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CBHS Health Fund Limited

Prestige (Gold)

Restricted Insurer

$967.07 / month

(Before Rebate, Discount & Loading)

Available in NT

You may be entitled to an Australian Government Rebate on the above premium. Your premium may also include a Lifetime Health Cover Loading, an Age-based Discount or an insurer discount. Check with your insurer for details.

This policy covers: Two adults & dependants, including non-student dependants (3 or more people, only 2 of whom are adults).

Children (0 - 17), students (18 - 30) and non-students (18 to 30), as well as persons with a disability who qualify as a child, student and non-student in these age ranges.

Restricted insurer: Membership of this insurer is restricted to current and past employees of Commonwealth Bank Group, franchisees, contractors, and their families.

Policy ID: CBH/J11/DAFO2Y

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy provides accident cover - check with insurer for details.
  • This policy does not provide benefits for travel or accommodation outside of hospital.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Assisted reproductive services
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Insulin pumps
Joint reconstructions
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
Weight loss surgery

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: No excess

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members Waiting periods:
  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments
Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Gap Assist benefit - $200 per person per calendar year. Access to a second opinion provider.

Extras Cover

By using a CBHS Choice Network provider you will have lower out-of-pocket costs on Dental and Optical and have access to more "no gap" services. A list of providers is available on the CBHS website.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Acupuncture 2

$1,000 per person

combined limit for acupuncture, chinese medicine, remedial massage & other services

  • Initial visit: $33
  • Subsequent visit: $33
Ante-natal/Post-natal classes 2

$105 per person

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Audiology 2

$360 per person

  • Initial visit: $60
  • Subsequent visit: $60
Blood glucose monitors* 12

$500 per person

  • Per monitor: 100% of charge
Chinese medicine 2

$1,000 per person

combined limit for acupuncture, chinese medicine, remedial massage & other services

  • Initial visit: $33
  • Subsequent visit: $33
Chiropractic 2

$1,000 per person

combined limit for chiropractic & osteopathy

  • Initial visit: $61
  • Subsequent visit: $40
Dietetics/dietary advice 2

$360 per person

  • Initial visit: $75
  • Subsequent visit: $42
Endodontic 6

$700 per person

  • Filling of one root canal: $157
Exercise physiology 2

$360 per person

  • Initial visit: $35
  • Subsequent visit: $35
Eye therapy (orthoptics) 2

$455 per person

  • Initial visit: $60
  • Subsequent visit: $60
General dental 2

No annual limit

  • Fluoride treatment: $27
  • Scale & clean: $68
  • Surgical tooth extraction: $182
  • Periodic oral examination: $38
Health management / Healthy lifestyle 2

$730 per person

sub-limits apply

  • Health management: 100% of charge
Hearing aids* 12

$2,200 per person

  • Hearing aid: 100% of charge
Home nursing 2

$2,800 per person

  • Initial visit: $80
  • Subsequent visit: $80
Major dental* 12

$8,060 per person

sub-limits apply

  • Full crown veneered: $750
Non PBS pharmaceuticals 2

$1,000 per person

combined limit for non pbs pharmaceuticals & vaccinations

  • Per eligible prescription: $150
Occupational therapy 2

$800 per person

  • Initial visit: $61
  • Subsequent visit: $35
Optical 6

$450 per person

  • Multi-focal lenses & frames: $350
  • Single vision lenses & frames: $270
Orthodontic 12

$3,200 per person

$3,200 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: $3200
Orthotics (podiatric orthoses) 12

$1,500 per person

  • Orthotics supply & fit: $145
Osteopathy 2

$1,000 per person

combined limit for chiropractic & osteopathy

  • Initial visit: $61
  • Subsequent visit: $35
Physiotherapy 2

$900 per person

  • Initial visit: $61
  • Subsequent visit: $43
Podiatry 2

$400 per person

  • Initial visit: $50
  • Subsequent visit: $35
Psychology 2

$500 per person

  • Initial visit: $140
  • Subsequent visit: $80
Remedial massage 2

$1,000 per person

combined limit for acupuncture, chinese medicine, remedial massage & other services

  • Initial visit: $33
  • Subsequent visit: $33
Speech therapy 2

$1,850 per person

  • Initial visit: $95
  • Subsequent visit: $46
Vaccinations 2

$1,000 per person

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: $150
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $33}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$105 per person}

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$360 per person}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $60}

Blood glucose monitors*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Per monitor: 100% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $33}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $61}

{Subsequent visit: $40}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$360 per person}

Examples of maximum benefits

{Initial visit: $75}

{Subsequent visit: $42}

Endodontic

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

Examples of maximum benefits

{Filling of one root canal: $157}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$360 per person}

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $35}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$455 per person}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $60}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Fluoride treatment: $27}

{Scale & clean: $68}

{Surgical tooth extraction: $182}

{Periodic oral examination: $38}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$730 per person}

{sub-limits apply}

Examples of maximum benefits

{Health management: 100% of charge}

Hearing aids*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$2,200 per person}

Examples of maximum benefits

{Hearing aid: 100% of charge}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$2,800 per person}

Examples of maximum benefits

{Initial visit: $80}

{Subsequent visit: $80}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$8,060 per person}

{sub-limits apply}

Examples of maximum benefits

{Full crown veneered: $750}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per eligible prescription: $150}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$800 per person}

Examples of maximum benefits

{Initial visit: $61}

{Subsequent visit: $35}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$450 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: $350}

{Single vision lenses & frames: $270}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$3,200 per person}

{$3,200 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: $3200}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per person}

Examples of maximum benefits

{Orthotics supply & fit: $145}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $61}

{Subsequent visit: $35}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$900 per person}

Examples of maximum benefits

{Initial visit: $61}

{Subsequent visit: $43}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $35}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Initial visit: $140}

{Subsequent visit: $80}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for acupuncture, chinese medicine, remedial massage & other services}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $33}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,850 per person}

Examples of maximum benefits

{Initial visit: $95}

{Subsequent visit: $46}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: $150}

Ambulance cover

In NT this policy provides:

Emergency: Unlimited with a waiting period of 1 day.

Call-out fees: Will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover: Coverage for emergency ambulance services if you’re transported directly to a hospital or treated at the scene during a medical emergency. This transport or treatment must be provided by a State Government or a private ambulance service that we recognise, e.g., the Royal Flying Doctor Service. Cover includes transport from the scene of an accident or medical event such as a heart attack.

For further information about this policy see: https://www.cbhs.com.au/health-insurance/ambulance-cover

Insurer Details

CBHS Health Fund Limited

Prestige (Gold)

Restricted Insurer

$967.07 / month

(Before Rebate, Discount & Loading)

Available in NT

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/CBH/J11/DAFO2Y

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