Prestige

Prestige is a premium level of cover with the same benefits as Comprehensive Hospital and Top Extras plus more...

The Prestige package is made up of:

Hospital cover 

  • no co-payment or excess
  • the option to keep a non-student dependant up to the age of 25
  • access to Best Doctors 
  • highest benefits in the CBHS product suite
  • Access Gap Cover plus $200 Gap Assist which will help you with additional out-of-pocket medical expenses
  • access to chronic disease management programs and hospital substitute treatment
  • waiting periods and restrictions may apply

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Extra cover 

  • Prestige has the highest level of Extras benefits

See below for details


Hospital cover

Prestige hospital cover will cover you for:

  • Accommodation for overnight, same day and intensive care covered for private or shared room in agreement private and public# hospitals
  • 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, radiologists, 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
  • 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*)
  • Chronic Disease Management 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.
Gap Assist#
To further help you reduce your out-of-pocket expenses as a result of hospitalisation, Prestige also includes a medical gap benefit called Gap Assist, $200 per person per calendar year towards out-of-pocket expenses.

# All hospital services provided in a public hospital are eligible for Minimum Default Benefits. These benefits are stipulated by the Department of Health and listed in the relevant Private Health Insurance (Benefit Requirement) Rules. Some hospitals may charge above the Minimum Default Benefit for shared room accommodation. Please note that fees charged in excess of Minimum Default Benefits are an out-of-pocket expense and are not eligible for reimbursement under CBHS policies.

A benefit is not payable in respect of a service that was rendered to a Member if the services can be claimable from any other source.


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Extras cover

Dental

  • Preventative Dental (2 month waiting period)

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Oral Examinations (011, 012, 013) $35 - $45 Unlimited Calendar Year
    X-Ray (022) $28
    Removal of plaque (111) $41
    Removal of calculus (114, 115) $65 - $70
    Fluoride application (121) $25
    Mouthguard (151,153) $130 - $150
    Fissure sealing (161) $34

    General Dental (2 month waiting period)

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Fillings $81 - $150
    Unlimited
    Calendar Year
    Consultations & examinations $28 - $40
    X-rays $21 - $60
    Extractions or surgical dental $50 - $255

    Major Dental (6 month waiting period)

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Periodontic (gum treatment) $24 - $260 $700 Calendar Year
    Endodontic (root canal treatment) $7.50 - $180 $700
    Inlays / Onlays / Facing / Veneers $260 - $600 $1,440 Any 5 years
    Dentures & Implants $20 - $810 $1,500
    Occlusal Therapy $17 - $260 $920 Lifetime

    Major Dental (12 month waiting period)

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Orthodontia 70% $3,200 Lifetime
    Crowns & Bridges $10-$720 $3,500 Any 5 years

Prescribed optical

  • (6 month waiting period)

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Frames
    Frames $140 $450 Calendar Year
    Lenses 
    Single Vision (pair)(212) $130
    Bifocal (pair)(312) $140
    Trifocal Vision (pair) (412) $150
    Multifocal (pair) (512) $210
    Contact Lenses 
    Contact Lenses (852) $220

Therapies

  • Therapies (2 month waiting period)

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Therapies
    Physiotherapy (Initial/Subsequent) $61/$43 $900 Calendar Year
    Chiropractic (Initial/Subsequent) $61/$40 $1,000
    Osteopathy (Initial/Subsequent) $61/$35
    Hypnotherapy $80 $360
    Occupational Therapy (Initial/Subsequent) $61/$35 $800
    Speech Therapy (Initial/Subsequent) $95/$46 $1,850
    Clinical Psychology $30-$140 $500
    Ante natal/Post natal physiotherapy 70% $105
    Podiatry (excl. artificial aids: e.g. orthotics) $30-$50 $400
    Audiology $60 $360
    Eye Therapy $60 $455
    Dietician $15-$75 $360

    Alternative Therapies (2 month waiting period)

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Alternative therapies
    Natural therapies
    Buteyko, Herbal Medicine Consultations, Homeopathy, Naturopathy, Nutrition
    $33 $1,000 Calendar Year
    Oriental therapies
    Acupressure, Acupuncture, Chinese Herbal Medicine Consultation, Chinese Massage, Kinesiology, Reflexology, Shiatsu, Traditional Chinese Medicine Consultation
    Massage therapies
    Alexander Technique, Aromatherapy, Bowen Therapy, Deep Tissue Massage, Feldenkrais, Lymphatic Drainage, Myotherapy, Remedial Massage, Rolfing, Sports Massage, Swedish Massage, Therapeutic Massage

General health

  • (2 month waiting period)

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    General Health
    Blood Glucose Accessories 70% $320 Calendar Year
    Home visits by Registered Nurse $120 (>4 hrs) $80 (<4 hrs) $2,800
    Non-Pharmaceutical Benefits Scheme drugs requiring a prescription by law 100% less the current government prescribed co-payment up to $150 per prescription $1,000 Calendar Year
    Travel & accommodation+ 50% of the cost for accommodation (shared room rate) airfare, train, bus or 15c per kilometre car  $500 Per Membership Per Calendar Year

    + Travel is only payable for a patient who requires essential medical and dental treatment, where it is not available at a facility within a 160 km round trip of the member's home. In order to claim travel a patient must be visiting a specialist and will require a referral letter. Excludes Ronald McDonald house.

Health care aids

  • (12 month waiting period)

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Health care aids
    Artificial aids $10-$1,500 $1,500 Any 3 years
    Hearing aids 70% $2,200
    Blood pressure monitor, Nebuliser, Glucometer 70% $500

Wellness benefits

  • Description 90% of the cost up to the overall limit below
    Health checks Overall limit Benefit Period
    Breast examinations (i.e. mammograms/x-rays)
    Bone density tests
    Skin cancer screening
    Bowel/prostate cancer screening
    Eye Screenings
    $300 Calendar Year
    Health management
    Quit smoking programs2
    Weight management programs2
    Stress management courses2
    $200 Calendar Year
    Yoga1
    Pilates1
    Gym membership/Personal training1 $230 ($200 sub limit on personal training) Calendar Year

    1 CBHS can only pay a benefit for gym membership/personal trainer/pilates /yoga where the gym/personal trainer/yoga/pilates service is provided as part of a health management program, certified by your GP or a recognised provider confirming that the gym/personal trainer/yoga/pilates program is a health management program. Approval form is available from CBHS. Please note that GP consultations are not covered by CBHS.Must be approved by CBHS

A benefit is not payable in respect of a service that was rendered to a Member if the services can be claimable from any other source.

Each group of services within Extras and Packages cover has an overall limit on the amount you can claim. Most limits are based on per person per calendar year, unless otherwise stated in our Extras table.

Download Prestige 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.