Specialist - Categories of Insurance

Specialists Categories

Download the Categories of Insurance Guide

a) Introduction

There are a range of Categories for Specialists and they are listed in the following tables.

The Category you select should best reflect your qualifications and/or the nature of the work you undertake.

If you:

practise in more than one Category; or
are performing procedures not normally associated with your Category

please provide us with the details and we will assess your circumstances individually.

If you undertake or intend to undertake any cosmetic procedures you will need to be in a Category that provides cover for such cosmetic procedures. Please refer to the Cosmetic Procedure definition (Note 2 below).

Notes

In considering your Category please note the following:

You are not covered under the Policy for matters that arise from practice undertaken under a Rights of Private Practice Agreement
Cosmetic Procedure means any procedure directed towards the preservation, correction or improvement of appearance where there are no underlying medical, clinical or pathological reasons for undertaking such procedures, but excludes any professional service in respect of which an eligible person is entitled to a Medicare benefit, within the meaning of the Health Insurance Act 1973
Liposuction of more than 500mls of aspirate in total must be performed in an accredited day surgery or operating theatre (refer to page 10 of the Categories of Insurance Guide)
No cover is provided for procedures involving fat transfers to breasts commenced in the period 1 July 2003 to 30 June 2010. For the purpose of this exclusion "commenced" means the date of the first fat injection.

b) Specialist Category listing

Category	Includes	Excludes
Allergy	All activities and procedures normally undertaken by an Allergist which you are appropriately trained, qualified and accredited to undertake
Anaesthesia	All activities and procedures normally undertaken by an Anaesthetist which you are appropriately trained, qualified and accredited to undertake
Cardiac Thoracic Surgery	All activities and procedures normally undertaken by a Cardio Thoracic Surgeon which you are appropriately trained, qualified and accredited to undertake
Cardiology – Non Interventional	All activities and procedures normally undertaken by a Non Interventional Cardiologist which you are appropriately trained, qualified and accredited to undertake including: Cardiography Cardioversion Cardiac ultrasound Stress testing - with available resuscitation support	Procedures listed in Cardiology - Interventional
Cardiology – Interventional	All activities and procedures normally undertaken by an Interventional Cardiologist which you are appropriately trained, qualified and accredited to undertake including: Angiograms Angioplasty Electrophysiology studies Insertion of pacemakers Plus activities listed under Cardiology – Non Interventional
Cytology	All activities and procedures normally undertaken by a Cytologist which you are appropriately trained, qualified and accredited to undertake
Dermatology	All activities and procedures normally undertaken by a Dermatologist which you are appropriately trained, qualified and accredited to undertake including: Botulinum toxin injections and dermal fillers Chemical peels – superficial epidermal only, such as glycocholic acid peels Laser therapy, excluding laser resurfacing MOHS surgery Microsclerotherapy for facial lesions Sclerotherapy	Procedures listed in Dermatology Cosmetic
Dermatology Cosmetic (refer Notes 1-4 above)	All activities and procedures normally undertaken by a Cosmetic Dermatologist which you are appropriately trained, qualified and accredited to undertake including: Dermabrasion Grafts Laser resurfacing Liposuction Major flaps Medium and deep chemical peels (dermal peels using agents such as phenol and trichloroacetic acid) Plus activities listed under Dermatology
Emergency Medicine	All activities and procedures normally undertaken by an Emergency Medicine Physician which you are appropriately trained, qualified and accredited to undertake
Endocrinology	All activities and procedures normally undertaken by an Endocrinologist which you are appropriately trained, qualified and accredited to undertake
Endocrine Surgery	All activities and procedures normally undertaken by an Endocrine Surgeon which you are appropriately trained, qualified and accredited to undertake
Gastroenterology – Non Procedural	All activities and procedures normally undertaken by a Non Procedural Gastroenterologist which you are appropriately trained, qualified and accredited to undertake
Gastroenterology – Procedural	All activities and procedures normally undertaken by a Procedural Gastroenterologist which you are appropriately trained, qualified and accredited to undertake
General Medicine	All activities and procedures normally undertaken by a General Physician which you are appropriately trained, qualified and accredited to undertake
General Surgery	All activities and procedures normally undertaken by a General Surgeon which you are appropriately trained, qualified and accredited to undertake including: Breast reconstruction following cancer surgery Procedures as per Cosmetic Medicine Level A listed on page 15 of the Categories of Insurance Guide	Any other Cosmetic Procedures as defined under Note 2 above
General Surgery – Cosmetic (refer Notes 1-4 above)	All activities and procedures normally undertaken by a Cosmetic General Surgeon which you are appropriately trained, qualified and accredited to undertake including: Abdominoplasty Blepharoplasty Cosmetic rhinoplasty Dermabrasion Dermal fillers Face lift Hair transplantation procedures Labiaplasty Laser resurfacing Liposuction/lipoplasty Mammoplasty - reduction/augmentation Maxillo-facial surgery Medium and deep chemical peels – dermal peels using agents such as phenol and trichloroacetic acid Meloplasty Otoplasty Penile extension/thickening
Genetics	All activities and procedures normally undertaken by a Geneticist which you are appropriately trained, qualified and accredited to undertake
Geriatric Medicine	All activities and procedures normally undertaken by a Geriatrician which you are appropriately trained, qualified and accredited to undertake
Gynaecology	All activities and procedures normally undertaken by a Gynaecologist which you are appropriately trained, qualified and accredited to undertake If you undertake the following procedures: Amniocentesis CVS Ultrasounds for the detection of foetal abnormalities and they represent more than 50% of your Gross Income, please indicate in the Additional Information Section of the Change of Details or Application Form.
Haematology	All activities and procedures normally undertaken by a Haematologist which you are appropriately trained, qualified and accredited to undertake
Immunology	All activities and procedures normally undertaken by an Immunologist which you are appropriately trained, qualified and accredited to undertake
Infectious Diseases	All activities and procedures normally undertaken by an Infectious Diseases Physician which you are appropriately trained, qualified and accredited to undertake
Intensive Care – excluding Neonatal	All activities and procedures normally undertaken by an Intensivist which you are appropriately trained, qualified and accredited to undertake	Neonatal Intensive Care
Maxillo-facial Surgery	All activities and procedures normally undertaken by a Maxillo-facial Surgeon which you are appropriately trained, qualified and accredited to undertake including: Procedures as per Cosmetic Medicine Level A as listed on page 15 of the Categories of Insurance Guide	Any other Cosmetic Procedures as defined under Note 2 above
Neonatal Intensive Care	All activities and procedures normally undertaken by a Neonatal Intensivist which you are appropriately trained, qualified and accredited to undertake
Nephrology	All activities and procedures normally undertaken by a Nephrologist which you are appropriately trained, qualified and accredited to undertake
Neurology	All activities and procedures normally undertaken by a Neurologist which you are appropriately trained, qualified and accredited to undertake
Neurosurgery	All activities and procedures normally undertaken by a Neurosurgeon which you are appropriately trained, qualified and accredited to undertake
Nuclear Medicine	All activities and procedures normally undertaken by a Nuclear Medicine Physician which you are appropriately trained, qualified and accredited to undertake
Obstetrics and Gynaecology	All activities and procedures normally undertaken by an Obstetrician which you are appropriately trained, qualified and accredited to undertake including: Cordocentesis Decompression of foetal abdominal cavities Foetal blood transfusions
Occupational Medicine	All activities and procedures normally undertaken by an Occupational Medicine Physician which you are appropriately trained, qualified and accredited to undertake
Oncology	All activities and procedures normally undertaken by an Oncologist which you are appropriately trained, qualified and accredited to undertake
Ophthalmology – Non Procedural – Office Practice Only	This Category is for Non-Procedural Ophthalmologists who only perform the following activities: Cautery/removal of cysts of the eyelids Electrolysis of lash follicles Incision and curettage of tarsal cysts Laser capsulotomy Laser iridotomy Laser retinal photocoagulation (other than photodynamic therapy with Verteporfin) Laser trabeculoplasty Lavage (syringing, probing) of tear passages Pterygium and removal of corneal or scleral foreign bodies Punctum snip
Ophthalmology – Procedural	All activities and procedures normally undertaken by an Ophthalmologist which you are appropriately trained, qualified and accredited to undertake including: Laser surgery for refractive error Cosmetic Procedures around the eye area Cosmetic Procedures beyond the eye area provided income from such procedures does not exceed 10% of your annual Gross Income.	Cosmetic Procedures beyond the eye area where annual Gross Income from such procedures exceeds 10%. Refer Note 2 above for definition of Cosmetic Procedure
Ophthalmology – Cosmetic (refer Notes 1-4 above)	All activities and procedures normally undertaken by an Ophthalmologist which you are appropriately trained, qualified and accredited to undertake including: Cosmetic procedures
Orthopaedic Surgery	All activities and procedures normally undertaken by an Orthopaedic Surgeon which you are appropriately trained, qualified and accredited to undertake
Otolaryngology Head and Neck Surgery	All activities and procedures normally undertaken by an Otolaryngology Head and Neck Surgeon which you are appropriately trained, qualified and accredited to undertake including: Otoplasty and Rhinoplasty for cosmetic purposes subject to total income from such procedures not exceeding 10% of your annual Gross Income.	Cosmetic Procedures Otoplasty and Rhinoplasty where total Income from such procedures exceeds 10% of your annual Gross Income. Refer Note 2 above for definition of Cosmetic Procedure.
Otolaryngology Head and Neck Surgery – including Cosmetic (refer Notes 1-4 above)	All activities and procedures normally undertaken by a Cosmetic Otolaryngology Head and Neck Surgeon which you are appropriately trained, qualified and accredited to undertake including: Cosmetic procedures
Paediatric Medicine – excluding Neonatal Intensive Care	All activities and procedures normally undertaken by a Paediatrician which you are appropriately trained, qualified and accredited to undertake	Neonatal Intensive Care
Paediatric Surgery	All activities and procedures normally undertaken by a Paediatric Surgeon which you are appropriately trained, qualified and accredited to undertake
Pain Medicine	All activities and procedures normally undertaken by a Pain Medicine Physician who works exclusively in the area of Pain Medicine which you are appropriately trained, qualified and accredited to undertake
Palliative Care	All activities and procedures normally undertaken by a Palliative Care Physician which you are appropriately trained, qualified and accredited to undertake
Pathology and/or Laboratory Haematology	All activities and procedures normally undertaken by a Pathologist and/or Laboratory Haematologist which you are appropriately trained, qualified and accredited to undertake
Pharmacology	All activities and procedures normally undertaken by a Pharmacologist which you are appropriately trained, qualified and accredited to undertake
Plastic and Reconstructive Surgery	All activities and procedures normally undertaken by a Plastic and Reconstructive Surgeon which you are appropriately trained, qualified and accredited to undertake including: Procedures as per Cosmetic Medicine Level A as listed on page 15 of the Categories of Insurance Guide	Any other Cosmetic Procedures as defined under Note 2 above
Plastic, Reconstructive and Cosmetic Surgery (refer Notes 1-4 above)	All activities and procedures normally undertaken by a Plastic, Reconstructive and Cosmetic Surgeon which you are appropriately trained, qualified and accredited to undertake including: Abdominoplasty Blepharoplasty Cosmetic rhinoplasty Dermabrasion Dermal fillers Face lift Hair transplantation procedures (including scalp reductions/flaps) Labiaplasty Laser resurfacing Liposuction/lipoplasty Mammoplasty – reduction/augmentation Maxillo-facial surgery Medium and deep chemical peels – dermal peels using agents such as phenol and trichloroacetic acid Meloplasty Otoplasty Penile extension/thickening
Psychiatry	All activities and procedures normally undertaken by a Psychiatrist which you are appropriately trained, qualified and accredited to undertake
Public Health and Preventative Medicine	All activities and procedures normally undertaken by a Public Health and Preventative Medicine Physician which you are appropriately trained, qualified and accredited to undertake
Radiation Oncology	All activities and procedures normally undertaken by a Radiation Oncologist which you are appropriately trained, qualified and accredited to undertake
Radiology	All activities and procedures normally undertaken by a Radiologist which you are appropriately trained, qualified and accredited to undertake including: Up to 3 employed medical technologists (e.g. radiographers, sonographers etc) per Radiologist If the number of employed medical technologists exceeds 3 full time equivalent staff per Radiologist, then advise us in the Additional Information Section of the Change of Details or Application Form
Rehabilitation Medicine	All activities and procedures normally undertaken by a Rehabilitation Medicine Physician which you are appropriately trained, qualified and accredited to undertake
Respiratory Medicine	All activities and procedures normally undertaken by a Respiratory Physician which you are appropriately trained, qualified and accredited to undertake
Rheumatology	All activities and procedures normally undertaken by a Rheumatologist which you are appropriately trained, qualified and accredited to undertake
Sports Medicine	All activities and procedures normally undertaken by a Sports Medicine Specialist which you are appropriately trained, qualified and accredited to undertake
Surgical Specialties – Office Practice Only	This Category is for Surgeons who do not perform any surgery but are still practising as a consulting Specialist
Urology	All activities and procedures normally undertaken by a Urologist which you are appropriately trained, qualified and accredited to undertake
Vascular Surgery	All activities and procedures normally undertaken by a Vascular Surgeon which you are appropriately trained, qualified and accredited to undertake

Download the Categories of Insurance Guide