Medibank Overseas Student Health Cover. Medibank Overseas Student Health Cover

Transcription

1 Medibank Overseas Student Health Cover Medibank Overseas Student Health Cover

2 Studying in a foreign country is an exciting experience Keeping healthy will help you get the most out of your studies and ensure you enjoy your time in Australia. While having adequate arrangements for private health insurance is a mandatory condition of most student visas, private health insurance also gives you greater control over when and where you can receive hospital and medical treatment while in Australia. Medibank is one of Australia s largest private health insurers and Medibank Overseas Student Health Cover is a leading choice for international students studying in Australia. We re here to help you access the right advice and support you may need in relation to your health cover needs. Our experienced staff are here to help you look after your health and wellbeing from the day you arrive. Do I need OSHC? It is a condition of most student visas to have private health cover for the duration of your visa. See page 19 for more information. 2

3 Welcome to Medibank How does the Australian health care system work? 5 Medibank health cover that gives you more 6 Mi Health better health support for our members 8 Cover for hospital treatment 10 Cover for medical treatment 12 Prescription medicines 13 Manage your membership online 14 Added benefits 14 Looking after your everyday health with optional extras 15 How to claim 16 Out-of-pocket expenses 17 Reducing your out-of-pocket expenses 17 Things worth knowing 18 Other important information 25 Glossary 26 Membership of Medibank Private, including entitlement to and payment of benefits, is subject to our OSHC Membership guide. Premium rates, benefits and the OSHC Membership guide are subject to change from time to time. If you anticipate treatment for which you are expecting a benefit from Medibank, please contact us before commencing treatment to confirm that the benefit you expect will be paid. Ensure you read this brochure thoroughly and retain a copy for future reference. As requested by Department of Health and Ageing under the OSHC Deed, Medibank will be required to provide the name and contact details of any OSHC member (new or existing) to the Department of Immigration and Citizenship (DIAC) where any refund of the student s OSHC premium is made by Medibank or the student has chosen to cancel their OSHC policy. Personal information is handled in accordance with our Privacy policy, which is available at medibank.com.au and our Medibank stores. 3

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5 How does the Australian health care system work? The Australian health care system is divided into a public and a private system. The public system Australia has a national public health system called Medicare. It provides eligible Australian residents with access to free treatment as public patients in public hospitals and free or subsidised treatment by doctors and other health professionals. Australian residents contribute to the health care system through their taxes. Medicare is not generally available to overseas visitors, including international students. The private system Many Australian residents: choose to receive treatment in private hospitals want to choose the doctor who treats them in hospital want more options when they go to a private hospital want cover for services of other health professionals like dentists and physiotherapists. Generally, many Australian residents take out private health insurance to help cover these costs, which are usually not covered by Medicare. It s easy to join just call or (if calling from outside Australia), visit medibank.com.au/oshc or drop into a Medibank store. 5

6 Medibank health cover that gives you more Mi Health a new level of health support You ll get even more value from your OSHC with access to Mi Health. It s a range of health support services including access to our Medibank nurses that are available to discuss any health question big or small. Mobile health apps to manage your health on the go, Health Hub our online health resource and Hospital Support, providing a Medibank representative to answer your questions whilst in hospital. For more information about our Mi Health services see pages 8 and 9. Manage your membership online Online Member Services puts you in control of your membership 24 hours a day, 7 days a week. Register for Online Member Services at medibank.com.au/studentregistration It takes less than a minute to sign up. For more about using Online Members Services, see page 14. Value at Members Choice hospitals Our Members Choice hospital network is one of the largest in Australia, covering most private hospitals. Visit a Members Choice hospital and you will get better value for money compared to a non Members Choice hospital, as long as the service you receive is covered by our agreement with the hospital and is included under your cover. For more information about our Members Choice network see page 17. feelbetter rewards At Medibank, we ll take care of you even when you re in perfect health. With our feelbetter rewards program you have access to a variety of offers which have been tailored towards health and wellbeing, leisure and lifestyle, entertainment and everyday living. Special offers include discounts on: movie tickets magazine subscriptions hotel accommodation and car hire. 6

7 For any health question big or small call a Medibank nurse 24 hours a day, 7 days a week. Call 1800 Mi Health ( )

8 Mi Health better health support for our members Mi Health is our new range of health support services, to help you manage your health and lifestyle while in Australia. With Mi Health you will have access to many support tools - Medibank Nurse 24/7 advice, mobile health apps, online health hub and hospital support representatives. Medibank Nurse 24/7 Have you ever been so worried about your health that it s distracted you from your studies? Or have you ever needed medical advice late at night or on a weekend, when medical centres are closed? For any health question, big or small; call a Medibank nurse. As a Medibank OSHC member, a reassuring voice is only a phone call away. You can call a Medibank nurse for help 24 hours a day and seven days a week, with any health questions you or your family might have, including: If you are feeling unwell and not sure what to do Advice on if you should see a doctor If you need to see a doctor quickly, our nurses can help you make an appointment with your local medical centre or regular doctor (GP) Help finding medical centres, pharmacies, hospitals and more Translation services are available, so our nurse s advice is clear and easy to understand. Our Medibank nurses are here to help you 24 hours a day, seven days a week. With one phone call you can get trusted advice from a registered nurse for any health question. Like to know more? For more information about Mi Health, call or visit medibank.com.au 8

9 Online Health Hub Our online Health Hub gives you access to information from doctors to help you keep healthy. Tools to help assess your current health age verses your real age Programs to help you plan a healthy lifestyle with meal and fitness plans and tips on how to manage stress Videos on health conditions and medical procedures Information including articles, healthy recipes, exercise ideas, plus much more. All OSHC members can access the Online Health Hub, simply by logging onto our Online Member Services at medibank.com.au Mobile Health Apps With our Mobile Health Apps you can find health answers quickly, anytime. Symptom Checker* Check your symptoms, find out what you can do about them and when you should seek treatment from a professional. *Only available on iphone. iphone is a trademark of Apple Inc. Energy Balancer Helps you balance the food you re eating with exercise or everyday activities like walking or driving! If you weigh around 60 kgs, one banana = 15 minutes of walking or 5 minutes of running Or if you weigh around 75 kgs a meat pie = 57 minutes of social tennis or 101 minutes of gardening. Hospital Support We have Hospital Liaison Representatives available at selected Members Choice hospitals who can help you with any questions you may have during an overnight stay, including: What you are covered for under your OSHC When and how to claim What out-of-pocket expenses you may need to pay What you are entitled to as a private patient. So you can rest-up and rest-assured that you re getting the most out of your cover. The Mi Health services are provided by Medibank Private Limited and its related companies. If you use these services, these companies may share your personal (including sensitive) information and collect, use and disclose that information in accordance with Medibank Private s new Privacy Policy effective as of 26 September Please read the new Privacy Policy at or obtain a copy by visiting a Medibank store or telephoning

10 Cover for hospital treatment Medibank OSHC helps with the cost of being treated in a private hospital or in a public hospital as a private patient. It also allows you to choose your own doctor as well as which hospital you would prefer to attend. What benefits are paid? For the services included under OSHC we ll pay benefits towards: Private hospital accommodation overnight admission in a shared or private room same day admissions intensive care theatre fees Public hospital accommodation as a private patient overnight admission (shared room only) same day admissions (shared room only) outpatient accident and emergency department fees, including outpatient medical and post-operative services (fees raised by the hospital for treatment where you are not an admitted patient) Surgically implanted prostheses and other items on the Australian Government s Prostheses Schedule. Eligible ambulance services where immediate professional attention is required. Please note that any charge above your benefit will form part of your out-of-pocket expenses. See page 17 for more information. Are you covered for ambulance services? Ambulance services are included under your Medibank OSHC. Unless you are already covered (e.g. under a state scheme), we ll cover the cost of eligible ambulance services if you need immediate professional attention and your medical condition is such that you couldn t be transported any other way. See page 23 for full details. 10

11 What s covered? Service Ambulance services (see page 23 for more info) Appendicitis treatment Removal of tonsils and adenoids Shoulder and knee reconstruction surgery and investigations Psychiatric treatment Rehabilitation treatment Surgical removal of wisdom teeth (for hospital charges only) Obstetrics and pregnancy-related services Fertility treatment e.g. IVF and GIFT programs Cosmetic surgery/procedures All other in-hospital services recognised for Medicare benefit purposes Key: c Services we pay benefits towards b Services we don t pay benefits towards OSHC c c c c c c c c b b c Waiting periods apply including: 12 months for obstetrics and pregnancy-related services 12 months for pre-existing conditions (excluding psychiatric treatment). Note: cosmetic surgery/procedures are excluded on all Medibank covers. For more information on waiting periods, please refer to Things worth knowing on pages

12 Cover for medical treatment Medibank OSHC helps cover the cost of doctors services. These services can be provided either in hospital or out of hospital. Out of hospital services include visits to your local doctor or medical centre. For advice on where to seek medical treatment call and speak to one of our registered Medibank nurses 24 hours a day, 7 days a week on 1800 Mi Health ( ). What benefits are paid? The Medicare Benefits Schedule (MBS) lists a standard fee for most surgical and medical procedures (MBS fee). The amount of benefit you can expect to receive from us is calculated as a percentage of the MBS fee. However, you ll have to pay any additional cost if the doctor charges you more than the benefits we pay you. The benefits you receive for medical services under Medibank OSHC are: Out of hospital Service Benefit Medical services received out-of-hospital (e.g.: doctor s visits, pathology, medical services at a public hospital emergency department where you re not admitted) General practitioners Specialists (including pathology & x-rays) 100% of the MBS fee The published 85% MBS fee^ In hospital Service Benefit Medical services received when admitted to hospital Doctors & specialists (including pathology & x-rays) 100% of the MBS fee ^ The published 85% MBS fee may not equal exactly 85% of the total MBS fee but an amount published in the MBS as set by the Australian Government. For any health question big or small call a Medibank nurse 24 hours a day, 7 days a week. Call 1800 Mi Health ( ) 12

13 Prescription medicines Your Medibank OSHC helps cover the cost of prescription medicines, with the exception of oral contraceptives and medicines prescribed for cosmetic purposes. Maximum annual limits apply as per the table below: Level of cover Limit per item Annual limit (per calendar year) Singles $50 $300 Families $50 $600 (sub-limit of $300 per person) You will have to pay part of the cost of each prescription only item before any benefits are paid (this is known as a co-payment). You will also have to pay for any charges above the benefit that we pay. Please refer to your OSHC Membership guide which lists in more detail what is covered and not covered under your policy. Important information You may incur significant out-of-pocket expenses if high cost prescription medicines are required for your treatment when in hospital. This is because Medibank OSHC pays limited benefits for prescription medicines and most international students studying in Australia are not eligible for subsidised pharmaceuticals under the Australian Government s Pharmaceutical Benefits Scheme (PBS). Prescription medicines used for oncology (cancer) and other treatments can be very expensive for people who do not have access to subsidised pharmaceuticals. For more information on the PBS visit health.gov.au 13

14 Manage your membership online Added benefits Online Member Services (OMS) is an easy, secure way to manage your membership at your convenience. You can manage most aspects of your membership when it suits you, online at home or on the go, 24 hours a day 7 days a week. Online Member Services is available to: view your membership details download forms or product brochures update your contact details send a secure to Medibank order a replacement membership card renew your membership register your bank account details for payment of claims (via EFT) submit a doctor s claim (GP claims only) find a provider. Online Member Services also provides access to Health Hub our online health resource with tools, programs, videos and information to help you plan a healthy lifestyle. As a Medibank member you get access to lots of discounts and tips to help you stay fit and healthy. It s our way of adding value to your health cover and making your time in Australia more enjoyable. feelbetter rewards program Our feelbetter rewards magazine is packed with heaps of discounts on health, fitness, travel, nutrition, leisure & lifestyle products. Special offers include: discounted movie and theme park tickets discounts on health and fitness club memberships discounts on magazine subscriptions great deals on outdoor and entertainment products great deals on travel products Our feelbetter rewards are always being updated. To find out more about the feelbetter rewards program, and check out the latest offers, visit the Member Services section at medibank.com.au It s easy to register Simply visit medibank.com.au/studentregistration and follow the prompts. 14

15 Looking after your everyday health with optional extras Medibank extras helps to cover the cost of everyday health services that are not included in your OSHC, such as dental care if you get a toothache, physiotherapy for sporting or other muscular injuries and optical items such as prescription glasses or contact lenses. We ve negotiated capped charges or discounts with the following healthcare professionals so you can claim a percentage back* depending on your level of cover. Dental Physio Chiro Naturopathy Acupuncture Remedial massage Podiatry Plus at all optical retailers, you can claim up to 100% back** on a range of glasses or contact lenses regardless of your level of extras cover. * Where eligible and subject to your annual limits and waiting periods. ** For eligible services up to your annual limit. Waiting periods apply. Extras cover is not included in your OSHC, but is available for an additional cost. For more information call , visit medibank.com.au or ask in a Medibank store. What s in it for me? If you re interested in cover for dental, acupuncture or remedial massage ask us about our extras cover. Our friendly staff will help you find the right extras cover to fit your needs. 15

16 How to claim There are a number of ways you can claim with Medibank. Online You can submit a doctor s claim online (GP claims only) through our Online Member Services at medibank.com.au If a benefit is payable we ll process your claim and, depending on your preference, we ll either send out a cheque or transfer the money into your nominated membership bank account. Note: Extras is not part of your OSHC cover, but if you have purchased an extras cover separately, you can also claim for most extras online. By mail Complete and sign your claim form and send it to us with your service provider s account attached, and the receipt (if the account has been paid). In person at a Medibank store Complete and sign a claim form and drop it off at a Medibank store with your service provider s account attached and a receipt (if the account has been paid). On campus Medibank has special arrangements with some on-campus medical practices that provide a direct claiming system. Please ask your educational institution for more details or visit medibank.com.au/oshc and select Find a provider. Paid Accounts Where you have paid your accounts, we will pay any benefit that you are entitled to, either by sending you a cheque or transferring the money into the nominated membership bank account. Cheques for paid accounts will be sent to the contributor and a statement will be sent to the claimant where the claimant is aged 16 or over. Unpaid Accounts Where you haven t paid your accounts, we ll pay the benefit directly to the service provider. You will receive a statement from us detailing the payment made to the provider on your behalf and any associated out-of-pocket costs you will need to pay. Medibank retains all account and receipt documentation. Benefit payments are accompanied by a statement that contains all information relevant to each service claimed. Medibank will not pay benefits on claims that are submitted more than two (2) years after the date of service. You can get a claim form online at medibank.com.au or by calling Before you lodge a claim it is a good idea to take a photocopy of the form and any bills or receipts you provide to Medibank. 16

17 Out-of-pocket expenses Reducing your out-of-pocket expenses Some costs from a visit to hospital or a doctor are not covered under your Medibank OSHC. These are known as out-of-pocket expenses, that is, expenses you will have to pay for out of your own pocket. Having Medibank OSHC helps reduce your hospital and medical out-of-pocket expenses, but you may still have to pay for some things. Where possible we suggest you call us before you go to hospital so we can help you estimate what your out-of-pocket expenses are likely to be. To find your nearest Members Choice provider or direct billing medical centre visit medibank.com.au/oshc and select Find a provider. Great benefits with our Members Choice network Generally, when you visit any hospital, there will be additional costs that you will not be covered for (out-of-pocket expenses). However if you visit one of our Members Choice private hospitals you can reduce your out-of-pocket expenses. Our Members Choice hospital network is one of the largest in Australia, covering most private hospitals. Plus, at most Members Choice hospitals you can expect to be covered for things that you wouldn t generally be covered for at a non Members Choice hospital like in-hospital physiotherapy to aid your recovery, local phone calls, TV and newspapers. OSHC direct billing medical centres Medibank has developed a national direct billing service with some medical centres which allows them to bill Medibank directly for your doctor s consultation. Using a direct billing medical centre may minimise the amount you will have to pay upfront. 17

18 Things worth knowing Understanding private health insurance can be complicated. This section is designed to help make things a little easier for you. It contains some important information about Medibank OSHC along with explanations of commonly used terms you may not be familiar with. It also gives you an overview of some of our key terms and conditions. It s important you have a good look through the OSHC Membership guide which is available at medibank.com.au/oshc. You ll also receive a copy of this once you join. This Membership guide forms part of the terms and conditions of your OSHC with Medibank. All members of OSHC are subject to the terms and conditions and policies contained in this guide, as varied from time to time. It s also important to read the Cover Summary where you ll receive further details about your cover and entitlements. Looking after your health in Australia 18

19 Do I need OSHC? It is a condition of most student visas to have private health cover for the duration of that visa. Medibank OSHC is designed for people who are the holder of a student visa or: (a) is an applicant for a Student Visa; and (b) is the holder of a Bridging Visa; and (c) was, immediately before being granted the Bridging Visa, the holder of a Student Visa. If at any stage your student visa status changes, OSHC will no longer be suitable for your needs. To discuss our broader range of health insurance products, please visit a Medibank store or call If you are found to be ineligible for OSHC, Medibank may take steps including terminating your membership or transferring you to an alternative cover. Medibank may backdate this change and require you to pay any additional premiums and/or repay any higher benefits you received on your OSHC. Expatriate Australian students If you are an expatriate Australian coming to Australia on a student visa to undertake formal studies, and you are not eligible for Medicare, you are required to take out OSHC for the full length of your student visa. Norwegian and Swedish students Most Norwegian and Swedish students studying in Australia are covered by health insurance arrangements provided by their Government, and are not eligible to join OSHC. However, a Norwegian or Swedish student must take out OSHC if they are not eligible for cover under their own Government s insurance arrangements. Belgian students Belgian students studying in Australia are not required to take out OSHC under the terms of the Reciprocal Health Care Agreement that exists between our two Governments. However, OSHC might still be beneficial for these students as it offers a more comprehensive level of cover. How do I switch from another Australian OSHC insurer? You can transfer your OSHC to Medibank from any other Australian OSHC insurer. Your period of membership with the other insurer will count towards the waiting period you may need to serve with Medibank OSHC. However, if your cover with the other insurer has lapsed or expired, other conditions do apply. Please see the OSHC Membership guide available at medibank.com.au/oshc, a Medibank store or call for more information. 19

20 Are obstetrics and pregnancyrelated services included? Yes, Medibank OSHC pays benefits towards obstetrics and pregnancy-related services for you or your spouse/partner. There is a 12 month waiting period for obstetrics and pregnancy-related services. Benefits are not generally payable for any items or services obtained while you are serving a waiting period. To find out more about obstetrics and pregnancy-related services call If you have a baby don t forget to add them to your membership within 2 months from the date of their birth. Does OSHC cover just me or my family as well? Medibank OSHC offers two types of membership: Single membership covers you (the student) only Family membership covers you (the student) and your dependants (such as your spouse/partner and any dependent children). Refer to page 26 to understand what we mean by a dependant. Adding your spouse and children If you are on a single membership and your spouse and/or children are coming to join you in Australia, they can be added to your cover provided they have been authorised to enter Australia and reside with you (the student) for the duration of their stay. You will need to pay an additional premium to change your membership from a single to a family cover. You can do this at any Medibank store or at a participating educational institution. When your family arrives, Medibank or your educational institution will need to see their passports and visas so that the period of cover can be confirmed. A new membership card listing all members covered will be posted to you at your Australian residential address registered with Medibank. 20

21 Adding a newborn to your cover A new-born baby may be added to an existing single membership with effect from his or her date of birth and without having to serve an additional waiting period provided that: the application is received by Medibank within two (2) months of their date of birth, and the membership is changed to a family membership, and the family premium is paid, from their date of birth. To find out more visit medibank.com.au, call us on or visit a Medibank store. Please note, your parents or guardians cannot be covered under your OSHC. If they are living with you while you are studying, they will need to buy their own health insurance. Medibank offers a range of covers designed for visitors to Australia. Waiting periods What waiting periods apply to OSHC? A waiting period is a period of time you need to wait after taking out your cover before you re entitled to receive benefits for services or items covered. These waiting periods include: 12 months for obstetrics and pregnancy-related services 12 months for pre-existing conditions (excluding psychiatric treatment) A pre-existing condition is an ailment, illness, or condition where signs or symptoms existed at any time during the six months before your cover commenced. Benefits are not generally payable for any services or items obtained while you are serving a waiting period. The waiting period does not apply when your treating medical practitioner certifies and Medibank agrees that the member required emergency treatment. 21

22 What is not covered? Public and private hospitals In a public or private hospital you are not covered for: fertility treatment e.g. IVF and GIFT programs cosmetic surgery/procedures any part of the accommodation charge raised by a public hospital that exceeds the benefit for a shared room, if you are accommodated in a single room at your request any services or items in a Members Choice hospital that are not covered by our agreement with the hospital the difference between the charges raised by a non Members Choice hospital and the benefit payable by Medibank any items provided to you on discharge from a hospital any ancillary services provided to you in hospital that are not related to the reason for your hospital stay out-patient charges raised by private hospitals surgically implanted prostheses and other items not included in the Australian Government s Prostheses Schedule the gap for surgically implanted prostheses and other items on the Australian Government Prostheses Schedule. the cost of newspapers, TV hire and telephone calls, except as covered in some Members Choice hospitals. Medical services treatment not considered medically necessary (e.g. health screening services and cosmetic surgery) any difference between your doctor s charge and the benefit payable by Medibank any medical examinations, x-ray or pathology required by the Department of Immigration and Citizenship (DIAC) as part of the student visa renewal process. Prescription medicines your prescription medicine co-payment for each prescription medicine costs in excess of the benefit payable for each prescription medicine costs in excess of the maximum annual benefit payable for prescription medicines medicines other than prescription medicines medicines prescribed for cosmetic purposes oral contraceptives. 22

23 Ambulance services What is covered? Where you need immediate professional attention and your medical condition is such that you couldn t be transported any other way, you are covered for services provided by an ambulance provider approved by Medibank, in the following circumstances: ambulance transportation to a hospital to receive immediate professional attention when an ambulance is called to provide immediate professional attention but transport by ambulance is not needed when, as an admitted patient, the hospital requires you to be transferred from one hospital to another (excluding transfers between public hospital facilities) transport by air ambulance, where pre-approval has been obtained from Medibank by the air ambulance provider. What is not covered? We don t pay benefits for any ambulance service that has not been defined under What is covered. This includes the following circumstances: ambulance services where immediate professional attention is not required (e.g. general patient transportation) any ambulance transport required after discharge from hospital inter-hospital transfers when you re transferred from one public hospital to another public hospital as an admitted patient any ambulance costs that are fully covered by a third party arrangement, such as an ambulance subscription or a federal/state/territory ambulance transportation scheme, WorkCover or the Transport Accident Commission any air ambulance services that are fully subsidised, such as South Care or NRMA Care Flight. For more information on ambulance services call us on It s important to call us on for information on recognised providers and the benefits you re entitled to before getting treatment. 23

24 Will my OSHC automatically renew? Your OSHC will not automatically renew. It is your responsibility to keep your OSHC current for the entire length of your student visa and a condition of most student visas (limited exceptions apply please see page 19 for details). If you purchased your Medibank OSHC prior to 1 July 2010 you may need to renew your OSHC once it expires. If your student visa expiry date changes, you will need to ensure your OSHC will cover you for the duration of your student visa. How do I renew my OSHC? Renew online at medibank.com.au/oshc Call our dedicated renewals phone line on Have your membership number and credit card (Visa or MasterCard) ready when you call Visit a Medibank store. Make sure to also take your Electronic Confirmation of Enrolment (ecoe) or passport showing your current visa is still valid. If your visa is not valid and you re in the process of applying for a new one, you must contact your education institution to obtain your ecoe before you can renew your OSHC. You may also be able to renew your Medibank OSHC through your education institution. Please speak to your institution s international student advisor to find out more. Can I still be covered after I finish my studies? If you are staying in Australia on another visa after your student visa expires, you are no longer eligible for OSHC. However, Medibank has a range of health covers which will help keep you protected should any unforeseen medical circumstances arise. If you take out another Medibank hospital cover within two months of your OSHC expiring, you will not have to serve any waiting periods for those benefits to which you were entitled to under your OSHC. Call Medibank on or visit your nearest Medibank store, to discuss the best health cover options to suit your needs. How do I join or renew my OSHC? Online at medibank.com.au/oshc Call (renewals only) Visit a Medibank store Through your educational institution We re always here to help We are always here to help call us on , ask_us@medibank.com.au or drop into a Medibank store 24

25 Other important information What if I have a complaint? We ll try to resolve any complaint you may have the first time you raise it with us please contact us with any issues through the contact points on the back of this brochure. If you believe your complaint has not been satisfactorily dealt with, let us know and we ll escalate your complaint. You can also write to our Customer Resolutions team at Medibank, GPO Box 9999, Melbourne, VIC Free independent advice is also available from the Private Health Insurance Ombudsman on Private Patients Hospital Charter The Private Patients Hospital Charter is a guide to what it means to be treated as a private patient in hospital. It sets out what you can expect from your doctors, the hospital and your private health insurer. To download a factsheet please visit health.gov.au Private Health Insurance Code of Conduct We re proud to be a signatory to the Private Health Insurance Code of Conduct. The code was developed by the private health insurance industry and aims to promote the standards of service to be applied throughout the industry. The code is designed to help you by ensuring that: information which we provide to you is written in plain language our employees are competently trained to deal with your enquiries we protect the privacy of your information in line with the privacy legislation you have access to a reliable and free system of addressing complaints with us. A copy of the code is available online at privatehealth.com.au/codeofconduct Disclaimer Medibank encourages providers to offer high quality products and services at competitive prices to its members. Where Medibank recognises a provider, advertises on behalf of a provider, or appears by reference or logo or otherwise in an advertisement of any provider, to the fullest extent allowed by the law, such advertising or reference should not be construed as: an endorsement by Medibank; an acknowledgment or representation by Medibank as to fitness for purpose; or a recommendation or warranty by Medibank; of, for, or in relation to, the product and/or service of the provider. Accordingly, to the fullest extent allowed by law, Medibank neither takes nor assumes any responsibility for the product and/or service provided. Members should make and rely on their own enquiries and seek any assurance or warranties directly from the provider of the service or product. Note Policies of insurance issued under, or on the terms of, any products described in this publication are referable to the Medibank Private Limited (ABN ) health benefits fund. 25

26 Glossary If you are unsure of some of the words and phrases we have used in this brochure, here is a brief explanation. Benefit A benefit is an amount of money payable by Medibank to, or on behalf of, a member for an expense approved by Medibank. Contributor A student in whose name an application for membership of Medibank s OSHC has been accepted. This is usually the first-named person on the membership card. Unless approved by Medibank, a person aged under 16 is not eligible to be a contributor. Cosmetic surgery A service that is not clinically necessary that can t be billed to Medicare. Under all Medibank covers, no benefits are payable towards procedures or hospital costs associated with cosmetic surgery or procedures not recognised by Medicare. Dependant A person who is: a spouse or de facto partner of an Overseas Student or a child or a step-child of an Overseas Student who is not married (or in a de-facto relationship) and has not turned 18. Department of Immigration and Citizenship (DIAC) The Australian Government department responsible for, among other things, immigration and entry, stay and departure arrangements for non-citizens. Doctor A registered medical practitioner including a general practitioner, specialist, surgeon or anaesthetist. General practitioner (GP) A doctor who does not specialise in a particular area but treats patients for a wide range of conditions that do not require specialist care. Inpatient A person who has been formally admitted to a registered hospital for the purpose of obtaining professional attention. This includes same day admissions. Medicare Australia s national health care system which provides permanent Australian residents with access to free treatment in public hospitals and free or subsidised treatment by doctors. Medicare Benefits Schedule (MBS) This schedule lists all the services for which Medicare pays benefits and the rules that apply to the payment of those benefits. Each service has a fee that s been set by the Australian Government for the purpose of calculating the Medicare benefit payable for that service (called the MBS fee). 26

27 Obstetrics and pregnancy-related services This includes all treatment specified in the Medicare Benefits Schedule (MBS) as obstetrics as well as any type of treatment related to the management of pregnancy, labour and childbirth, including ante-natal and post-natal care. Outpatient A patient who receives medical attention at a hospital outpatient department or accident and emergency department, but is not formally admitted to the hospital. An outpatient may be charged both hospital fees and doctors or specialists fees. Prescription medicine A medicine that may be legally obtained only where prescribed by a medical or dental practitioner to treat a particular medical condition. Specialist A doctor who specialises in treating patients in a particular category, for example a doctor who specialises in treating people with some form of heart condition. Surgically implanted prostheses An approved manufactured item or piece of equipment that is surgically implanted or applied, generally during a hospital surgical procedure to replace or assist a body part or function. Examples include pacemakers, defibrillators, cardiac stents and joint replacements. Waiting period The period of time a member must wait after taking out cover before they can receive a benefit for services or items included on their cover. 27

28 call or call (if calling from outside Australia) visit medibank.com.au/oshc ask in store write to us at Medibank Private GPO Box 9999 Brisbane QLD 4001 Australia When your family visit they can get cover too. Medibank also provides a range of covers for visitors to Australia. Medibank Private is a signatory to the Private Health Insurance Code of Conduct. The Private Health Insurance Code of Conduct logo is a trademark of, and is used under authorisation from, Private Healthcare Australia. The information contained in this brochure is current at the time of issue, 14 May 2012, and supersedes all previously published material. It only applies to Medibank branded products. Medibank Private Limited ABN MPL