Membership Suspension Guide

Transcription

1 Membership Suspension Guide

2 2 3 At GMF Health we understand that there are times when you may need to consider suspending your health insurance cover. Travelling overseas for more than three months If you have been a member for more than two months and you are going overseas for three months or more, you can suspend your membership for up to three years whilst your are overseas. We do not pay benefits for treatment that occurs outside Australia, including general treatment such as dental and glasses and hospital or medical treatment. The Federal Government does have a Reciprocal Health Care Agreement with some countries, but even in these countries free treatment is only provided in an emergency. Because of this we recommend that you consider obtaining travel insurance (with medical cover) before you leave Australia. If you suspend your membership, you will also need to consider whether the Federal Government s Medicare Levy Surcharge will apply to you while you are overseas. The additional levy applies if you earn over a certain income threshold. For more information please contact a GMF Health Member Service Consultant on More information on the Federal Government Reciprocal Health Care Agreement and the Medicare Levy can be obtained from Medicare. Holders of Newstart or Sickness Allowance cards If you hold a Newstart or Sickness Allowance entitlement card you can suspend all, or part of your membership for the duration indicated on the card. If you do suspend your Hospital cover while you hold a Newstart or Sickness Allowance entitlement you will only be able to obtain healthcare provided by the Public Health system. This may mean that you won t have access to your choice of doctor, and you may also have to join waiting lists for any surgery which is not considered to be an emergency. Why suspend my cover why not cancel it? By suspending your cover you retain all the benefits earned prior to your commencing. This means that you will not be required to re-serve waiting periods, and you will retain length of membership benefits such as higher annual maximums, plus higher benefits for certain items covered by Extra s cover. These benefits are automatically forfeited if your cover is cancelled. And, if you are over 31, suspending your membership will also mean that you will avoid paying any Lifetime Health Cover loading that you were not already paying prior to the commencing. This loading can increase your hospital premium from 2% up to a maximum of 70%. For full details on how the Federal Government Lifetime Health Cover loading applies please call GMF Health on or visit health.gov.au Privacy Policy HBF Health Limited ABN trading as GMF Health (GMF) complies with the Privacy Act 1988 (Cth) to ensure that your personal (including sensitive) information (Information) is protected. GMF will use the Information collected from third parties in connection with your application. When you make the application you concent to HBF collecting related sensitive information directly from the third parties or, if you are not the applicant, you give consent on behalf of that applicant. To assist in this collection, you authorise the third party to provide GMF any additional information or assistance concerning the application. GMF is also obliged by the Private Health Insurance Act 2007 (Cth) to maintain certain transaction records and make those records available to the Department of Health and Ageing, the Private Health Insurance Ombudsman and Medicare Australia. We will disclose this and any other information as required by law. If you do not provide personal information which is required, GMF may not be able to process your application. In most circumstances you have a right to access any personal information, which we collect and hold about you. Please contact us if you wish to access your personal information. We may deny your request in some circumstances and if we do this, we will tell you why. GMF collects, uses and discloses your Information in accordance with our Privacy Policy, which is available at gmfhealth. com.au or on request by calling a GMF member service consultant on Our Privacy Policy contains further information about how GMF handles your Information. This includes information on how you can access and/ or seek the correction of your Information that we hold about you as required by law, how to make a complaint about the way your Information is being handled by GMF and how GMF will deal with your complaint. If you have any questions about how GMF handles your Information, please contact our privacy officer by writing to GPO Box C101, Perth, Western Australia, 6839.

3 4 5 GMF Health Membership Suspension Terms and Conditions Suspension due to overseas travel 1) The option to suspend GMF Health cover is only available to members who are travelling overseas for at least three (3) consecutive months. The maximum period of is three years. 2) Suspension is only available to members who have held membership with GMF Health for at least two (2) months prior to the commencement date. 3) A Membership Suspension Application must be completed in full and submitted to GMF Health before the member leaves Australia. 4) If you suspend your policy prior to leaving Australia, when you resume your cover you ll be required to back-pay your premium for the period of time that you were still in Australia before heading overseas. This ensures continuity of cover. 5) Any waiting periods that have not been completed prior to the GMF Health cover commencement date, must be completed upon the resumption of the membership. 6) GMF Health cover cannot be suspended if premiums are more than two (2) months in arrears at the time that the is due to commence. 7) Upon resumption of the GMF Health cover, members are entitled to the same level of benefit(s) that they held prior to the membership commencing. 8) The period of the will not be included in the calculation of length of membership benefit entitlements. 9) During the period of Australian Government Rebate on private health insurance cannot be claimed for the cover suspended. 10) During the period of Medicare Levy Surcharge may apply. 11) No benefits are payable under the suspended cover if the service was received during the period. 12) GMF Health cover cannot be resumed if the member s return to Australia is for less than six months and/or for holidays. 13) GMF Health cover cannot be resumed if the member s return to Australia is for the purpose of medical treatment where the member has not resumed permanent Australian residency. 14) Suspended members must apply to resume GMF Health cover within 30 days of permanently returning to Australia. 15) Policies not resumed within this 3 year period will be cancelled and any remittance held in credit on the policy will be applied prior to cancellation. 16) To resume GMF Health cover a Membership Resumption Application must be completed and submitted to GMF Health along with a copy of the boarding pass which confirms the date when the member permanently arrived back in Australia. An 'International Movement Record', available from the Department of Immigration, is also acceptable (refer to form 1359 at Suspension due to Newstart or Sickness Allowance entitlements 1) The applicant must have been a GMF Health member for at least two (2) months prior to the commencement date. 2) Members cannot suspend their cover if their premiums are not up to date at the time that the is to commence. 3) A Membership Suspension Application must be completed in full and submitted to GMF Health along with a copy of the member's Centrelink entitlements. 4) Requests for cover will not be backdated by more than two (2) months from the date that GMF Health receives the Membership Suspension Application. 5) Any waiting periods that have not been completed prior to the GMF Health cover commencement date, must be completed upon the resumption of the membership. 6) Upon resumption of the GMF Health cover, members are entitled to the same level of benefit(s) that they held prior to the membership commencing. 7) The period of the will not be included in the calculation of length of membership benefit entitlements. 8) During the period of Australian Government Rebate on private health insurance cannot be claimed for the cover suspended. 9) During the period of Medicare Levy Surcharge may apply. 10) No benefits are payable under the suspended cover if the service was received during the period. 11) When a member s entitlement card expires and a new card is issued, the member must provide GMF Health with a copy of the new card to ensure continuation of the Membership Suspension. 12) Members must immediately advise GMF Health when their Newstart or Sickness Allowance entitlements are withdrawn.

4 7 Membership Suspension To suspend all, or part of your health insurance cover please complete the details below and submit with any documentation that is requested on the application. Terms and Conditions apply, and are fully explained in this guide. Please ensure you read the terms and conditions before you apply to suspend your cover. If you require clarification of any of the terms and conditions, or you have any other questions please ask your GMF Health Member Service Consultant. Membership Suspension Form Membership Number Surname Given Name(s) Address State Postcode Home Phone Mobile Work Phone Option A Suspension for Overseas Travel If you are travelling overseas for more than three months you have the option of suspending your membership. Terms and Conditions apply. 1) Travel Details Date of Departure Date of Expected Return Number of Months Absent / / / / Option B Suspension for Unemployment or Sickness Benefits If you hold a Newstart or Sickness Allowance card you have the option of suspending all or part of your membership for the duration indicated on the entitlement card. Terms and Conditions apply. 1) Entitlement Card Number (Please attach a copy to this form) 2) Cover to be suspended Hospital Only Extras Only Hospital & Extras Declaration I acknowledge that on my request GMF Health have suspended my membership. I have read and fully understand the terms and conditions that apply to my of membership and understand that my health insurance cover will not resume until I notify GMF Health in accordance with the membership and resumption terms and conditions. Member signature Date

5 8 9 Membership Resumption To resume your GMF Health Cover please complete the details below and submit with any requested documentation. Terms and Conditions apply, and are fully explained in this guide. If you require clarification of any of the terms and conditions, or you have any other questions please ask your GMF Health Member Service Consultant. Membership Resumption Form Membership Number Surname Given Name(s) Address State Postcode Home Phone Mobile Work Phone Option A Resumption following Overseas Travel If you suspended your membership due to overseas travel please complete this section and return to GMF Health along with evidence of your arrival date back in Australia. Terms and Conditions apply. 1) Travel Details Date of arrival back in Australia / / Declaration I acknowledge that the information contained above is true and correct and I have read and fully understand the terms and conditions that apply to my resumption of membership. Member signature Date

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7 GMF Health Head Office 130 Egan Street, Kalgoorlie WA 6430 Postal Address PO Box 513, Kalgoorlie WA 6433 T Monday to Friday 7am to 5pm (WST) E welcome@gmfhealth.com.au W gmfhealth.com.au The information in this brochure was correct at time of print. Minor changes may have occurred since that date. If major changes occur, the brochure will be replaced. This brochure should be read carefully and retained for your future reference. Details of any minor changes can be obtained from GMF Health upon request. HBF Health Limited ABN GMF /07/2015