Better Hospital (Bronze+)

Lots of procedures in a private hospital, with some exclusions to keep your costs down

Get cover for things like heart and vascular system and plastic and reconstructive surgery (medically necessary). See inclusions

Skip cover for things like back, neck and spine and implantation of hearing devices. See exclusions

Emergency ambulance

30 day cooling off period

Tell us if you’re not happy within 30 days of joining and we’ll cancel your cover plus refund any premiums paid (as long as you haven’t made a claim).

Hospital cover explained

Download hospital factsheet

24 out of 38 clinical categories

Choose your own specialist or surgeon

You might avoid the Medicare Levy Surcharge

Understanding what's covered

Inclusions

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

Hospital treatment for the investigation and treatment of the eyes and content of the eye sockets.

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.

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

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

Hospital treatment for surgery for joint reconstructions.

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

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

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

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

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

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

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

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

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

Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails.

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.

Hospital treatment for the investigation and management of diabetes.

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

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

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

Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity.

Hospital treatment for surgery to the teeth and gums.

Hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon. Benefits are limited to only cover hospital accommodation and the cost of a prosthesis per the Prosthesis List, as laid out in the Private Health Insurance (Prosthesis) Rules. Medical services such as the anaesthetist or the surgeon’s account in respect to Podiatric Surgery are not covered under hospital products.

Restricted

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

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

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.

Exclusions

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

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

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

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

Hospital treatment for dialysis treatment for chronic kidney failure.

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

Hospital treatment for fertility treatments or procedures.

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.

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

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

Hospital treatment for the investigation of sleep patterns and anomalies.

Hospital FAQs

A waiting period is the time between joining Frank and when you’re covered for a treatment or service. If you receive a service or treatment during a waiting period, you are not eligible to receive a benefit payable from us, regardless of when you submit the claim.

Hospital waiting periods apply to:

New members to health insurance
Members who transfer from another health fund who haven’t fully served the required waiting periods
New members that have had a gap in their hospital cover for more than 30 days
Current members that upgrade their cover for newly included services

Waiting Period – 0 days

Accidents- bodily injuries resulting from accidents which occur after the date of joining or upgrading to a higher cover.

Waiting Period – 2 months

Rehabilitation, palliative care, psychiatric and non-pre-existing conditions.

Waiting Periods – 12 months

Pre-existing conditions.

An out of pocket cost is a fee charged by the specialist above the benefit that Medicare and Frank combined contribute towards an inpatient procedure.

Medicare will pay the first 75% of the Medicare Benefits Scheduled fee (MBS) and Frank will contribute at least 25% of the remaining amount.

The MBS fee is only a recommendation and private surgeons in Australia are able to charge what they deem appropriate for their services. If the fee they charge is greater than the set MBS fee, you will be required to pay the difference; this is called a ‘medical gap’ or an out-of-pocket cost.

We won't pay on any services that are:

Excluded on your level of cover
Received whilst you are within waiting periods
Treatment with unregistered providers
Claims for people not listed on the policy
Treatment outside of Australia
Any outpatient emergency department service fees (e.g. observation, x-rays, drugs and lab tests
Treatment that occurred outside of your policy being active
Any outpatient medical cost

To reduce medical out of pocket costs associated with medical procedures the Australian Health Service Alliance (AHSA) access gap scheme is an opt in billing scheme that provides higher benefits than the Government’s schedule fee (MBS) and limits the out-of-pocket costs for the procedure.

Specialists must be registered for Access Gap Cover (AGC) and choose to opt-in to the scheme for each procedure.

There are two scenarios for how you may be billed by your specialist when they use the AGC scheme:

No Gap - this is where there will be no gap from the specialist to pay following the procedure

Known Gap – this is where you will be charged a maximum gap of $500 per specialist, per admission to hospital or a maximum of $800 for obstetric services.

If you elect to be treated as private patient in a registered public hospital, we pay towards your stay up to the commonwealth default rate for shared room accommodation less any excess or co-payment outlined on your hospital product.

As a private patient in a public hospital, you may have a choice of doctor however you cannot avoid public hospital queues. The length of a public hospital queue is determined by the hospital and is not influenced by Frank.

Choosing to be a private patient in a public hospital could result in out-of-pocket medical claim costs. You will receive informed financial consent for any hospital admission.

Disclaimer

Rates are effective 1 April 2024. | All contribution quotes by this calculator are subject to variation and should therefore be considered indicative contribution rates. | All prices include the Australian Government Rebate on Private Health Insurance as per selected income level and do not include any applicable Lifetime Health Cover loading. | All payments are only available via direct debit from a bank/ credit union account.| Frank does not issue payment notices or invoices.