For a high level of non-restricted hospital cover for services or treatments, Comprehensive Hospital can provide you with complete peace of mind in case the unexpected arises.
- No restrictions on treatments received as an admitted patient
- Daily co-payment option for reduced premiums
- Access gap cover
- Emergency ambulance
- Access to private hospitals
Comprehensive hospital will cover you for:
- Accommodation for overnight, same day and intensive care for private or shared room in agreement private and public hospitals. If an excess option has been selected, the excess will apply
- Theatre and labour ward fees covered in agreement private hospitals (excluding restricted services*)
- 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 and 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
- Pharmacy covers most drugs related to the reason for your admission in agreement private hospitals
- Boarder accommodation covers 100%, up to $160 per admission, if not included in hospital agreement
- Emergency ambulance transport for an accident or medical emergency by approved ambulance providers
- Hospital Services where a Medicare benefit is payable (excluding restricted services*)
*Restricted Benefits (Services) not fully covered
The services listed below, when provided in a private hospital, are eligible for Minimum Default Benefits prescribed by private health insurance legislation. These benefits relate to hospital bed charges and are unlikely to cover the fees charged for a private hospital admission. Members may incur large out of pocket expenses for theatre fees together with the difference between the Minimum Default Benefit and the bed charge raised by the hospital.
The services listed below are also eligible for hospital benefits in a public hospital at a shared room rate. Public hospitals do not raise charges for theatre use.
- cosmetic surgery
- podiatric surgery
- laser eye surgery
- other services for which a Medicare benefit is not payable
what’s not covered?
Comprehensive hospital cover will not cover you for:
- If member is admitted into a non-agreement private hospital benefits are payable only at the minimum rate specified by law. These benefits may only provide a benefit similar to a public hospital shared room rate. These benefits may not be sufficient to cover admissions in a non-agreement private hospital
- Hospital services received within policy waiting periods
- Nursing home type patient contribution, respite care or nursing home fees
- Take home/discharge drugs (non-PBS may be eligible for benefits from Extras cover)
- Aids not covered in hospital agreement (may be eligible for benefits from 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
Waiting periods apply to those who are new to private health insurance or those who already have cover with CBHS or another fund, and choose to upgrade to a higher level of cover.
Parts of waiting periods served within one health fund can be completed in another when
a person transfers funds. If you upgrade your level of cover waiting periods may apply to
benefi ts not previously included within your original cover.
|hospital waiting periods
|pre-existing conditions, pregnancy related services
|Psychiatric, rehabilitation, palliative care, all other treatments
|Accidents*, emergency ambulance transport
* Accident means an injury as a result of unintentional, unexpected actions or events that require treatment by a registered
practitioner, but excludes pregnancy.
Download Comprehensive Hospital Product Sheet
When deciding if this product is right for you, please refer to the CBHS Health Benefit Fund Rules. This information should be read carefully and retained.