Why won't my doctor participate in the Access Gap Cover scheme?
It is up to your doctor to decide whether they will charge you at the Access Gap Cover rate. Even if the doctor has participated in this scheme before, it does not guarantee that the doctor will participate in Access Gap Cover in for your treatment. Doctors are free to choose whether they will participate in Access Gap Cover on a patient by patient basis. This decision remains solely with the doctor.
What kind of things might I have to pay for while in hospital?
There are some additional services offered at some hospital that may not be covered by CBHS. Examples of these include:
- Boarder fees
- Meals for my partner
Should you require any of these services, please contact the Member Care Centre on 1300 654 123 to find if they are covered at your hospital.
Am I classified as an in-patient when having chemotherapy on a daily basis?
You will be covered for chemotherapy received on a daily basis as long as the hospital you are receiving the treatment from has an agreement with CBHS, and admits you as a day patient.
What am I covered for when going to the emergency ward of a private hospital?
CBHS will only pay benefits towards services received as an inpatient of a hospital. If you attend a private hospital emergency ward and incur costs as an out-patient (that is, you are not admitted to hospital), you will not be able to claim these costs through CBHS.
Am I covered for a medical procedure in my doctor's room rather than a hospital?
If you receive services in your doctor's rooms rather than a day surgery or hospital and you have Top Extras you would be entitled to 70% of the cost up to a maximum of $160 for the outpatient "theatre fee". If you do not have Top Extras, you would not be entitled to any benefits from CBHS, you would only be entitled to benefits from Medicare.
Do I have to pay my Daily Co-payment for a day procedure?
Can I receive benefits towards home nursing after a hospitalisation?
If you have Top Extras cover you will receive some benefits towards home visits by a registered nurse. Contact the Member Care Centre for further information.
What is a Pre-existing Ailment?
A Pre-existing Ailment is an illness or condition where the signs or symptoms were evident (whether diagnosed by a doctor or not) at any time during a period of 6 months immediately prior to the time of joining CBHS. This is an industry standard rule applied by all health funds for the protection of existing members. The rule applies for 12 months continuous membership from the date of joining or when a member upgrades their cover.
Am I covered 100% for prostheses?
To at least the minimum benefit specified in the prosthesis list issued under Private Health Insurance legislation.
Why does CBHS want me to provide a medical report for my planned hospitalisation?
When joining, upgrading or resuming your cover from suspension, there is a 12 month waiting period for pre-existing ailments. You need to provide a medical report so our medical advisor can assess whether or not the condition is pre-existing.