Cancer treatment in hospital: It is important to be aware that health insurance will only cover the portion of costs that relate to an admission to hospital. Specialist fees outside of hospital or other outpatient fees in relation to chemotherapy or radiotherapy aren’t covered.
High cost drugs are sometimes requested for the Treatment of some cancers. Typically high-cost drugs are for newer Treatments that are not recognised by the Pharmaceutical Benefit Scheme (PBS) because the PBS considers them to be still under clinical trial and therefore experimental Treatments. Health insurance will not Cover high cost drugs for the same reasons (or may only Cover a small portion of the cost). It is the responsibility of the treating doctor, and Hospital, to inform Patients about the potential for large out-of-pockets as a result of high cost drugs.
Customers without full cover for Psychiatric Treatment are able to use a one-off waiver to upgrade their cover and have immediate access to applicable in-hospital mental health services. This waiver is only available to customers who have held hospital cover for at least the previous two months and have a valid referral from a consulting psychiatrist. To find out more, call us on 13 22 44.
Benefit Limitation Period - Minimum Benefits Payable (BLP - MBP) means that unless you're transferring from a Complying Health Insurance Product (see Policy Booklet), there will be significant out-of-pocket costs if you go to hospital for this treatment in the first 12 months of your policy. After serving the 2 month Waiting Period, your benefit will be limited to "Minimum Benefits Payable" for the following 10 months. After this period of time you are entitled to the full benefit claimable for the treatment.
Minimum Benefits Payable (MBP) means that we will pay the minimum amount of benefits that we are required to pay under the Private Health Insurance Act, to or on behalf of a customer for hospital treatment under a Hospital cover. If you’re attending a Private Hospital for these services, there will be significant out-of-pocket costs. If a treatment important to you is listed as MBP, we recommend you consider a higher level of cover.
INCL - Hospital Treatment provided by a registered Podiatric Surgeon is limited to cover for accommodation and prosthetic devices. No benefits are payable for Podiatric Surgeon fees, medical specialist fees (e.g. Anaesthetist) or theatre costs. Refer to the Policy Booklet for more information.
