1) Determine level of cover
Comprehensive Hospital
If you have Comprehensive Hospital cover and your chosen hospital is contracted with CBHS, you will be covered for all accommodation, intensive care, theatre and labour ward fees. If your chosen hospital is not contracted with CBHS you will be covered up to pre-set limits. Any daily excess is payable at the time of admission.
Limited Hospital & Basic Hospital
For members on Limited or Basic Hospital you will be covered for accommodation in a shared room, intensive care, theatre and labour ward fees in a Public Hospital. Any daily excess is payable at the time of admission.
If you have Limited or Basic Hospital and wish to attend a Private Hospital you will experience significant out-of-pocket expenses.
2) Ensure all relevant waiting periods have been served
12 months waiting periods apply to pregnancy/obstetrics if you are new to private health insurance, or have upgraded to a higher level of cover.
3) Ask your doctor if they will charge under the Access Gap Scheme
Access Gap allows CBHS to pay above the schedule fee for doctors' services provided to you as an inpatient, covering the entire doctors' fees or leaving you with significantly reduced out-of-pocket expenses.
The Access Gap scheme can be used for the obstetrician, anaesthetist, assistant surgeon and pathology.
Click here to view Access Gap participating doctors who have agreed to be listed. Just because your doctor isn't on this list doesn't mean they won't participate, so don't be afraid to ask them. You might just save yourself a lot of money.
4) Ask for a written quote for the cost of your treatment
Even if your doctor charges above the Access Gap fee, you will be able to find out what out-of-pocket expenses will be incurred prior to receiving treatment.