Brain and Nervous System

What is covered under Brain and Nervous System?

Hospital Cover for Brain and Nervous System is for hospital treatment to investigate and treat:

• the brain
• brain-related conditions
• diseases of the brain and nervous system
• spinal cord and peripheral nervous system.

Examples include:

• stroke
• brain or spinal cord tumours
• head injuries
• epilepsy
• Parkinson’s disease.

This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).

Some treatments you might expect to be in the Brain and Nervous System clinical category are under other clinical categories. For example:

• treating spinal column (back bone) conditions under Back, Neck and Spine
• chemotherapy and radiotherapy for cancer under Chemotherapy, Radiotherapy and Immunotherapy for cancer.

Does Hospital Cover include Brain and Nervous System?

What does ‘optional’ mean?

‘Optional’ means that the Australian Government allows insurers to choose whether or not to cover the clinical category under that Hospital Cover tier.

What does ‘restricted cover’ mean? 

Restricted cover means the insurer pays only limited benefits. 

If insurers offer cover for Brain and Nervous System under a Basic policy, they can do so on a ‘restricted’ basis. If you are admitted as a private patient in a private hospital for treatments under this clinical category, you will face considerable out-of-pocket costs.

Always check with your insurer before agreeing to be treated as a private patient in a private hospital if you have restricted cover for Brain and Nervous System. 

Does Medicare cover Brain and Nervous System?

Yes. Medicare includes all treatments under the Brain and Nervous System clinical category. 

If there is an MBS item number for the treatment, Medicare covers it.

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