A basic level of hospital cover, designed for those who just want the basics. It is designed for those who want the option of choosing their own doctor or specialist when receiving treatment in a public hospital.
what’s covered?
Basic hospital cover will cover you for:
- Accommodation for overnight, same day and intensive care for a shared room in a public hospital. We will also pay an amount for accommodation in a private hospital or private room of a public hospital - this amount will be the minimum amount specified by applicable legislation
- Theatre and labour ward fees are not raised in a public hospital
- Medical expenses related to providers for services while admitted in hospital e.g. fees from doctors, surgeons, anaesthetists, pathology, imaging etc. Covered for all services eligible for benefits from Medicare up to Medicare Benefits Schedule (MBS) Fee. Members have their choice of doctor/surgeon in a public or private hospital. CBHS will cover the difference between the Medicare benefit and the MBS fee for services provided as an admitted patient to a hospital
- Access Gap Cover is where a provider chooses to participate under an arrangement with the fund. CBHS covers up to 100% of an agreed amount in excess of the MBS fee which reduces or eliminates your out-of-pocket medical expenses (i.e. surgeons, anaesthetists, pathology, imaging fees etc)
- Surgically implanted prostheses to at least the minimum benefit specified in the prosthesis list issued under Private Health Insurance legislation
- Emergency ambulance transport for an accident or medical emergency by approved ambulance providers
Basic hospital cover will not cover you for:
- If member is admitted into an agreement or non-agreement private hospital, benefits are payable at the minimum rate specified by law - accordingly substantial out of pocket expenses can be incurred
- Hospital services received within policy waiting periods
- Nursing home type patient contribution, respite care or nursing home fees
- High cost, experimental or non TGA approved drugs
- Take home/discharge drugs (non-PBS drugs may be eligible for benefits from your Extras cover)
- Treatments where no medicare benefits are availible
- Aids not covered in hospital agreement (may be eligible for benefits from your Extras cover)
- Services claimed over 24 months after the service date
- Services provided in countries outside of Australia
- Prostheses used for cosmetic procedures, where no Medicare benefit is payable
- Ambulance transfers between hospitals
- Labour ward fees in an agreement and non agreement private hospital
Note: Ambulance transfers between hospitals
Basic Hospital cover is not adequate for Private Hospital treatment as you will incur significant out-of-pocket expenses.
Download Basic Hospital Product Sheet
When deciding if this product is right for you, please refer to the CBHS Health Benefit Fund Rules.
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