What does gold hospital cover include?

On this page

• Treatments commonly only included with gold hospital cover
• Pregnancy and birth cover
• Inpatient IVF
• Cataracts and joint replacements
• Weight loss surgery and insulin pumps
• Other treatments and procedures you're still covered for
• What does it mean to be “covered” and what are you covered for?
• Additional treatment items included with Police Health
• What's not covered
• Next step: learn more about our cover 

Gold hospital cover (gold health insurance) covers all 38 clinical categories and is the highest level of hospital cover in Australia. 

What does that mean for police and their families? It's a common question, and we've outlined some of the key benefits you need to know. 

Treatments commonly only included with gold hospital cover

While some ‘Silver Plus’ hospital policies cover high-cost procedures and treatments, gold hospital cover gives you extra certainty because it must have them to be referred to as ‘Gold’. 

Here are some of the most common high-cost procedures and treatments that you'll be covered for with gold hospital cover*. 

Pregnancy and birth cover

If you're looking to start a family, gold hospital cover may the best option to ensure you're covered.  

Any hospital cover labelled ‘gold’ must include pregnancy and birth, so you can be assured that you're covered. 

See the 14 best benefits of private pregnancy cover with Police Health 

Assisted reproductive services: IVF and more support

Police Health's Gold Hospital covers In vitro fertilisation (IVF), but there are some important things to remember. 

It's only for the components that involve an admission to hospital as an ‘inpatient’ as well as those services that have a valid Medicare item number that are eligible for benefits. 

For example, if your surgical procedure of harvesting eggs is carried out in an operating theatre you’ll be admitted as an in-patient to hospital. 

In this instance, Police Health's Gold Hospital cover will provide a benefit toward the theatre fees, hospital accommodation, anesthetist and treating doctors’ fees. 

For IVF, private hospital cover in Australia typically has a 12-month waiting period if the treatment is considered a pre-existing condition, meaning you’ll need to serve this time before you can claim benefits. 

Cataracts and joint replacements

Joint replacements are one of our more common procedures members claim for. 

It highlights the value of having the right level of cover in place, especially for police. 

Gold hospital cover is also important for police because it covers the clinical category, cataracts. 

This covers the surgery to remove a cataract and replace with an artificial lens. 

Recent studies show cataracts aren’t just a seniors’ condition. And, police & emergency service workers are at risk

This natural clouding of the eye’s clear lens can show up as early as your 40s.

Read more

Osteoarthritis isn’t an ‘old-person’s’ condition. Certain careers, like policing, can exacerbate it

And police are at greater risk.

Read more

Weight loss surgery and insulin pumps

Two more popular categories that you're guaranteed to be covered for are weight loss surgery and insulin pumps. 

Common weight loss surgeries include gastric banding, gastric bypass and sleeve gastrectomy.  

While insulin pumps benefits are provided for  the provision and replacement, we recommend you catch up on the rules about what can and can't be claimed. 

Other treatments are still covered

Don't forget, there are 32 more clinical categories that you're covered for including the below. 

Heart and vascular system and lung

Includes procedures such as heart surgery (eg bypass or stents), and some lung procedures. 

Bone, joint and muscle procedures

For the investigation and treatment of diseases, disorders and injuries of the musculoskeletal system. Examples include hand surgery and joint fusion. 

Digestive and internal health treatments

For the investigation and treatment of the digestive system, including the esophagus, stomach, gall bladder, pancreas, spleen, liver and bowel. 

This includes gall stones removal and irritable bowel syndrome. 

Chemotherapy, radiotherapy and immunotherapy for cancer 

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

What does it mean when you're “covered”? 

Police Health specialises in gold hospital cover, giving you ultimate peace of mind when the unforeseen happens. 

To help show how, here's what you're covered for with our Gold Hospital cover*. 

Freedom to choose your hospital

Police Health’s Gold Hospital covers you in any recognised hospital or day surgery of your choice (public or private) anywhere in Australia.  

We also have contracts with around 500 private hospitals around the country, which you can search for on our website.  

Choosing a Contracted Hospital will ensure you avoid any unnecessary out-of-pocket costs. 

Theatre fees/labour ward

You're covered for eligible treatments in contracted hospitals. 

Hospital accommodation

Coverage for intensive/coronary care accommodation, same day hospitalisation and day surgery accommodation, in either a private or shared room (subject to availability) for eligible treatments in contracted hospitals.  

Please note, this is subject to the 35-day hospital rule. 

Drugs supplied

You'll be covered when related to the reason for admission in hospital and covered under the agreement we have with the hospital.  

Some high-cost drugs are excluded. Public hospitals generally supply medication without charge. 

Please note, private hospital cover in Australia does not cover discharge drugs (medication to take home) after you leave the hospital. 

Doctor's fees for hospital treatment

At a minimum, we will cover the difference between the Medicare rebate and the Medicare Benefits Schedule (MBS) Fee.  

If your doctor chooses to use the Access Gap Cover schedule of fees, we can cover up to 100% of the doctor’s agreed fee. Read more about it here. 

Additional treatment items included in our Gold Hospital cover

Police Health's Gold Hospital cover has treatment items that can help you and your family, including; 

• Ambulance - Covered for emergency transport, clinically required non-emergency transport, and treatment not requiring transport
• Aids and appliances - Benefits towards continuous positive air pressure (CPAP) Machines and Non-surgical Aids and Appliances such as (but not limited to): Insulin Pumps, Prosthetic Eye (Nonimplant), External Breast Prothesis, Pressure Garments, Ankle or Knee Brace, Custom Footwear
• Travel and accommodation – Up to $500 per calendar year per policy
• Hospital at home – We have agreements with some hospitals to deliver out-of-hospital care to patients for services such as wound management, intravenous therapy and post-natal care
• Home nursing
• Antenatal education
• Lactation nursing consultants
• Robotic assisted surgery - In most cases robotic assisted systems used in surgery (like the da Vinci Surgical Robot) is covered under our contract with the hospital. Before booking your surgery please call us to confirm so you can make an informed decision before being treated
• Support programs to get you back to your best ;
  • Cancer Support Program
  • Healthy Weight for Life Programs for; Osteoarthritis Management, Heart Health and Type 2 Diabetes
  • Kieser Osteoarthritis and Spinal Program 

What's not covered: important information 

It's important to know what's not covered to help avoid future headaches. You can read a non-exhaustive list here, and if you're still unsure you can call us on 1800 603 603. 

Next step: learn more about our cover 

If you're ready to join or want to know more about our cover, you can find more on Gold Hospital page. 

See what's covered in Police Health's Gold Hospital 

*All benefits may be subject to Waiting Periods, Limits and other conditions. Providers must be recognised by us. Review the cover tables on the Combined, Hospital and Extras pages, and your State Premium and Benefit Guide or contact us for more information.