- Treatment in a private hospital for medically necessary treatment.
- Medicare covers 75% of the Medical Benefit Schedule (MBS) fee set by the Government for doctors’ charges and TUH covers the remaining 25%.
- Accommodation, theatre fees, intensive care, cardiac care, industry approved prostheses and hospital medication in almost all private hospitals in Australia. Find out more
- This cover is available with no excess or can include a $300 or $500 excess to reduce premium costs.
- The excess is payable by adults on the policy if they are admitted into hospital.
- The excess is only payable once per adult per calendar year.
- Covers single dependants until age 21, and full-time student dependants up to age 25.
- If you have Total Care Hospital with $300 excess and Comprehensive Extras covers you can purchase extended dependant cover for a premium loading of approximately 30%. This allows your non-student dependants, who are single and earn less than $50,000 a year, can stay on your policy until age 25.
What’s not included?
- Hospital treatment that is not medically necessary or treatment which is not eligible for Medicare benefits;
- GP visits or other specialist appointments before you are admitted or after you are discharged from hospital;
- Gap fees charged by specialists over the Medicare Benefits Schedule;
- Experimental procedures/therapies;
- High-cost medications; and
- Robotic surgery consumables.
Benefit Limitation Period (BLP)
A benefit limitation period of the first 12 months of membership applies for members who are new to private health insurance and those transferring from other funds, with hospital cover which pay restricted benefits for private hospital accommodation related to psychiatric services. During the BLP, we pay the public hospital default benefits as per legislation, which means you may have significant out-of-pocket costs to pay for the treatment. Waiting periods still apply for services with a BLP. For example, after serving the 2 months waiting period, your psychiatric benefit will be limited to a default benefit for the following 10 months. After 12 months you are entitled to the full benefit claimable for the treatment.
For further information, please refer to the Important Information Guide.
For full information on included services, benefits, limits, excesses, pre-existing condition rules and waiting periods, download the Total Care Hospital brochure and read in conjunction with the Important Information Guide.
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