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1 Hospital cover Healthy Hospital Prefer to pay lower premiums? Healthy Hospital 200 & 500 offers the same comprehensive benefits as our Premium Hospital cover, with the addition of an excess. By choosing either Healthy Hospital 200 or 500, members can take advantage of the lower premiums by choosing to pay an excess on top of any patient contribution that would normally apply to Premium Hospital. Healthy Hospital 200 & 500 provide members with two excess policy options, enabling you to choose the premium level that best suits your needs. The excess applies to the cost of in-patient hospitalisation in either a private, public or day hospital facility. For singles, the excess is only payable once in any rolling 12 month period (once the excess is paid in full). From the day you go into hospital, Navy Health will not charge another excess for a minimum of 12 months. For families, the excess is payable per admission up to the family maximum of 2 admissions, in any rolling 12 month period. For example, if Mary goes to hospital whilst covered under Healthy Hospital 200, an excess of $200 is payable. If within twelve months of paying the excess, Mary s husband Joe goes into hospital, the $200 excess is to be paid again. For any subsequent hospitalisations in the same rolling 12 month period, no excess is payable. Extra Savings Add extras cover to your package and get money back on the specialised treatments you use. For more information, refer to page 9. Please note waiting periods may apply, please refer to page 32. ^ Includes 30% Federal Government Rebate deduction / Single / 10% Reservist Discount / VIC, NSW, ACT, SA, QLD, TAS $2.50 From a day^ 12

2 Medical & Hospital Benefits explained Navy Health aims to close the gap on out-of-pocket in-hospital expenses. A gap payment is the difference between the fee charged by the hospital or doctor and the benefit paid by Navy Health. Gap payments may arise depending on the following: Access Gap When treated as a private patient in a hospital, members may face extra costs when the treating doctor charges more than the Medicare Benefits Schedule (MBS) allows for the service provided. The Access Gap scheme is designed to help minimise or eliminate these costs. Where there is an agreement in place and the treating doctor chooses to participate in the Access Gap Scheme, the insurer will cover the cost above the MBS fee to an agreed level on the Access Gap fee. If the doctor s fee is higher than the agreed Access Gap fee, the patient is responsible for paying the balance. Medicare 75% MBS Fee Access Gap Fee is limited to; $400 above the Australian Health Services Alliance (AHSA) set fee for all items except obstetrics $800 above the AHSA set fee for obstetrics only. Gap Medical Total Doctor s Fee Access Gap Fee Fund 25% Fund 100% Gap Patient 100% If the member receives treatment as a private patient in a hospital from a doctor that chooses not to participate in the Access Gap Scheme, Gap Medical benefits will apply. Under Gap Medical benefits, Medicare will cover 75% of the MBS fee for the service that has been provided. The insurer will pay the remaining 25% of the MBS fee. If the doctor charges more than the MBS fee, the member will be responsible for any gap payment. The gap is defined as the monetary variation between the MBS fee and the doctor s fee. Private Hospital & Day Facilities Contracted Facilities Prior to admission please check with your hospital as to whether or not your treatment or service is contracted. Contracted services relate to hospital fees such as accommodation and theatre. Navy Health has been able to negotiate 100% benefits on most treatments and services at over 490 private hospitals and day facilities. Product excesses still apply. To search for agreement hospitals and specialists in your area, please go to navyhealth.com.au Prosthesis items are payable at 100% of the minimum Government recommended fee. There is at least one prosthesis item available for every surgery with no outof-pocket expense to the patient. Drugs prescribed for discharge and drugs not directly associated with the reason for admission are excluded from contracts and are the patient s responsibility. In addition, if a patient chooses to stay in an executive suite, the patient will be required to pay the difference between the private room benefit and the executive suite charge. Psychiatric Treatment & Rehabilitation Day Programs Prior to your admission to a Psychiatric or Rehabilitation Day Program, please check with Navy Health as limits may apply. Private Hospital & Day Facilities Non-Contracted Services Prior to admission please check with your hospital as to whether or not your treatment or service is contracted. Contracted services relate to hospital fees such as accommodation and theatre. If you find that your impending hospital treatment or service is not contracted, we strongly recommend you contact our Member Services team to obtain benefit information prior to admission, as out-of-pocket expenses will apply. Product excesses may also apply. Benefits are not payable if treatment is for medical services not recognised by Medicare Australia. Exclusions Please be aware that sometimes service exclusions may apply for hospital services where Medicare does not pay a benefit. To be sure of coverage, please call Navy Health Member Services on prior to arranging admission. 29

3 Privacy + security Peace of mind Security Policy At Navy Health we take the issue of Member Privacy and Security very seriously. Under our Privacy Policy, we will NOT discuss any details about a membership except with the policy holder, unless they have given authority for us to do so. There are two types of Authority; Authority to Operate which gives the person permission to change details on the policy and act as the policy holder s proxy. They cannot, however, cancel the policy, only the policy holder can request this. Authority to Query which only allows the person to make enquiries about the policy. Navy Health undertakes security checks whenever you contact our Member Services team to ascertain that we are speaking to the policy holder. We also provide members with the opportunity to establish a password on their policy for added security. Privacy Policy Navy Health is committed to protecting your privacy. We are required by law to protect personal and confidential information such as information relating to your health and other personal details. We comply with all Federal and Victorian legislation details relating to confidentiality and privacy, including where relevant, the Privacy Act 1988 (Cth), and the Health Records Act 2001 (Vic). To view a copy of Navy Health s Privacy Policy visit the Navy Health website at navyhealth.com.au Read and Retain Please ensure that you always read and retain all information received from Navy Health, regarding your membership. Information Collection Statement Navy Health Ltd is a body corporate established under the Corporations Act You may contact Navy Health Ltd by writing to Navy Health Ltd, PO Box 172 Box Hill Vic. 3128, by ing or by calling You have the right to gain access to the information held by Navy Health Ltd about you but not any other person unless the other person has provided explicit permission for you to do so The information collected by Navy Health Ltd is only that necessary to provide you with a service or product, such as assessing or processing claims Navy Health Ltd may disclose any of this information to the following individuals or organisations: As required by law to a government organisation such as the Department of Health and Ageing, Medicare Australia (formerly the Health Insurance Commission) or Centrelink; To a hospital or provider in helping us administer a claim which has been made for services provided; Another organisation who helps us process transactions, access data or provide services, such as contractors who assist us in the provision of customer services; Membership details and benefits paid need to be confirmed to the membership holder. If you choose not to provide information to Navy Health Ltd we may not be able to provide you with your chosen service or benefit Navy Health Ltd policies for the management of personal information are set out in the publication entitled Navy Health Ltd Privacy Policy available from Navy Health Ltd. 34

4 Claiming Making claims By Post, & Fax A completed Navy Health claim form must accompany all claims submitted. You can receive payment by direct deposit into a nominated bank account (within Australia and excluding credit cards). Receipts forwarded for benefits will be held by Navy Health on your behalf. Receipts will not be returned to the member. Claim forms can be downloaded from the Navy Health website at navyhealth.com.au Electronic Claiming All you need is your Navy Health membership card to use the electronic claiming system. After a consultation your card can be swiped through the electronic claiming facility by the service provider. They will enter the claim details and process the transaction on your behalf. Once the transaction has been authorised by Navy Health electronically you simply pay the balance amount. (This is the difference between the fee charged for the treatment and the amount paid by Navy Health). Ask your provider if they are connected to an electronic claiming system. Online Claiming You can make claims for all extras services (excluding Orthodontic, Ambulance, MPAs & Pharmacy) through Online Member Services at navyhealth.com.au Natural Therapies and Recognised Providers Natural therapies include Acupuncture, Aromatherapy, Chinese Herbal Medicine, Homeopathy, Myotherapy, Naturopathy, Remedial Massage Therapy, Remedial Therapy and Western Herbal Medicine. Benefits are only payable for services rendered by a recognised provider in a private practice. Benefits are not payable on any prescribed medications, herbal or dietary preparations, or organised weight reduction programs. The provider registration process for Natural Therapy services, including the issuing of provider numbers, is managed by the Australian Regional Health Group (ARHG) on behalf of Navy Health Limited. Natural Therapy providers must be eligible members of an association that the ARHG recognises for benefit. Medically Prescribed Appliances (MPA) MPA claims must be accompanied by a referral from a registered practitioner. The following are examples of items that can be claimed under the MPA category: Nebulisers*, Humidifiers*, Blood Glucose Monitors*, Heart Rate/Blood Pressure Monitors*, Support Aids/ Mobility Aids, Compression Garments, Non-cosmetic Prosthesis (Premium Extras only), and TENS Machine/ Circulation Booster*. The MPA category also covers repairs to appliances that are covered under the category and up to the annual limit. * Any three (3) year period. The maximum three year replacement period applies to any three year rolling period from the first date of purchase. Department of Veterans Affairs Gold Card Holders Members who are, or become Department of Veterans Affairs (DVA) Gold Card holders have the option of retaining or cancelling their cover with Navy Health. Where a member chooses to retain their coverage, benefits will be paid on out-of-pocket costs incurred after the DVA payment, however the benefit must not exceed the total charge or the Navy Health benefits and annual limits. Where a member with a DVA Gold Card has Premium Hospital coverage, Navy Health will pay the supplement (top up) benefit for a private room in a private hospital, as DVA already cover the cost of a shared ward. Where a member chooses to cancel their coverage, they must advise Navy Health in writing of the issue date. The cover will be cancelled from the date Navy Health receives written notification. The person holding the DVA Gold Card may then re-apply for membership to Navy Health without waiting periods or penalties, as they are deemed to have continuity of cover. Any person who has previously held a DVA Gold Card is entitled to join Navy Health without serving any waiting periods. Proof of previous DVA Gold Card status is required. Definitions The term member in this booklet refers to a policy holder as defined in the Navy Health Ltd Rules. Feedback Policy If for any reason you are not satisfied the service you receive from Navy Health or feel that it has failed to meet your expectations, we would appreciate your feedback. We are committed to resolving your complaints in a fair and efficient manner and view your feedback as a vital opportunity to improve. Navy Health provides an accessible, impartial, free-of -charge complaints handling procedure for members. This procedure can be viewed at navyhealth.com.au or by telephoning

5 Direct Debit Service Agreement This agreement ( Direct Debit Service Agreement ) outlines the terms and conditions of the direct debit arrangements between the person signing the direct debit request ( you ) and Navy Health ( us ). You agree to be bound by these terms and conditions upon your execution of the Direct Debit Request. Direct Debit Arrangements (a) We will, in accordance with the terms of the direct debit request and any other existing agreement, periodically debit the nominated account for the agreed amount(s). (b) The debits will occur according to the frequency you have nominated i.e. fortnightly, monthly or as agreed. The amount debited will vary according to the amount falling due. (c) If any drawing falls due on a non-business day, it will be debited from the nominated account on the prior business day. Your rights (a) You can change your direct debit arrangements by calling us on or logon to member services at navyhealth.com.au at least five (5) business days prior to the next direct debit. Changes include altering arrangements, stopping an individual debit or cancelling a direct debit request completely. (b) We will give you at least 14 days notice by telephone or writing (including ) of any change to the terms of the direct debit arrangements, unless otherwise agreed. Your Obligations (a) You must ensure that: (i) before completing the direct debit request, you check the account details of your nominated account are accurate (check against a recent statement from your financial institution); (ii) your nominated account can accept direct debits (your financial institution can confirm this); (iii) your nominated account has sufficient clear funds on the drawing date to allow payment to be made in accordance with the direct debit request and any other existing agreement between you and us. (b) You must advise us immediately if your nominated account is not current. (c) If any drawing is returned or dishonoured by your financial institution, we may, at our discretion, reprocess the transaction following receipt of the notification of return or dishonour, or request an alternative form of payment from you. We may also charge any dishonour fees back to you. (c) If you believe we have drawn on your account incorrectly, please contact us on so the matter can be resolved. We will make every attempt to resolve the dispute within five (5) business days. 35

6 Some general information Code of Conduct Navy Health abides by the Private Health Insurance Association Code of Conduct. By subscribing to the Code, Navy Health ensures that members receive clear information and transparency in their dealings with Navy Health. The code ensures Navy Health will: Continue to improve standards of practice and service; Provide information to members in clear and plain language; Ensure the policy documentation is full and complete; Ensure that Navy Health staff are appropriately trained to provide clear explanations; Provide members with access to an internal dispute resolution procedure and advise members of their rights to take an issue to the Private Health Insurance Ombudsman (PHIO). A copy of the Code may be provided on request or can be viewed at navyhealth.com.au Private Health Insurance Ombudsman The Office of the Private Health Insurance Ombudsman (PHIO) has been set up by the Government to deal with complaints where the member has not been able to resolve an issue with their insurer. Whilst we actively encourage all members to discuss any such matters with our office in the first instance, the PHIO will gladly mediate if required. The PHIO can be contacted on or you can write to; The Private Health Insurance Ombudsman, Suite 2, Level George Street Sydney NSW 2000 Navy Health Rules and Constitution New memberships must be in accordance with the rules and constitution of Navy Health Ltd. Benefits are also paid in accordance with these rules. Members can view Navy Health s rules on receipt of a written request. All members are bound by the rules of Navy Health Ltd. Health + Care The Health + Care is supported by several service providers. Navy Health is not involved in the assessment of patients eligibility to uptake these programs. It is important to know that the early discharge and hospital substitute program is NOT available in all hospitals; referrals to the program are made by your doctor or hospital staff. We recommend you check with your hospital or contact your provider to discuss what services may be available to you. Call for more information about early hospital discharge or hospital substitute programs that may be suitable for your care. Navy Health is continually seeking new initiatives to improve your access to quality health services. For up to date information regarding our Health + Care Program, please visit navyhealth.com.au Broader Health Cover Health + Care is an example of Broader Health Cover recently introduced by the Australian Federal Government. This enables private health insurers to pay claims for health services that can be delivered just as effectively at home as they can in hospital. The changes allow for treatment to be provided either in conjunction with hospital care or as a substitute. It may even mean you avoid a hospital stay altogether. As the government relaxes rules around what may be covered by insurers, we will continue to develop more products and services to assist members in achieving and maintaining good health. Refer to navyhealth.com.au to find out more about Broader Health Cover and our Health + Care Program. 36

7 Benefit Year For General Treatment (Extras) the Navy Health benefit year is July 1 to June 30. For hospital products with an excess, the benefit period is a rolling calendar year (i.e. the excess on any of the Healthy Hospital products is payable once per person, in full, up to the family maximum, in any rolling 12 month period). When Does Membership Cease? A membership will cease on a date advised and paid to by the member or automatically when contribution payments are more than one month in arrears. Young Adults If a non student dependant takes up any extras cover within 30 days of being ineligible to continue under a parent s membership, Navy Health will allow the dependant to retain the hospital cover provided under the existing family membership until they attain 25 years of age, marry, or enter into a de facto relationship. Continuity of hospital cover, at an equivalent level of cover to that carried over from a parent s membership will be provided when the dependant seeks cover in their own right provided the parent s membership is still current and cover is activated within 30 days of being ineligible for inclusion under a parent s membership. A dependant can take up membership in their own right at any time after being ineligible to continue under their parent s cover however some waiting periods may apply unless membership is taken up within 30 days. The new membership will take effect from the day after they lose their eligibility on their parent s membership. Cooling Off Period Members can choose not to proceed with their Navy Health cover and request to have any premiums reimbursed. This reimbursement is on the provision that the member expresses their request in writing, within 30 days of their cover commencing and that no claims have been lodged or are pending during the 30 day cooling off period. Suspension of Membership Navy Health at its absolute discretion may allow, within a clearly defined limited set of circumstances, for a member to suspend their membership for an agreed period. Where the suspension has been approved in writing by the insurer, members will be advised of the conditions relating to waiting periods and pre-existing condition rules which may be applied upon reinstatement of membership. The agreed suspension period is not subject to change without written notification to and written confirmation from Navy Health. For more information please go to navyhealth.com.au Benefits When Do Benefits Cease? Benefits are not payable on any services rendered subsequent to a member s last financial paid to date, the date on which a membership is cancelled or when a membership is in suspension. When Are Benefits Not Payable? Benefits are not payable when: claims are over 2 years from the date of service; the provider is not recognised in a private practice or for Natural Therapies the provider is not recognised by the Australian Regional Health Group (ARHG) or HICAPS; the service forms any part of a payment from Workers Compensation, Third Party or any other liability provision. Navy Health reserves the right to seek full reimbursement on any benefits paid in these circumstances; the procedure does not have an assigned Commonwealth Medical Benefits Schedule item number; the claim is within a specified waiting or replacement period or annual/sub limits have been reached; Access Gap providers submit medical claims 2 years after the date of service, unless approved by Medicare Australia for benefits; services performed, or products from outside of Australia cosmetic surgery during a period of suspension or when membership is in arrears. Overseas Benefits Navy Health will not pay benefits on any services, treatments or products received outside of Australia. As a consequence we strongly advise all members consider Navy Health Travel Insurance when travelling overseas to cover emergency expenses when outside of Australia. (Refer to navyhealth.com.au for more details) 31

8 Information & conditions Coverage Waiting Periods Waiting periods for extras items are detailed in this brochure and need to be read carefully in conjunction with the conditions of the selected cover. Hospital benefits are payable after two months of membership on the selected level of cover, excluding pre-existing conditions. Maternity (or admissions related to the management of) and IVF procedures attract a 12 month waiting period at the selected level of cover. If you transfer to a higher level of cover new waiting periods will be applied, however benefits at the previous level will still be available whilst the new waiting periods are being served. Transfers between or from products containing a lesser level or predetermined excess will result in additional waiting periods being applied. Any excess applicable to a higher excess product from which a member is transferring will continue to be applied for a period of up to 12 months after transfer. Dependants are required to complete waiting periods of the same length as members. Pre-existing Conditions* The pre-existing condition waiting period provides protection for existing members against people joining or upgrading cover only when they require treatment. This assists Navy Health in keeping premiums as low as possible. Claims and benefits within the first 12 months of joining the insurer or increasing to a higher level of cover are subject to the pre-existing condition rule. A pre-existing condition is where signs or symptoms of an ailment, illness or condition, in the opinion of a medical practitioner appointed by Navy Health existed at any time during the 6 months preceding the day on which you joined the insurer or transferred to a higher benefit cover. This is irrespective of whether your medical practitioner, you and/or your dependants were aware of the condition or ailment. The pre-existing condition rule also applies when resuming a suspended membership and symptoms or signs developed during the suspension period. * Excludes Psychiatric, Rehabilitation & Palliative care. Transfer from other registered private health insurers There are no qualifying periods if you are accepted for membership after transferring a current membership from another Australian Registered Private Health Insurer and had an equivalent level of cover, and completed all waiting periods. Normal waiting periods will apply to those aspects of Navy Health cover not covered previously by your previous insurer, and for those items specifically nominated within the products as requiring extended waiting periods. Navy Health will not pay immediate benefits at a higher level than those provided by the previous insurer. Navy Health annual limits will be reduced by the amount of benefit already paid by the previous insurer for similar services in the current benefit year of transfer. The Clearance Certificate Application (FORM D) may assist you with your transfer to Navy Health. Online Member Services Navy Health members can use the Navy Health Website at navyhealth.com.au to view details of their membership, claims history, update contact details, change coverage, etc. Preferred Optical Providers If a member uses one of Navy Health s Preferred Optical Providers, they can receive an additional benefit (subject to the annual maximum). To view the list of Preferred Optical Providers go to navyhealth.com.au. The Preferred Optical Provider list is subject to change without notice. Prosthetic Appliances Prosthesis appliances or devices surgically implanted during a hospital stay are subject to two benefit types, either no gap or gap permitted. These items are listed on the Commonwealth Prosthesis Schedule. When a gap permitted benefit applies the insurer will pay the recommended minimum benefit as shown on the Schedule. The Schedule will have at least one no gap prosthesis or device item for every in hospital procedure on the Medical Benefit Schedule (MBS) for which the insurer provides cover. No benefit is payable where the hospital charges for a prosthetic appliance or device not listed on the Schedule. Podiatry surgery Limited benefits are available when Podiatric Surgery is performed in a contracted hospital by an Australian Government Accredited Podiatrist. For further information, please call Navy Health Member Services on

9 Information & conditions Points to know Membership Single Membership Cover is for the member only and therefore would need to be adjusted to the family rate if dependants or a partner were to be added. A single membership should be adjusted to the family rate at least two months prior to the expected date of birth of a child if cover for the child is required at birth. Family Membership Cover is for the member with a spouse/partner plus; any unmarried children until they attain the age of 22 years or enter into defacto relationship any unmarried children between the age of 22 and 25 years who are full time students attending an education facility within Australia. A dependant who is no longer eligible for cover under a parent s membership is able to take out membership in their own right. If the new cover is started within thirty (30) days at an equivalent level, no additional waiting periods will apply. For more information please call or go to navyhealth.com.au Single Parent Family or Military Family with one serving adult Cover is for one adult and dependants. For a military family with one serving adult, the serving person is the membership owner but cannot make a claim on the membership. Dependants Only or Military Family with two serving adults Cover is for children only. The members (adults) are not entitled to claim benefits on a Dependant only cover. When Does Membership Commence? Membership will only be accepted from the date when the first contribution is received, or on the date on which the application form is received by Navy Health, whichever is the latest. Backdating of membership is not permitted. How Can I Change my Membership? Any changes to the status of membership (i.e. level of cover, adding or deleting dependants) cannot be undertaken without Navy Health receiving written notification of the change. Likewise, the change cannot be taken as being actioned without the member receiving written acknowledgement from Navy Health. The application forms supplied by Navy Health can be used for that purpose or the member can use the Navy Health website. The effective date of any change will be the date notification is received by Navy Health. The easiest method of changing details is via Online Member Services at navyhealth.com.au Here you can change/verify your details without needing to contact Navy Health directly. Cover Changes Upward (increased entitlement) changes in the level of cover will result in the member and any persons covered undergoing new waiting periods. Whilst these waiting periods are in force, benefits will still be payable as they would normally have been under the previous level of cover. Higher benefits are not payable for ailments or conditions in evidence at the time of transfer (regardless of whether or not they have been diagnosed) until a waiting period of 12 months has been served. Higher level Maternity (and the management of) and IVF procedures benefits will not be payable for a period of 12 months after transfer. For transfers within the extras products, the waiting periods for higher benefits are those listed for new members. At all times the benefits paid under a previous level of cover are considered when determining residual benefit entitlements. When are Contributions Payable? Payment of contributions are always in advance. Direct debit payments can be made on a fortnightly, monthly, six monthly or yearly basis. A 2% discount has been applied for members choosing to pay half yearly and a 4% discount has been calculated for those members choosing to pay annually. 30

10 Government initiatives Lifetime Health Cover Lifetime Health Cover (LHC) is applicable to hospital cover only. From July 1, 2000 any person joining a private health insurer will be subject to the Government s LHC legislation. Briefly, this implies that people joining on or after July 1, 2000 who are 31 years of age or over will pay a premium based on their age at the date they joined the insurer. Hospital base premium costs will increase by 2% for each year of age the person delays joining the health insurer after turning 30 years of age. The premiums reflected throughout this product brochure are our base premium rates and do not include the LHC surcharges. To calculate your LHC loading, determine your age as at 1st July and then multiply by the allocated percentage by the hospital premium you have chosen. Then add this amount to the premium. This is the total premium you will pay if you take out hospital cover after the LHC standard birthday age of 31. If you are considering hospital cover for more than one adult, determine each adult s age and respective LHC loading and then take the average of these loadings. Multiply the average by the hospital premium that you have chosen and then add this calculation to the base premium. To cover small gaps, such as switching from one insurer to another, you are able to be without private hospital cover for periods totalling 1094 days (ie three years less one day) during your lifetime, without affecting your loading. If you have a gap of 1095 days you will pay a 2% loading. For every 365 days without cover after that, your loading will increase by 2%. If you apply to your health insurer to suspend your cover for a short period, and it agrees, this period of suspension does not affect your LHC loading (you are considered to be maintaining your cover). 38 Once you have paid a LHC loading on your private hospital insurance for 10 continuous years, the loading is removed as long as you retain your hospital cover. If you drop your hospital cover again for more than the allowable days, you will be liable to pay the LHC loading again. Lifetime Health Cover on Discharge Health care costs of serving members are met by the Commonwealth until the date of discharge. This is regarded as the equivalent of private health insurance and as such, no Lifetime Health Cover penalty applies to members of the ADF when they separate, providing they take out hospital cover immediately following discharge. ADF Personnel & DVA Gold Card Holders If you are a member of the Australian Defence Forces (ADF) your medical services are provided by the ADF, so you are considered to have hospital cover. If you discharge from the ADF after the 1st of July following your 31st birthday, you have 24 months to join a health insurer and still pay the base rate premium. If you discharge from the ADF before the 1st of July following your 31st birthday, then the normal rules apply. If you hold a Department of Veterans Affairs (DVA) Gold Card you are considered to have hospital cover. If you have held a Gold Card at any time since 1 July 2000, and the card was subsequently withdrawn by the DVA, you may claim the period you held the card as a period with private health insurance. Federal Government Rebate The Federal Government is committed to making private health insurance affordable and as such offers a Private Health Insurance Rebate to eligible private health insurer members. The rebate can be redeemed in three ways: As a reduced premium payable to Navy Health; As a rebate on an annual income tax return; As a cash payment from a Medicare Office. Members must formally register with Navy Health for the reduced premiums to apply. To register you will need to complete the application form in the Application section of this brochure. Please be aware that the Federal Government has proposed changes to the Rebate. As such, we encourage you to visit navyhealth.com.au for the latest information, news and updates. Medicare Levy Surcharge The Medicare Levy Surcharge (MLS) aims to encourage higher income earners to take out private hospital cover and, where possible, to use the private health system to reduce demand on the public system. Most Australian taxpayers already have a Medicare Levy of 1.5% of their income included in the amount of tax they pay. The MLS is an additional surcharge imposed on higher income earners who do not have an appropriate level of hospital cover. You do not have to pay the surcharge if your taxable income is below the income threshold, or you have taken out hospital cover with a frontend deductible or excess of up to $500 for singles or up to $1,000 for families/couples. There are many changes being proposed for the MLS and as such, we encourage you to visit navyhealth.com.au for the latest information, news and updates. General treatment (extras) cover and ambulance cover do not exempt you from the MLS. For more information regarding the MLS please go to navyhealth.com. au or the Australian Taxation Office website at

11 Federal Government Rebate & Medicare Levy Surcharge The government proposed to change the Rebate on Private Health Insurance and Medicare Levy Surcharge in early At the time of printing the changes were still to be passed however the table below highlights how the rebate and surcharge will be means tested, if passed, from the 1 July, Tier 0 No change to rebate or MLS Tier 1 Tier 2 Tier 3 Income for MLS Purposes Single Less than $84,000 Couple/Family Less than $168,000 Single $84,001 - $97,000 Couple/Family $168,001 - $194,000 Single $97,001 - $130,000 Couple/Family $194,001 - $260,000 Single More than $130,000 Couple/Family More than $260,000 Federal Government Rebate <Age 65 Age Age 70+ (Age of the oldest person on membership) Medicare Levy Surcharge (MLS) 30% 35% 40% 0.0% 20% 25% 30% 1.0% 10% 15% 20% 1.25% 0% 0% 0% 1.5% For more information and applicable examples of LHC, please go to 39

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