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 5) 2020

31 July 2020 (F2020L00978)

Sch 2: 1 Aug 2020 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 6) 2020

29 Sept 2020 (F2020L01244)

Sch 2: 30 Sept 2020 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 7) 2020

30 Oct 2020 (F2020L01378)

Sch 3: 1 Nov 2020 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 1) 2021

25 Feb 2021 (F2021L00155)

Sch 2: 1 Mar 2021 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 2) 2021

19 Mar 2021 (F2021L00264)

Sch 1: 20 Mar 2021 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 3) 2021

25 June 2021 (F2021L00856)

Sch 2: 1 July 2021 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 4) 2021

30 June 2021 (F2021L00906)

Sch 1: 1 July 2021 (s 2(1) item 1)

—

Private Health Insurance (Complying Product) (Age of Dependants) Amendment Rules 2021

19 Aug 2021 (F2021L01137)

Sch 1 (items 1, 2, 6, 7): 20 Aug 2021 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 5) 2021

17 Sept 2021 (F2021L01295)

Sch 1 and 3: 20 Sept 2021 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 6) 2021

26 Oct 2021 (F2021L01461)

Sch 1: 1 Nov 2021 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 7) 2021

22 Dec 2021 (F2021L01879)

Sch 1: 1 Jan 2022 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 1) 2022

28 Jan 2022 (F2022L00080)

Sch 1: 1 Mar 2022 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 2) 2022

1 Mar 2022 (F2022L00230)

Sch 1: 1 Mar 2022 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 3) 2022

11 Mar 2022 (F2022L00303)

Sch 1: 20 Mar 2022 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 5) 2022

28 Apr 2022 (F2022L00635)

Sch 1: 1 July 2022 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 6) 2022

30 June 2022 (F2022L00897)

Sch 2: 1 July 2022 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 8) 2022

5 July 2022 (F2022L00954)

Sch 1: 6 July 2022 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 10) 2022

7 Sept 2022 (F2022L01182)

Sch 1: 20 Sept 2022 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 12) 2022

27 Oct 2022 (F2022L01404)

Sch 1: 1 Nov 2022 (s 2(1) item 1)

—

Private Health Insurance Legislation Amendment Rules (No. 13) 2022

31 Oct 2022 (F2022L01417)

Sch 1: 1 Nov 2022 (s 2(1) item 1)

—

Part 1

r 2.....................

rep LA s 48D

r 3.....................

rep LA s 48C

r 4.....................

am F2018L00393; F2018L01414; F2019L00481; F2021L01137

ed C35

am F2021L01295

Part 2

r 5.....................

am F2021L01137; F2021L01295

r 5A....................

am F2018L00393

r 6.....................

am F2018L01414

r 8.....................

am F2018L01414

r 8A....................

am F2015L01449; F2016L00353; F2016L00985; F2016L01447; F2016L01464; F2017L00243; F2017L00776; F2017L01219; F2018L00314; F2018L00918; F2018L01316

ed C13

am F2019L00328

ed C17

am F2019L00328; F2019L00925

ed C21

am F2019L01221

ed C22

am F2020L00272

ed C25

am F2020L00862; F2021L00264; F2021L00856; F2021L01295; F2022L00303; F2022L00897; F2022L01182

r 9AA...................

ad F2018L01304

am F2018L01414

r 9A....................

ad F2018L00393

r 9B....................

ad F2018L00393

Part 2A

Part 2A..................

ad F2018L01414

r 11A...................

ad F2018L01414

r 11B...................