Confirmed diagnosis of myelodysplastic syndrome with a low to mild (>1.5-4.5) International Prognostic Scoring System requiring continuing and ongoing supportive care with regular transfusion of blood products, chemotherapy, or other equivalent treatments Myeloma classified as stage 2 on the Durie Salmon scale or ISS, requiring chemotherapy or radiotherapy or immunotherapy
3
Myeloma classified as stage 1 on the Durie Salmon scale or ISS, requiring chemotherapy, radiotherapy or immunotherapy
4
5
Bone marrow or stem cell transplant to treat a disease other than cancer
Cancer exclusions
All non-melanocytic skin cancers (such as basal cell carcinomas and squamous cell carcinomas) unless there has been a spread to lymph nodes or distant organs or shows evidence of ulceration.
Any myeloproliferative diseases including polycythaemia rubera vera and essential thrombocytosis.
Cervical, vaginal or prostatic intraepithelial neoplasia (dysplasia) with histology showing CIN-1 to CIN-2, VIN-1 to VIN-2 or PIN-1 to PIN-2, each inclusive.
24. Schedule of Categories – heart and arteries category
Key term
Heart attack means the death of a portion of the heart muscle as a result of inadequate blood supply to the relevant area, confirmed by a cardiologist or general physician and evidenced by:
Typical rise and/or fall of cardiac biomarkers (Troponin T or Troponin I or CK-MB) with at least one value above the 99th percentile of the upper reference limit;
and at least one of the following:
Signs and symptoms of ischaemia which are consistent with myocardial infarction; or
New serial ECG manifestations of acute myocardial infarction with the development of any one of the following:
– ST changes;
– T wave inversion;
– Left bundle branch block (LBBB);
– Pathological Q waves; or
Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality.
A rise in cardiac biomarkers resulting from a percutaneous procedure for coronary artery disease is excluded unless the baseline value is normal and the elevation is greater than 10 times the 99th percentile of the upper reference limit.
If the above tests are inconclusive, AIA will also consider the evidence in conjunction with other appropriate and medically recognised tests.
Other acute coronary syndromes including but not limited to angina pectoris are excluded.
Severity Level
Conditions
Heart attack resulting in permanent and irreversible left ventricular ejection fraction of less than 30% (two measurements of at least 6 months apart) whilst on ongoing optimal therapy for a minimum of six months, and significant and irreversible physical impairment to the degree of at least Class III of the New York Heart Association Functional Classification System of cardiac impairment. Cardiomyopathy means impaired ventricular function of variable aetiology, resulting in permanent and irreversible left ventricular ejection fraction of less than 30% (two measurements of at least 6 months apart) whilst on ongoing optimal therapy for a minimum of six months, and significant and irreversible physical impairment to the degree of at least Class III of the New York Heart Association Functional Classification System of cardiac impairment.
1
1156 ALB-PC version 7 Effective 12 May 2026
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