Relocating cover for Mohs surgery (including excision and closures) to the ‘Skin lesion services’ benefit, except for closures requiring general anaesthesia.

Mohs surgery including excision and closure following surgery is covered under the ‘Surgical procedures’ benefit.

Mohs surgery, including excision and closure is covered under the ‘Skin lesion services’ benefit where it is performed under local anaesthetic, no anaesthetic or oral sedation. This benefit has a policy limit of $5,000 each claims year, with a sub-limit of $1,000 for skin lesion services performed by a general practitioner.

The 'Surgical Procedures' benefit provides cover for the following procedures when performed under general anaesthetic or IV sedation:

• Excision or biopsy of skin lesions; or
• closure of the wound following a Mohs surgery.

Introducing a $150 sub-limit each claims year for skin cryotherapy.

Skin cryotherapy performed under local anaesthetic, or no anaesthetic is covered under the ‘Skin lesion services’ benefit.

Skin cryotherapy performed under general anaesthetic or sedation is covered under the ‘Surgical procedures’ benefit.

No sub-limit each claims year.

Skin cryotherapy is covered under the ‘Skin lesion services’ benefit with a sub-limit of $150 each claims year.

Moving skin lesion procedures performed by non-skin specialists from the ‘Surgical procedures’ benefit into the ‘Skin lesion services’ benefit.

The ‘Skin lesion services’ benefit only covers healthcare services performed by a skin specialist. Eligible skin lesion procedures performed by non-skin specialists are covered under the ‘Surgical procedures’ benefit.

Eligible skin lesion procedures performed by non-skin specialists will now be covered under the 'Skin lesion services' benefit.

We are extending the period that members must have continuous cover under their plan for healthcare services relating to impacted or unerupted tooth extraction from 1 year to 3 years.

Continuous cover period is 1 year

After 1 year of continuous cover on this plan, cover is provided for extractions of unerupted or impacted teeth.

Continuous cover period is 3 years

After 3 years of continuous cover on this plan, cover is provided for the complete extraction or partial removal of unerupted or impacted teeth.

We are clarifying that removing teeth - either partly or completely - is covered under the ‘Surgical procedures’ benefit when removal of teeth is required before an eligible surgical treatment, chemotherapy, or radiotherapy.

No cover for tooth extraction when it is required for eligible surgical treatment, chemotherapy or radiotherapy

No exception in tooth extraction exclusion for teeth required to be removed for eligible surgical treatment, chemotherapy or radiotherapy.

Cover for tooth extraction or partial removal of teeth when it is required for eligible surgical treatment, chemotherapy or radiotherapy

Cover is provided for complete extraction or partial removal of teeth if removal is required before an eligible surgical treatment, chemotherapy or radiotherapy. Must be on referral from the treating specialist.

We are making changes to the wording of the exclusion for ‘Extraction of teeth’ to clarify that extraction of teeth includes the complete extraction or partial removal of any part of a tooth, tooth root or tooth remnant.

Exclusion wording

No cover for extraction of teeth except for what is covered under the ‘Surgical procedures’ benefit.

Exclusion wording

No cover for extraction of teeth, including the complete extraction, partial removal of any part of a tooth, tooth root or tooth remnant, except for what is covered under the ‘Surgical procedures’ benefit.

Cover for varicose vein procedures for legs and related duplex vein mapping will only be available after 3 years of continuous cover.

No continuous cover period required for varicose vein procedures for legs and related duplex vein mapping.

Members are eligible for up to two procedures for each leg during their lifetime. If you have multiple procedures during a single operation, we count these as separate procedures under the lifetime limit for each leg.

Cover for varicose vein procedures for legs and related duplex vein mapping is available after 3 years of continuous cover on this plan.

Members are eligible for up to two procedures for each leg during their lifetime. If you have multiple procedures during a single operation, we count these as separate procedures under the lifetime limit for each leg.

The lifetime limit does not apply to duplex vein mapping.

We are removing the exclusion for robot-assisted surgery from the policy document and adding it to the list of ‘Unapproved healthcare services’, with cover available for selected procedures.

Costs related to, or incurred as a consequence of, robot-assisted surgery are excluded as a healthcare service that we don’t cover in section C of the policy document except for the following selected procedures which are covered under the ‘Surgical procedures’ benefit:

• Robot-assisted hysterectomy (with or without oophorectomy and/or salpingectomy, or both)
• Robot-assisted sacrocolpopexy
• Robot-assisted ventral hernia repair
• Robot-assisted prostatectomy
• Robot-assisted partial nephrectomy
• Robot-assisted total hip replacement
• Robot-assisted knee replacement
• Robot-assisted transoral surgery.

Robot-assisted surgery is excluded through its inclusion on the list of unapproved healthcare services except for the following procedures which are covered under the ‘Surgical procedures’ benefit when performed by an Affiliated Provider:

• Robot-assisted hysterectomy (with or without oophorectomy and/or salpingectomy, or both)
• Robot-assisted sacrocolpopexy
• Robot-assisted prostatectomy
• Robot-assisted partial nephrectomy
• Robot-assisted total hip replacement
• Robot-assisted knee replacement
• Robot-assisted transoral surgery.

There is no cover for robot-assisted ventral hernia.
The policy exclusion for robot-assisted ventral hernia repair will be removed from the list of policy variations and robot-assisted ventral hernia repair is instead being added to the list of unapproved healthcare services.