Hospital cover

Treatment at home

Travelling to and from the hospital for regular treatments can be exhausting. This service is available for clinically approved eligible members to undergo chemotherapy treatment in the comfort of their own home. This allows you to have greater control over your treatment and limit the daily disruption to you and your family.  

What's included? 

• Treatment for chemotherapy in private and comfortable surroundings at home
• One-on-one appointments with supportive clinical staff
• Less time having to travel and wait for treatments typically completed at the hospital
• Less risk of exposure to infections which may occur during hospital visits

Who’s eligible to have Chemo at Home?

• Aged 18 years or over
• Must be a current Seniors Health Insurance member
• Have held an active hospital cover that includes chemotherapy and have served all the required waiting periods
• Require IV chemotherapy, subcutaneous chemotherapy, or intramuscular chemotherapy for cancer (MBS item 13950*)
• Clinically assessed and approved by your specialist to undergo chemo at home
• Meet all home facility requirements assessed by the service provider;
• Have been admitted to hospital for inpatient treatment before transitioning;
• Enrolment into the service must be arranged by the treating team prior to discharge;
• Reside in a location serviced by one of our At Home providers;

* Currently, ‘at home’ services are restricted to IV chemotherapy, subcutaneous chemotherapy, and intramuscular chemotherapy. These treatments are regarded as safe outside of a clinical setting.

Fund Rules and Policy Booklet terms apply.

Information about our service providers 

Chemo at Home is delivered in partnership with Kinship and View Health chemo@home. Please contact the service provider to find out whether your area is covered by treatment at home.

Treatment at home

You can now receive haemodialysis treatment in the comfort of your own home. For clinically approved eligible members, this service allows you to undergo haemodialysis treatment in private and in a comfortable setting.

What's included?

• Treatment for dialysis in private and comfortable surroundings at home
• One-on-one appointments with supportive clinical staff
• Less time having to travel and wait for treatments typically completed at the hospital
• Reduced likelihood of catching infections which may occur during hospital visits

Who’s eligible for Haemodialysis at Home?

• Aged 18 years or over
• Be a current Seniors Health Insurance member 
• Held a continuous Hospital cover for 12 months which includes dialysis and served all the required waiting periods
• Clinically assessed and approved by your specialist to undergo dialysis at home
• Live in an area that’s covered by Dialysis Australia
• Having facilities at home deemed suitable as assessed by Dialysis Australia
• Have commenced inpatient treatment in a hospital setting before transition to dialysis at home. 

Fund Rules and Policy Booklet terms apply.

Information about our service providers 

Haemodialysis at Home is delivered in partnership with Dialysis Australia. Please contact the service provider to find out whether your area is covered by treatment at home.

Treatment at home

Clinically approved eligible members can receive IV treatment at home in private and comfortable surroundings of your own home.

What’s included?

• Less time having to travel and wait for treatments typically completed at the hospital
• Reduced likelihood of catching infections which may occur during hospital visits
• One-on-one appointments with supportive clinical staff
• Treatment in private and comfortable surroundings at home
• Greater control over your treatment program
• Limit daily disruption to you and your family  

Who’s eligible for IV Infusions at Home?

• Aged 18 years or over
• Live in an area that’s covered by our service providers
• Be a current Seniors Health Insurance Hospital member 
• Have held an active hospital cover for 12 months that includes the equivalent hospital treatment and served all the required waiting periods
• Clinically assessed and approved by your specialist to undergo IV treatments at home
• Have facilities at home deemed suitable as accessed by the service provider
• Received inpatient treatment in hospital prior to receiving approval to move to treatment at home

Fund Rules and Policy Booklet terms apply.

Information about our service providers 

IV Infusions at Home is delivered in partnership with Vitalis and Pop-Up Health. Please contact the service provider to find out whether your area is covered by treatment at home. In addition, some nib agreement hospitals are also contracted to facilitate this service.  

Treatment at home

Wound care treatment at home is available for clinically approved eligible members and enables you to undergo negative pressure wound care treatment in private and in comfortable surroundings.

What’s included? 

This service helps to:

• Decrease travel time and wait for treatments typically completed at the hospital
• Reduce the likelihood of catching infections which may occur during hospital visits
• Provide one-on-one appointments with supportive clinical staff
• Supply treatment in private and in comfortable surroundings at home
• Allow greater control over your treatment program
• Limit daily disruption to you and your family 

Who’s eligible for Wound Care at Home? 

• Aged 18 years or over
• Live in an area that’s covered by our service providers
• Be a current Seniors Health Insurance member
• Have held an active Hospital cover for 12 months that includes the equivalent inpatient treatment and served all the required waiting periods
• Been clinically assessed and approved by your specialist to undergo wound care treatments at home
• Have facilities at home deemed suitable as accessed by the service provider
• Received inpatient treatment in hospital prior to receiving approval to move to treatment at home

Fund Rules and Policy Booklet terms apply.

Information about our service providers 

Wound Care at Home is delivered in partnership with Vitalis and Pop-Up Health. Please contact the service provider to find out whether your area is covered by treatment at home. In addition, some nib agreement hospitals are also contracted to facilitate this service.  

Private health insurance offer two types of cover. Hospital cover pays for some of the costs of treatment in a private hospital or treatment in a public hospital as a private patient. Extras cover helps pay for any out-of-pocket expenses that aren’t covered by Medicare or provided by a hospital, such as dental procedures, chiropractic treatment, glasses and contact lenses, and physiotherapy. Most Extras policies allow you to claim back a certain percentage of costs for each service and will be subject to annual cover limits. You can choose to take out Hospital cover or Extras cover as standalone policies or combine the two.

You won't have to re-serve any waiting periods if you’re transferring to a policy that has the same or a lower level of benefits, as long as there’s a break in cover of 59 days or less. If you transfer part-way through a waiting period, you'll just need to serve the remaining waiting period before you can claim — so if you've only served six months of a 12-month waiting period, those six months will still count when transferring. If you upgrade your cover, you'll need to complete waiting periods for any new services. Where the excess on the new product is lower than the excess on the previous cover, the excess on the previous cover will apply until the unexpired waiting period has been served. Any benefit limits already used with your current fund will apply to your Seniors Health Insurance policy.

Health insurance premiums aren’t tax-deductible. However, the government may provide help with premiums in the form of the private health insurance rebate. This is a means-tested rebate which applies to Hospital, Extras and Ambulance policies. To be eligible for the rebate, you must be eligible for Medicare, have an appropriate level of hospital cover and meet the income requirement for the rebate.  Find out more about the health insurance rebate by visiting the Australian Tax Office website.

If you cancel your cover and take out private health insurance again in the future, you could receive Lifetime Health Cover (LHC) loading costs and may have to re-serve any waiting periods. 

LHC is a government initiative aimed at encouraging people to take out private hospital cover earlier in life and maintain it. If you don’t take out private hospital cover before 1 July after you turn 31, you’ll pay a 2% loading on top of your normal hospital premium for each year you don’t have hospital cover (up to a maximum of 70%). The loading applies for 10 years of continuous hospital cover. For every year you put off signing up for hospital cover, another 2% will be added. So if you wait until you’re 40, you’ll pay 20% more than someone on the same cover who joined when they were 31. For more information on LHC, visit this page.

If you earn over $97,000 as a single or $194,000 as a couple/family, you’ll also have to pay the Medicare Levy Surcharge (MLS) each year that you don’t have Hospital cover. The MLS is up to 1.5% of your income and is paid in addition to the Medicare levy, which is 2%. The surcharge is payable for every day you don't have hospital cover within the financial year. The Australian Tax Office uses a special definition of income (called income for MLS purposes) to determine whether you’re liable to pay the MLS, and the rate of MLS you’ll have to pay. This income is different to your taxable income.

Find out more about LHC and the MLS by visiting the Australian Tax Office website.

An excess is the amount of money you have to pay when making a claim on your Hospital cover — it doesn’t apply for Extras cover. Generally, the higher your excess is, the lower your premiums are. Depending on your cover, some of the remaining costs of your treatment are paid by Medicare and/or your health insurer. An excess shouldn’t be confused with out-of-pocket expenses or a ‘gap’, which are additional charges that aren’t covered by Medicare and are in addition to what your private health insurance will cover.