• What's covered?
  • What's partially covered
  • What's not covered
  • Waiting periods
  • Co-payment or Excess
  • Comprehensive Hospital (Gold) will cover you for:

    • Accommodation for overnight, same day and intensive care 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, 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.

     

    • Podiatric surgery (provided by a registered podiatric surgeon)1
    • Services for which a Medicare benefit is NOT payable

    1 Indicates benefits for accommodation at Minimum Benefits in relevant PHI (Benefit Requirements) Rules and prostheses benefits based on items listed by the Minister of Health. No benefit for medical or theatre costs.

  • Comprehensive Hospital (Gold) 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 (for residents in VIC, SA and NT).

    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:

    • Cosmetic services
  • 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* (except for hospital psychiatric services, rehabilitation and palliative care) 12 months
    Pregnancy and birth 12 months
    Hospital psychiatric services**, rehabilitation and palliative care 2 months
    Accidents***, emergency ambulance transport 1 day
    All Other Treatments 2 months

     

    * If a member has a pre-existing condition, a waiting period of 12 months will apply before we will pay hospital or medical benefits towards any treatment for that condition.

    ** Note that upon serving the two month waiting period, members can choose to upgrade their cover (once in a lifetime) and access the higher benefits for hospital psychiatric treatment associated with that cover, without serving an additional waiting period. For more details contact us on 1300 654 123 or by sending an email to help@cbhs.com.au.

    *** Accident means an unexpected or unforeseen event caused by an external force or object resulting in an injury to the body which requires treatment by a medical practitioner, Hospital or dentist (as the context requires) but excludes pregnancy.

  • You can reduce the cost of your Comprehensive Hospital (Gold) cover by agreeing to a daily co-payment or an excess.

    Co-payment options available: $0, $70 or $100 or Excess options available: $750


    Co-payment

    You can reduce the cost of your cover by agreeing to a daily co-payment of $70 or $100. 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.

    or

    Excess

    You can reduce the cost of your cover by agreeing to pay an excess of $750. This means that when you go into hospital you will pay the first $750 in respect to charges raised by the hospital. This excess is per person up to a maximum of $1500 per family membership per calendar year.

Other Hospital Covers

  • CBHS  Active Hospital (Silver Plus)

    Active Hospital
    (Silver Plus)

    Active Hospital (Silver Plus) is a high-level product that covers more than the basics while excluding some services you don’t need.

  • CBHS Limited Hospital (Bronze Plus)

    Limited Hospital
    (Bronze Plus)

    Mid-level cover with exclusions on services you're less likely to need.

  • CBHS Basic Plus Hospital

    Basic Plus Hospital


    For those after basic care in a public hospital that gives you the choice of you own doctor

What Our Members Think

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

What Our Members Think

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! 😃

- Jessica B

What Our Members Think

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

What Our Members Think

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

What Our Members Think

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

What Our Members Think

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

What Our Members Think

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. Thank you CBHS!!!

- Karen W

What Our Members Think

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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