Silver Plus Family Advanced

Hospital: what is covered

Restricted means partially covered for hospital costs as a private patient in a public hospital; in a private room or private hospital you may face significant expenses.

Excess, waiting periods and hospital

• Tier - Silver Plus
• Hospital - Private hospital, or a shared room in a public hospital
• Excess - Capped per person and per policy per year. $750 per person a year. $1,500 per policy a year.
• Co-payments - None.
• Known gap - Yes, with the fund's doctors
• Age-based discount - Not offered
• Accident cover - No
• Travel and accommodation benefits - No

Waiting periods

• Most treatments - 2 months
• Existing conditions - 12 months
• Pregnancy and birth - 12 months
• Rehabilitation, psychiatric and palliative care - 2 months

As filed by the insurer: Your choice of treating doctor or specialist. Access Gap Cover for eligible services (https://www.hif.com.au/healthinsurance/useful-links/find-a-provider to learn more and find your nearest known or no gap specialist). For family policies, no excess applies to dependants under the age of 18.

Private and shared room accommodation in an HIF-contracted private hospital (subject to availability of private room). Shared room accommodation in a public hospital, with the exception of public hospitals in New South Wales (NSW) where private and shared room coverage is available (subject to availability of a private room).

Extras: what you get back

Not covered: Audiology, Antenatal and postnatal, Vaccinations.

* Optical benefit paid on frames and prescription optical items. Pharmacy benefit paid after deduction of the PBS co-payment at 100% up to $80 per script. A $20 benefit (1 per person, per calendar year) will be paid on eligible claims for flu vaccinations from a registered pharmacy only. Benefits for replacement dentures and partial dentures are not paid within three years of previous supply.

Other services, as filed: Our Complementary Therapies includes: acupuncture, myotherapy, remedial massage and traditional Chinese medicine. Treatment must be provided by a practitioner who is registered with HIF in the speciality for which the charge is raised, benefits are not payable on medicines. A 12 month waiting period applies to IVF drugs. Other items covered: Asthmatic spacers, Diabetes Education, External Prosthesis, Humidifier/ Nebuliser and a Peak Flow Meter.

Advanced Extras is one of our higher value Extras cover options. It includes cover for over 20 services such as Dental, Physio, Chiro, Podiatry, Complementary Therapies, Pharmacy, Psychology and more.

Ambulance

Emergency and non-emergency ambulance. Call-out fees covered. Waiting period for emergency transport: 1 day. No limit on emergency transport.

Agreement hospitals in Queensland

HIF has agreements with 96 private hospitals here, as filed with the Ombudsman.

This policy's other options

Every state, household and excess the insurer filed for this policy, with the premium before the rebate.

Member retention (hospital cover)

76.2% is the Commonwealth Ombudsman's figure for HIF in its State of the Health Funds Report 2024-25 (Table 1, page 15; data at 30 June 2025).

The Ombudsman describes it as one measure of the comparative effectiveness of insurers and of their level of member satisfaction: the percentage of members, hospital memberships only, who have remained with the insurer for 2 years or more (page 12). It is published for the insurer, not for this policy, and is not adjusted for policies that lapse when a member dies. The Ombudsman cautions that no single indicator shows an insurer's overall performance (page 27).

It is shown as published. The list is not sorted, filtered or ranked by it.

Member retention is the Commonwealth Ombudsman's figure, from its State of the Health Funds Report 2024-25. Source: Licensed from the Commonwealth Ombudsman under a Creative Commons 4.0 licence. This report is available from the Commonwealth Ombudsman website at www.ombudsman.gov.au.

Where this comes from

Policy details come from the PrivateHealth.gov.au dataset published by the Private Health Insurance Ombudsman on data.gov.au (release of 1 Oct 2026), licensed under Creative Commons Attribution 3.0 Australia. Statement CZA7/SCDA2D, filed by Health Insurance Fund of Australia Limited, issued 17 June 2026.