• What's covered?
  • What's partially covered
  • What's not covered
  • Waiting period
  • Co-payment
  • Active Hospital will cover you for:

    • Accommodation for overnight, same day and intensive care for private or shared room in agreement private and public hospitals.
    • Theatre 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 with 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*).
    • Better Living programs to help you manage your health and wellness.
    • Hospital Substitute Treatment means the possibility of receiving rehabilitation treatment or the care of a registered nurse at home.

    * Check the 'What's partially covered' for a list of the 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.

    • Psychiatric services
    • Palliative care services
  • Active Hospital 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 a 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.

    Exclusions:

    For treatment listed as an exclusion there is no benefit payable and member will incur significant out of pocket expense for these services. Please review the exclusions on this cover and always check with CBHS to see if you are covered before receiving treatment. The following services are excluded from this cover:

    • Hip and knee joint replacement.
    • Other joint replacement.
    • Pregnancy related services.
    • Assisted reproductive services (e.g. IVF, GIFT)
    • Bariatric services - all including revision and reversal procedures (e.g. gastric banding, sleeve gastrectomy)
    • Cosmetic services
    • Other services for which Medicare benefit is NOT payable
  • Waiting periods:

    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 benefits not previously included within your original cover.

    Hospital waiting period Calendar month
    Pre-existing conditions 12 months
    Psychiatric, rehabilitation, palliative care, all other treatments or services 2 months
    Accidents Δ, emergency ambulance transport 1 day

    Δ Accident means an injury as a result of unintentional, unexpected actions or events that require treatment by a registered practitioner, but excludes pregnancy.

  • Co-payment

    There is a $100 co-payment for Active Hospital. This means that when you go into hospital you pay the relevant daily co-payment each day that you are in hospital up to a maximum of six (6) days per person or 12 days per family per calendar year. Co-payment does not apply for any dependent children on the policy.

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I joined as a CBHS member in 1978. Through many health events and challenges CBHS has always been there for me and my family. Their exceptional service over this time has always been appreciated.

- Jenny J

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I've not long joined CBHS from another fund, but so far I've been impressed by the super helpful and friendly staff, the higher claim limits and rebates at a very competitive premium, and how easy it is to lodge manual claims through the app. Thanks CBHS - you've won me over! 😃

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What I love about CBHS is their customer service - friendly staff and always ready to help and email you the information you ask about. Keep up the great work!!!

- Linda S

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I love CBHS as its so so easy to lodge a claim and whenever i need a question answered friendly consultant is one phone call away. The phone back option instead of waiting is brilliant!

- Rachel N

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I have been with CBHS since I began at CBA 15 years ago...Now I have three beautiful children, one who has a disability. Our top extras cover has been really essential for his early intervention. I do love the ease of claiming online.

- Annette E

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I am relatively new to CBHS and am loving it already. I worked for a CBA subsidiary a long time ago but was still eligible to join. So much better that the for-profit funds - our premium is only a little more and we pay a lower co-contribution and get great benefits. I am loving the massage rebate for my partner and gym rebate for me!

- David G

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I'm extremely happy with CBHS! I have been a customer for about six years. I think the price is reasonable. And i would refer you to my family and friends any day. Thankyou CBHS!!!

- Karen W

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Love CBHS as I never have to doubt that they've got my back when I need it. Been through other insurers who have limited options or limits, yet cost the same or more.

- Mark F

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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.