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RT Health - a division of The Hospitals Contribution Fund

Gold Ultimate Hospital $750 Excess - Family Extension and Top Extras - Family Extension

$777.81 / month

(Before Rebate, Discount & Loading)

Available in SA

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

This policy covers: One adult & dependants, including non-student dependants (2 or more people, only one of whom is an adult).

Children (0 - 17), non-classified* dependant (18 - 21), students (22 - 30) and non-students (22 to 30), as well as persons with a disability who qualify as a child, non-classified* dependant, student and non-student in these age ranges. *Non-classified dependant: Dependant 18-20

Policy ID: RTE/J3C/SDJH1Y

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 provides benefits for travel or accommodation outside of hospital - check with insurer for details.
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: You will have to pay an excess of $750 per admission. This is limited to a maximum of $750 per person and $1500 per policy per year.

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

No excess for day admission. No excess for dependants under the age of 22.

For further information about this policy see: https://rthealthfund.com.au/understanding-your-cover/#HospitalCoverGuides

Extras Cover

This health insurer does not operate a preferred provider scheme.

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

$750 per person

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

  • Initial visit: $40
  • Subsequent visit: $35
Ante-natal/Post-natal classes 2

$300 per person

  • Initial visit: $30
  • Subsequent visit: $30
Audiology 2

$160 per person

  • Initial visit: $80
  • Subsequent visit: $80
Blood glucose monitors 12

$600 per person

sub-limits apply

  • Per monitor: 80% of charge
Chinese medicine 2

$750 per person

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

  • Initial visit: $35
  • Subsequent visit: $30
Chiropractic 2

$500 per person

combined limit for chiropractic, osteopathy & other services

  • Initial visit: $49
  • Subsequent visit: $39
Dietetics/dietary advice 2

$500 per person

  • Initial visit: $55
  • Subsequent visit: $55
Endodontic 12

$1,500 per person

combined limit for endodontic & major dental

  • Filling of one root canal: $192
Exercise physiology 2

$750 per person

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

  • Initial visit: $40
  • Subsequent visit: $35
Eye therapy (orthoptics) 2

$500 per person

  • Initial visit: $40
  • Subsequent visit: $35
General dental* 2

No annual limit

  • Fluoride treatment: $44
  • Scale & clean: $72
  • Surgical tooth extraction: $190
  • Periodic oral examination: $35
Health management / Healthy lifestyle 2

$150 per person up to $300 per policy

  • Health management: 100% of charge
Hearing aids 24

$1,200 per person

sub-limits apply

  • Hearing aid: $600
Home nursing 2

$700 per person

  • Initial visit: $30
  • Subsequent visit: $30
Major dental 12

$1,500 per person

combined limit for endodontic & major dental

  • Full crown veneered: $782
Non PBS pharmaceuticals 2

$600 per person

  • Per eligible prescription: $70
Occupational therapy 2

$500 per person

  • Initial visit: $60
  • Subsequent visit: $53
Optical* 2

$300 per person

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic 12

$1,000 per person

$3,000 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge
Orthotics (podiatric orthoses) 12

$250 per person

  • Orthotics supply & fit: 100% of charge
Osteopathy 2

$500 per person

combined limit for chiropractic, osteopathy & other services

  • Initial visit: $53
  • Subsequent visit: $40
Physiotherapy 2

$550 per person

  • Initial visit: $60
  • Subsequent visit: $54
Podiatry 2

$500 per person

  • Initial visit: $45
  • Subsequent visit: $40
Psychology 2

$500 per person

  • Initial visit: $80
  • Subsequent visit: $60
Remedial massage 2

$750 per person

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

  • Initial visit: $40
  • Subsequent visit: $40
Speech therapy 2

$500 per person

  • Initial visit: $70
  • Subsequent visit: $60
Vaccinations 2

$150 per person

  • Per service: $50
Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

Ante-natal/Post-natal classes

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$160 per person}

Examples of maximum benefits

{Initial visit: $80}

{Subsequent visit: $80}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

{sub-limits apply}

Examples of maximum benefits

{Per monitor: 80% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $35}

{Subsequent visit: $30}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for chiropractic, osteopathy & other services}

Examples of maximum benefits

{Initial visit: $49}

{Subsequent visit: $39}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Initial visit: $55}

{Subsequent visit: $55}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: $192}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $35}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Fluoride treatment: $44}

{Scale & clean: $72}

{Surgical tooth extraction: $190}

{Periodic oral examination: $35}

Health management / Healthy lifestyle

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$150 per person up to $300 per policy}

Examples of maximum benefits

{Health management: 100% of charge}

Hearing aids

Waiting period:  24 months

Benefit limits per 12 months unless otherwise stated

{$1,200 per person}

{sub-limits apply}

Examples of maximum benefits

{Hearing aid: $600}

Home nursing

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

Examples of maximum benefits

{Initial visit: $30}

{Subsequent visit: $30}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per person}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Full crown veneered: $782}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person}

Examples of maximum benefits

{Per eligible prescription: $70}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $53}

Optical*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$300 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person}

{$3,000 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

Examples of maximum benefits

{Orthotics supply & fit: 100% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

{combined limit for chiropractic, osteopathy & other services}

Examples of maximum benefits

{Initial visit: $53}

{Subsequent visit: $40}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$550 per person}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $54}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Initial visit: $45}

{Subsequent visit: $40}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Initial visit: $80}

{Subsequent visit: $60}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per person}

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

Examples of maximum benefits

{Initial visit: $40}

{Subsequent visit: $40}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person}

Examples of maximum benefits

{Initial visit: $70}

{Subsequent visit: $60}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$150 per person}

Examples of maximum benefits

{Per service: $50}

RT Health members pay no gap on a range of popular dental and optical services through HCF Dental or Optical Centres and the More for provider network. Includes mental health services (psychology, approved counselling, mental health social worker and OCBT courses). Health aids include blood pressure monitors, CPAP machines & masks, tens machines, wheelchairs, wigs (conditions apply). Annual, membership, service and sub limits apply.

Other features of this general treatment cover: Health management / Healthy lifestyle includes benefits towards gym membership and Tai Chi, Yoga & Pilates. Combined limit is $150 per person, $300 per membership per calendar year. For more details contact our member care team on 1300 886 123 or visit rthealthfund.com.au.

For further information about this policy see: https://rthealthfund.com.au/understanding-your-cover/#HospitalCoverGuides

Ambulance cover

In SA this policy provides:

Emergency: With a waiting period of 1 day, limited to $5,000 per person per year.

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

Other features of this ambulance cover: Up to $5,000 per person per year for emergency ambulance attendance or transportation in the case of accident or illness. Cover applies anywhere in Australia. You can also purchase additional ambulance cover through a state government ambulance service.

For further information about this policy see: https://rthealthfund.com.au/understanding-your-cover/#HospitalCoverGuides

Insurer Details

RT Health - a division of The Hospitals Contribution Fund

Gold Ultimate Hospital $750 Excess - Family Extension and Top Extras - Family Extension

$777.81 / month

(Before Rebate, Discount & Loading)

Available in SA

RT Health - a division of The Hospitals Contribution Fund

http://www.rthealth.com.au

help@rthealth.com.au

1300 886 123

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/RTE/J3C/SDJH1Y

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