Top Hospital

The Top Hospital product provides comprehensive benefits for hospital accommodation, theatre fees, medical, surgical and other agreed charges in those private hospitals and day hospital facilities with which Defence Health has an agreement. Defence Health’s list of agreement hospitals is one of the largest in Australia so the available choice is very broad.

We are able to provide this level of hospital choice because Defence Health is a member of the Australian Health Service Alliance (AHSA), which represents 60% of the private health funds across Australia, and is responsible for facilitating arrangements between hospitals, doctors and health service providers on behalf of its member funds. Because AHSA is contracting with hospitals on behalf of millions of private health insurance members, Defence Health members benefit directly from the buying power this association delivers.

A current listing of more than 475 Defence Health agreement private hospitals and day hospital facilities is available on Find a hospital page.

Top Hospital

The Top Hospital product provides comprehensive benefits for hospital accommodation, theatre fees, medical, surgical and other agreed charges in those private hospitals and day hospital facilities with which Defence Health has an agreement. Defence Health’s list of agreement hospitals is one of the largest in Australia so the available choice is very broad.

We are able to provide this level of hospital choice because Defence Health is a member of the Australian Health Service Alliance (AHSA), which represents 60% of the private health funds across Australia, and is responsible for facilitating arrangements between hospitals, doctors and health service providers on behalf of its member funds. Because AHSA is contracting with hospitals on behalf of millions of private health insurance members, Defence Health members benefit directly from the buying power this association delivers.

A current listing of more than 475 Defence Health agreement private hospitals and day hospital facilities is available on Find a hospital page.

Excess options to reduce your hospital premium

You can reduce your premium by choosing Top Hospital with one of the excess options below. The excess you choose is payable by you once per policy per financial year. Importantly, the excess does not apply to your dependant children.

Excess options for couples and families

Top Hospital 300 - $300 excess
Top Hospital 500 - $500 excess
Top Hospital 800 - $800 excess

Excess options for singles

Top Hospital 250 - $250 excess
Top Hospital 400 - $400 excess

Excess options to reduce your hospital premium

You can reduce your premium by choosing Top Hospital with one of the excess options below. The excess you choose is payable by you once per policy per financial year. Importantly, the excess does not apply to your dependant children.

Excess options for couples and families

Top Hospital 300 - $300 excess
Top Hospital 500 - $500 excess
Top Hospital 800 - $800 excess

Excess options for singles

Top Hospital 250 - $250 excess
Top Hospital 400 - $400 excess

  Agreement private hospitals & public hospitals - What's covered
General hospital costs

100% covered for:

  • private or shared room accommodation
  • same day hospitalisation and day surgery
  • intensive / coronary care, etc.

If an excess option is selected, the excess will not apply to your dependant child.
Theatre fees / Labour ward 100% covered. If an excess option is selected, the excess will not apply to your dependant child.
Drugs supplied in hospital 100% covered when related to the reason for admission and covered under the agreement with the hospital. Public hospital generally supply drugs without charge.
Surgically implanted prostheses 100% covered for no-gap prostheses as defined in the Federal Government’s Prostheses Listing. There is a no-gap prosthesis available for every Medicare procedure. Other more expensive prostheses may be available for your surgery. However, if you agree to have one of these, your benefits will be limited to that payable for the no-gap alternative.
Doctor’s fees If your doctor chooses to use the Access Gap Cover schedule of fees Defence Health can cover up to 100% of the doctor’s fee. At a minimum Defence Health will cover the difference between the Medicare rebate and the Medicare Benefits Schedule (MBS) fee. More information...
Hospital in the home Defence Health has agreements with a number of hospitals to deliver out of hospital care to hospital patients for services such as wound management, IV therapy and post-natal care.
Ambulance treatment 100% covered for all treatment provided by a registered ambulance service in Australia, including emergency services, non-emergency services, mobile intensive care, air and sea ambulance services.
Complementary healthcare services

The following range of programs and services help you look after your health and wellbeing outside of hospital.

  • midwifery services
  • hospital substitute programs
  • early discharge support programs
  • chronic care programs
  • maternity support service
  • home nursing

When clinically appropriate to your personal circumstances, your treating practitioner will work with the service providers to put the most appropriate services in place for you. More information...

 

Treatment in a non-agreement private hospital

Cover is limited in non-agreement private hospitals. You will incur out-of-pocket expenses.

What is not covered

For details on what is not covered by Top Hospital please refer to the What is not covered page.

  Agreement private hospitals & public hospitals - What's covered
General hospital costs

100% covered for:

  • private or shared room accommodation
  • same day hospitalisation and day surgery
  • intensive / coronary care, etc.

If an excess option is selected, the excess will not apply to your dependant child.
Theatre fees / Labour ward 100% covered. If an excess option is selected, the excess will not apply to your dependant child.
Drugs supplied in hospital 100% covered when related to the reason for admission and covered under the agreement with the hospital. Public hospital generally supply drugs without charge.
Surgically implanted prostheses 100% covered for no-gap prostheses as defined in the Federal Government’s Prostheses Listing. There is a no-gap prosthesis available for every Medicare procedure. Other more expensive prostheses may be available for your surgery. However, if you agree to have one of these, your benefits will be limited to that payable for the no-gap alternative.
Doctor’s fees If your doctor chooses to use the Access Gap Cover schedule of fees Defence Health can cover up to 100% of the doctor’s fee. At a minimum Defence Health will cover the difference between the Medicare rebate and the Medicare Benefits Schedule (MBS) fee. More information...
Hospital in the home Defence Health has agreements with a number of hospitals to deliver out of hospital care to hospital patients for services such as wound management, IV therapy and post-natal care.
Ambulance treatment 100% covered for all treatment provided by a registered ambulance service in Australia, including emergency services, non-emergency services, mobile intensive care, air and sea ambulance services.
Complementary healthcare services

The following range of programs and services help you look after your health and wellbeing outside of hospital.

  • midwifery services
  • hospital substitute programs
  • early discharge support programs
  • chronic care programs
  • maternity support service
  • home nursing

When clinically appropriate to your personal circumstances, your treating practitioner will work with the service providers to put the most appropriate services in place for you. More information...

 

Treatment in a non-agreement private hospital

Cover is limited in non-agreement private hospitals. You will incur out-of-pocket expenses.

What is not covered

For details on what is not covered by Top Hospital please refer to the What is not covered page.
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