Better Hospital (Silver+) Cover | Vital Hospital (Bronze+) Cover | |
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What you're covered for | $250 excess | $500 excess | $250 excess | $500 excess | $750 excess |
Your choice of doctor/hospital | ||
Private hospital accommodation For both Better Hospital (Silver+) and Vital Hospital (Bronze+) when admitted as an inpatient at a private hospital or day facility for any of the Restricted (R) services you will have a benefit entitlement to the default rate benefit only. This will likely lead to large out-of-pocket expenses if admitted under this level of hospital cover. |
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Theatre fees For hospital services or treatments that have Restricted benefit availability, no benefit is paid towards the cost of theatre charges raised for inpatient services in a private hospital or day surgery. |
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Age-based discount eligible policy Did you know? All Territory Health Fund Hospital Covers are retained age-based discount policies, meaning we recognise on transferring your current age-based discount and apply this same discount to your new hospital policy with us. Learn more. |
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Nationwide Ambulance Cover Ambulance benefits will be applied to emergencies only and limited to one per person per Membership Year, when provided by recognised providers. Learn more. |
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Accommodation benefits Accommodation benefit up to $50 per night for Members travelling more than 300 kilometres return from their home address for hospitalisation. Conditions apply click here for further information. |
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Surgically implanted prostheses e.g. surgically implanted stents, screws and plates (for fractures) and pacemakers. Prosthesis benefits as per the Government listing. |
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Access Gap Cover A benefit over and above the Medicare Benefits Schedule for participating doctors on inpatient services. |
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Intensive care | ||
Nursing home type patients This amount is determined by the Federal Government. Certification is required. |
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Rehabilitation | ||
Palliative care | ||
Brain and nervous system | ||
Eye (not cataracts) | ||
Ear, nose and throat | ||
Tonsils, adenoids and grommets | ||
Bone, joint and muscle | ||
Joint reconstructions | ||
Kidney and bladder | ||
Male reproductive system | ||
Digestive system | ||
Hernia and appendix | ||
Gastrointestinal endoscopy | ||
Gynaecology | ||
Miscarriage and termination of pregnancy | ||
Chemotherapy, radiotherapy and immunotherapy for cancer | ||
Pain management | ||
Skin | ||
Breast surgery (medically necessary) | ||
Diabetes management (excluding insulin pumps) | ||
Blood | ||
Back, neck and spine | ||
Plastic and reconstructive surgery (medically necessary) | ||
Dental surgery | ||
Podiatric surgery (provided by a registered podiatric surgeon) | ||
Lung and chest | ||
Insulin pumps | ||
Implantation of hearing devices | ||
Pain management with device | ||
Sleep studies | ||
Cataracts | ||
Heart and vascular system | ||
Dialysis for chronic kidney failure | ||
Pregnancy and birth | ||
Assisted and reproductive services | ||
Joint replacements | ||
Weight loss surgery | ||
Hospital psychiatric servcies | ||
Hospital boarder Benefits up to $35 per day to a maximum of four days per person, where such accommodation is necessary for the wellbeing of the patient. |
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Surgery or hospital treatment where Medicare does e.g. elective cosmetic surgery, experimental treatment/ |
Clinical categories are defined by the Department of Health and detailed in the Private Health Insurance (Reforms) Amendment Rules 2018. A copy of the clinical categories, detailing the scope of cover can be accessed here.
Covered Benefits will be paid for this service |
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Restricted benefits: You will be covered for shared ward accommodation in a public hospital only. While you can choose to go to a private hospital or day surgery for the service or treatment, your admission is not fully covered and will likely result in large out-of-pocket expenses. Some private specialists may not operate in a public facility, please take this into consideration when making a hospital product choice. | |
Excluded benefit Hospital or day surgery admissions for these services in either a public or private facility will receive no benefit from Queensland Country. As well there is no benefit payable for services for which Medicare pays no benefit e.g. most cosmetic surgery. |