StepUp

A mid-level package cover with the same benefits as Limited Hospital and Intermediate Extras plus more…

The StepUp package is made up of:

Hospital cover highlights

  • Limited Hospital plus pregnancy related services
  • $70 daily co-payment excluding children under 13 years of age
  • Access Gap Cover plus $100 Gap assist which will help you with additional out-of-pocket expenses
  • Emergency Ambulance transport

+

Extra cover

  • StepUp has a good coverage of extras to fit in with your lifestyle.

See below for detail


Hospital component

StepUp hospital will cover you for:

  • Accommodation for overnight, same day and intensive care for private or shared room in agreement private and public hospitals (excluding restricted services*)
  • Theatre fees 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 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
  • Emergency ambulance transport for an accident or medical emergency by approved ambulance providers
  • Boarder accommodation covers 100%, up to $160 per admission, if not included in hospital agreement
  • 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, StepUp also includes a medical gap benefit called Gap Assist, $100 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.


+

Extras component

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 $350 Calendar Year
    Consultations & examinations $28 - $40
    X-rays $21 - $60
    Extractions or surgical dental $50 - $255

    Major dental

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Major Dental (6 month waiting period)
    Periodontic (gum treatment) $24 - $260
    $900
    Calendar Year
    Endodontic (root canal treatment) $7.50 - $180
    Inlays / Onlays / Facing / Veneers $260 - $600 any 5 years
    Dentures & Implants $20 - $810 any 5 years
    Occlusal Therapy $17 - $260 Calendar Year
    Major Dental (12 month waiting period)
    Crowns & Bridges $10 - $720 any 5 years
    Orthodontia 70% $1,400 Lifetime

Prescribed optical

  • (6 month waiting period)

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Frames 
    $250
    Calendar Year
    Frames $90
    Lenses
    Single Vision (pair) $70
    Bifocal (pair) $60
    Trifocal Vision (pair) $90
    Multifocal (pair) $100
    Contact Lenses
    Contact Lenses $160

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      $600
    ($300 sub limit per therapy)
    Calendar Year
    Chiropractic (Initial/Subsequent) $61/$40
    Osteopathy (Initial/Subsequent) $61/$35
    Occupational therapy (Initial/Subsequent) $61/$35
    Speech therapy (Initial/Subsequent) $95/$46
    Clinical Psychology (Individual/Group sessions) $30-$140
    Podiatry (excl. artificial aids: e.g. orthotics) $30-$50 $150
    Dietician $15-$75 $100

    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 $400 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
    Blood Glucose Accessories 70% $100 Calendar Year
    Non-Pharmaceutical Benefits Scheme drugs requiring a prescription by law 100% less the current government prescribed co-payment up to $75 per prescription $300

Health care aids

  • (12 month waiting period) - where referred by a doctor and recognised by CBHS

    Description 70% of the cost up to the per service benefit below Overall limit Benefit period
    Artificial Aids $10-$150 $150 Calendar Year

Wellness benefit

  • (2 month waiting period)

    Description 90% of the cost up to the overall limit below

    Overall limit Benefit Period
    Health Checks
    Breast examinations (e.g. mammograms/x-rays)
    Bone density tests
    Skin cancer screening
    Bowel/prostate cancer screening
    Eye Screenings
    $200 Calendar Year
    Health Management
    Quit smoking programs2
    Weight management programs2
    Stress management courses2
    $100 Calendar Year
    Yoga1
    Pilates1
    Gym membership/Personal training1 $115 ($100 sub limit on personal training)
    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.

Download StepUp 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.