We have included the following responses to the questions most frequently asked to help you better understand health cover. Please review these and then complete your own personal health cover requirements via our cover assessment form.

Can we transfer our private health cover from another fund?

Continuity of benefit entitlement applies when transferring between registered health funds. A clearance/claims history will be requested from your previous fund.

Who are participating providers?

A participating hospital/day clinic and others - i.e. - health care providers who have entered into an agreement relating to direct billing, etc. with a health fund. Such agreements are designed to secure maximum coverage and reduce/eliminate out-of-pocket expenses.

Explain an ‘excess’ hospital cover?

A great way to SAVE $$$
100% hospital cover premium is reduced if you choose to carry some of the cost yourself (your share is known as the excess).
The higher this excess (various options available with all funds), then the cheaper your premium will be.

Define ‘extras’ cover?

These are health services ranging from dental, optical, physiotherapy, chiropractic, naturopathy and others.

Waiting periods?

Waiting periods apply to new members who have not held health insurance previously. If transferring membership to another fund no waiting periods apply for equivalent cover.

What is Medical Gap Cover?

Health funds have incentives in place (Govt., approved scheme) to eliminate/reduce that amount by which your medical account exceeds the Medicare refund. In these instances, your doctor will bill the health fund, direct.

What is Lifetime Health Cover (LHC)?

Effective from 1st July 2000, the Federal Government introduced Lifetime Health Cover. People who obtain hospital cover after 1/7/2000 will be given a Certified Age at Entry (CAE) status, which reveals their age on joining. Loadings apply to uninsured persons if hospital cover is not taken out by the 1st of July after turning 31 years of age.

What is Federal Govt. 30% rebate?

Since January 1999, a 30% rebate applies to all health fund premiums. This Government rebate serves to reduce annual health costs to the consumer.
Effective 1 April 2005 the Govt. rebate is 35% and 40% for persons aged 65 - 69 and over 70 years respectively.

What is the Medicare Levy Surcharge?

The Medicare Levy is a surcharge on families/couples/single parent earning $154,000 or singles $77,000 per annum.

For additional information call tollfree 1800 246 162 (Freecall) to speak with a consultant.