Am I eligible to join CBHS?
You are eligible if you/and one of your parents, partner, siblings, dependants or grandparents are a current or former employee of the Commonwealth Bank Group (CBA Group).
If you are no longer employed by the CBA Group, you and your immediate family are still eligible to join or stay with CBHS.
If you previously worked for the Commonwealth Bank Group but did not join CBHS at the time, you and your immediate family will always remain eligible to join CBHS.
What do I have to do if I leave the CBA Group?
When you leave the CBA Group, you are still eligible to remain or re-join as a member of CBHS. Please contact us when you know your last day at CBA so that we can update your billing details.
Do I need to re-serve waiting periods when I join CBHS?
No, as long as you transfer from equivalent cover from another Australian health fund (as confirmed by your Transfer Certificate) and you have served all the waiting period with your previous fund, you will not be required to re-serve waiting periods with CBHS. Waiting periods may apply if you choose to upgrade to a higher level of cover.
What are my payment options?
We provide a wide range of payment types (direct debit, CBA and Bankwest salary deductions, invoice) for a variety of billing periods (fortnightly, monthly, quarterly, annual). We no longer accept billing in arrears.
Credit cards can be used via BPoint and BPAY for memberships paid 3, 6 or 12 months in advance. Please note we do not accept regular payments via credit cards.
Who can be covered by my couple or family policy?
We all know that couples and families come in lots of diverse sizes and shapes.
We love diversity and encourage it in our family!
In everything we do, CBHS works to ensure that there is no discrimination regardless of gender, cultural background, ethnicity or sexual orientation.
Up to two parents and their children can be covered by a family policy regardless of whether your family has one dad and one mum, one dad, one mum, two dads or two mums – our family policies can cover parents and their adopted children; and foster parents (including grandparents, aunts and uncles etc.) who have children in their legal care. For children to be included on a family policy, it’s important that guardianship be recognised by a Federal or State government agency such as Medicare or one of the state-based family/community services agencies and we may ask for evidence of this guardianship.
Children are covered by your family policy until they turn 18 (or 25 if they are still studying). If you have children aged 18 or over who aren’t studying, we encourage you to upgrade to our non-student dependant cover which covers them until they turn 25 regardless of their studying status.
For cover for other extended family members check out our eligibility rules.
If you have any questions about cover for your partner and/or family, please contact our Member Care team on 1300 654 123 or email firstname.lastname@example.org.
What is a student dependant?
A student dependant is someone who is at least 18 years of age but under the age of 25 years, does not have a partner and attending full time study at a recognised school, college or university.
Do I have to pay an excess / co-payment for my dependants?
CBHS will waive the co-payments for any dependant children on the membership for the following covers:
- Comprehensive Hospital 70 (Gold)
- Comprehensive Hospital 100 (Gold)
- Comprehensive Hospital $750 Excess (Gold)
- Limited Hospital 70 (Bronze Plus)
- Limited Hospital 100 (Bronze Plus)
- LiveLife (Gold)
- StepUp (Bronze Plus)
If you hold any other cover than all child dependants will be required to pay the excess or co-payment for their hospital admission if applicable.
If you have Hospital A Excess (Gold) or Hospital B Excess (Bronze Plus), you can log in to the Member Centre or contact CBHS to determine the excess that is payable.
How do I request a new membership card?
You can request a new membership card online via the CBHS Member Centre.
How can I obtain my tax statement?
Tax Statements are available for download from the Member Service Centre by following the steps below:
- Login to the CBHS Member Centre
- From the menu select Tax Statement
- Click on the Tax Statement you wish to view
- Your Tax Statement will then be displayed in PDF format
How much will I have to pay in taxes, rebates and levies?
CBHS recommends that its members consult their accountant or the Australia Tax Office to determine their obligations and impacts from taxes, rebates and levies. CBHS can provide general information on the Australian Government Rebate for private health insurance, and period of coverage, but cannot provide advice or recommendations for personal tax impacts.
How can I update my contact and address details?
You can update your contact and address details online via the CBHS Member Centre.
My product is “closed”, what does this mean?
CBHS continuously reviews its products. If a product becomes “closed”, no new members can purchase this policy but existing members that currently have this policy may remain on this cover. Please contact CBHS on 1300 654 123 for details of your product and to check if it still meets your needs.
What can I claim for?
CBHS provides a comprehensive (gold) range of products and services for members. What you’re eligible to claim for depends on your level of cover. Briefly, these are some of the categories of products that our packages may cover:
- Dental, Optical, physiotherapy and Chiropractic Services
- Artificial aids, healthcare appliances
- Hospital psychiatric, rehabilitation and palliative care
- Hospital cover ranging from basic plus and limited (Bronze Plus) to comprehensive (Gold)
- In-vitro fertilisation treatment
- Surgical podiatry, surgical dental, gym memberships and health management services
Find out more information here.
Can I claim for treatment, services or goods received overseas?
Under the CBHS Health Benefit Fund Rules and the Private Health Insurance (Accreditation) Rules 2008, benefits for treatments, goods and services listed under Extras covers are payable only if the provider is a CBHS Recognised Provider and meets the Private Health Insurance (Accreditation) Rules 2008.
Overseas providers do not meet this criteria therefore these claims are not eligible for CBHS Benefits.
What are the additional requirements for making a claim for health management services?
If you’re claiming for health management services such as gym memberships and personal training you should have a Health Management Program (HMP) Authorisation Form completed by your GP, specialist, or allied health service provider. This should be presented when you’re submitting your claim. Download an HMP form here.
How do I calculate my claims benefit?
We automatically calculate your claims benefit for you when you lodge a claim at your provider’s practice or when you lodge a claim online. If you claim through your provider, you’ll receive the benefit as a deduction in your out-of-pocket expenses. Your claims benefit will be based on the allowable claims percentage or per service limit and overall limit for the category and applicable benefit period.
You can also use the Online Benefit Quote tool that is available after logging in the Member Centre.
What is the CBHS Choice Network?
The CBHS Choice Network is a group of providers who are committed to reducing or removing the gap for Extras services on selected preventative dental and optical frames, lenses and contact lenses.
Find out more information here
Why does CBHS only allow same day claiming for electronic claims?
98% of claims are made on the spot in real-time. Within the other 2% of claims, we have found elements of inappropriate claims in backdated claims. Therefore we only allow same day claiming for electronic claims to protect our members.
What if the member does not have their CBHS membership card with them at the time of treatment?
CBHS member will have to pay for the treatment and then lodge a claim with CBHS in other ways available to our members, i.e. online, email, via fax or via post.
Why do I need to provide a doctor’s referral for certain claims?
CBHS requires a referral to be received from your medical practitioner as evidence that the particular product being claimed is required.
What types of services do I need a referral for?
CBHS requires a referral from your medical practitioner for Artificial Aids, Health Care Appliances and contraceptives.
How long will my referral last?
A referral received from a medical practitioner will last for the following time periods:
- Artificial Aids and Health Care Appliances – 3 years
- Contraceptives – 12 months
How can I claim on travel and accommodation?
CBHS pays benefits towards travel and accommodation to members who require essential medical or dental treatment where it is not available within a 160km round trip of the members' home. Benefits are paid for the member receiving treatment only.
Essential medical treatment means:
- The member has been referred for the treatment by a registered medical practitioner; and
- The member has given CBHS a medical certificate from the registered medical practitioner, which states that the treatment is essential.
CBHS requires the following in order to pay towards travel or accommodation:
- A medical certificate from the medical practitioner / a copy of the doctors invoice as confirmation you have attended the practice/clinic
- A copy of the receipt from the hotel, motel, etc. (for accommodation only)
- A completed and signed CBHS claim form.
Do I need to send CBHS the original receipts?
Do I need to send CBHS the original receipts? No. CBHS will accept scanned, faxed or duplicate receipts. CBHS does not require the original receipts to be submitted in order to process claims.
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 for your treatment. Doctors are free to choose whether they will participate in Access Gap Cover on a patient by patient basis, and 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 hospitals that may not be covered by CBHS. Examples of these include:
- Telephone use
- Boarder fees
- Meals for my partner
Should you require any of these services, please contact Member Care on 1300 654 123 to find out 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 you have Hospital Cover and 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 in-patient 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.
What is my daily co-payment?
If you have a daily co-payment on your membership, you will need to pay the relevant daily co-payment each day that you are hospitalised up to a maximum of 6 days per person or 12 days per family per calendar year.
Do I have to pay my excess / co-payment for a day procedure?
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 for all prostheses?
You are covered to 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, there is a 12 month waiting period for pre-existing ailments. You may be requested to provide a medical report so our medical advisor can assess whether or not the condition is pre-existing.
The report must be completed by the first doctor consulted for this condition. Download the Certificate for Medical Practitioner
Am I covered for a minor medical procedure in my doctor's room?
An example of a minor medical procedure could be the removal of a small cancerous spot where the doctor may perform this procedure in a sterile room and raises a specific fee for the use of the room.
This type of service is considered a non-admitted theatre fee. Benefits towards this specific fee are available under Top Extras, CBHS Prestige (Gold) and LiveLife (Gold) package covers. Benefits are 70% of the cost up a limit defined for your cover.
Please note that the bill for doctor services is payable by Medicare only.
Can I receive benefits towards home nursing after hospitalisation?
In some instances home nursing is provided by the hospital after you have been discharged and is payable by CBHS under your hospital cover as part of your admission costs.
Alternatively, if the above does not apply and you have Top Extras, LiveLife (Gold) or CBHS Prestige (Gold) package cover, you may receive benefits towards home nursing by a registered nurse.
Why does CBHS pay Ambulance claims differently depending on which state the service has been provided?
Each individual State Government has different arrangements in place, which determines how an ambulance claim is paid. As a result CBHS is required to pay these claims based on the state the service was provided in. A summary of the state based arrangements are detailed below:
- NSW & ACT residents – receive full ambulance cover with CBHS if hospital cover is held as a levy is included in your premiums. If you hold CBHS Ambulance Cover only, CBHS will pay towards emergency transport only
- QLD residents – a subscription is paid through the electricity bill, which covers them for ambulance services Australia wide
- NT, SA, VIC & WA residents – receive emergency ambulance cover with CBHS if hospital cover or ambulance cover is held
- TAS residents – a subscription is paid through their resident taxes if the services are performed in ACT, NT, NSW, TAS, VIC or WA. If the service is provided in QLD or SA emergency ambulance services are covered if you hold CBHS hospital cover or ambulance cover.
Are IVF treatments covered by CBHS?
No benefits are available for drugs used for IVF treatment from Extras cover under the pharmaceutical entitlement. CBHS does pay benefits towards inpatient IVF treatment in a contracted private hospital if your current hospital cover includes assisted reproductive services.
When is my baby an admitted patient?
Under rules set down by the Department of Health, the payment of gap medical benefits is restricted to medical services provided whilst an admitted patient of a hospital.
A new born baby is classified as an admitted patient when one or more of the following criteria apply:
- The baby is admitted to an approved neo-natal intensive care facility
- The baby is the second or subsequent born in a multiple birth situation (e.g. twins or triplets)
- The baby is more than 9 days old while still in hospital
If none of these criteria are met, your baby is not classified as an admitted patient for gap medical purposes and expenses can only be claimed through Medicare. (It is required that you indicate that your baby was not classified as admitted patient.) You will be eligible for 85% of the schedule fee through Medicare. No further benefits are available from CBHS.
Does CBHS pay for meals?
Generally, when mother and baby are in hospital, CBHS do not pay for the partner's meals or accommodation. Although there are benefits available for Boarder Fees (accommodation only) in some hospitals for specific situations, these benefits are subject to the conditions of the contract that is in place with CBHS. Please contact Member Care for further information.
Does my baby need to pay a co-payment?
If your baby needs to be admitted to hospital, you will be required to pay the relevant daily co-payment unless you have reached your family maximum of 12 days.
CBHS will waive the for any dependant under the age of 24 on the following covers only:
- Comprehensive Hospital (Gold) 70 & 100
- Comprehensive Hospital $750 Excess (Gold)
- Limited Hospital (Bronze Plus) 70 & 100
- Livelife (Gold)
- Stepup (Bronze Plus).
Does CBHS pay for antenatal classes?
Antenatal classes are covered on Top Extras, LiveLife (Gold) and CBHS Prestige (Gold) package cover. The benefit payable is 70% of cost, up to a maximum of $105.00 per confinement.
To claim for antenatal classes, CBHS requires an official receipt showing the provider's name, qualifications, dates and the cost of each class.
Can CBHS help with lactation classes?
CBHS can help if you have Top Extras, LiveLife (Gold) and Prestige (Gold) package cover. Lactation classes come under the midwifery benefit, which entitles you to 70% of the cost up to a maximum of $500 per confinement.
To claim for lactation classes, CBHS requires an official receipt showing the midwife's full name and nurse’s registration number.
Why doesn’t CBHS pay benefits towards home birthing?
CBHS does not pay benefits towards a midwife performing home birthing; this is because the midwives are not able to obtain insurance to cover this service. As the midwives do not have the correct insurance, CBHS will not pay towards this service.
What types of medical conditions qualify for Best Doctors?
Best Doctors provides services for a wide range of medical conditions. They can include everything from back pain and sports injuries to chronic diseases and life-threatening illnesses. However, Best Doctors does not provide emergency services or services for mental health disorders.
Do I have to travel or collect my own medical records?
No, all you have to do is make a confidential call to Best Doctors and they’ll handle everything for you. As all your contact with Best Doctors will be over the phone or the Internet, you do not need to travel, visit doctors’ offices or contact your doctor(s) to obtain records, images or other information related to your medical case.
Does Best Doctors share information about my case?
Best Doctors is 100% confidential. They will not tell CBHS about your call or its contents. The Best Doctors expert’s report is shared with your treating doctor(s) and with CBHS only with your written consent.
Who are the doctors Best Doctors uses?
Best Doctors physicians include the world’s top medical specialists. They are selected by other doctors through a comprehensive review process. Best Doctors surveys doctors to find out which doctors they trust most. Every doctor in the survey is asked, “If you or a loved one needed a doctor in a certain specialty, who would you choose?” Doctors cannot pay to be included on the Best Doctors list or nominate themselves for consideration.
Do I have to follow Best Doctors’ recommendations?
No. You remain in full control of your healthcare decision-making. The information you receive from Best Doctors is intended to help you make informed decisions regarding your diagnosis and/or treatment plan, and only you can decide whether you want to share the report with your treating doctor or not. Best Doctors will not share your report with your doctor unless you authorise it.
How will Best Doctors work with my treating doctor?
Best Doctors shares its expert’s findings with you first — and only with you. Then Best Doctors will share the expert’s report with your treating doctor once they have received your authorisation. They will not share the report without your consent. The goal of Best Doctors is to provide useful information so that you and your doctor can make more informed decisions together regarding your treatment.
Most doctors find that collaboration with other experts is very helpful, especially in complex situations. Best Doctors enables doctors to collaborate in a new way.
Isn’t asking for a second opinion from Best Doctors insulting to my doctor?
Not at all. Treating doctors who have worked with Best Doctors appreciate having access to respected experts in their field of practice. They also gain access to information regarding innovative diagnostic and treatment protocols that might not be available yet in their local communities.
How will Best Doctors maintain my privacy?
Best Doctors complies with all relevant state and national laws and regulations related to patient privacy. Unless required by law, your specific name and medical information will NOT be shared with anyone, including CBHS or treating doctor, without your written consent. On occasion, de-identified information may be used to help improve the Best Doctors program.
How do I know if I’m eligible for Best Doctors?
You’re eligible for Best Doctors if you are covered by a CBHS Prestige (Gold) policy.