Hospital Cover. Effective 1 April 2015

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1 Effective 1 April 2015 Hospital Cover PLEASE CAREFULLY READ AND RETAIN THIS BROCHURE. PLEASE READ IN CONJUNCTION WITH THE IMPORTANT INFORMATION GUIDE.

2 Whether you re starting out, raising a family or just want the security of superior Hospital Cover, we have a hospital cover for you! You can choose from two levels of hospital cover with different options to suit your budget. You can even purchase your cover alone or combine it with one of our extras covers. WAITING PERIODS If you have transferred from another health fund on a comparable level of cover you will not have to serve any waiting periods.! Immediate cover 2 Months 6 Months 12 Months Accidents All hospital and general services (unless specified otherwise) Palliative care Psychiatric services Rehabilitation Home Care Programs* Disease Management Programs *visit tuh.com.au for more information. Obstetrics (pregnancy and birth related treatment) Pre-existing conditions Plastic/reconstructive surgery (payable only if medically necessary) HOSPITAL COVER Our hospital covers provide hospital benefits at the contracted rate, for medically necessary treatment, which is eligible for Medicare benefit. INCLUDES: Private room (when available) or shared overnight accommodation Intensive care Theatre fees Same day accommodation Coronary care Surgically implanted prostheses (industry approved) Hospital medication charges as per our hospital contract Pharmaceutical Benefit Scheme (PBS) copayment where a hospital medication is related to your hospital treatment Medical Gap Cover (for inpatient medical services) No exclusions on conditions eligible for Medicare benefits Your choice of doctor or specialist Access Gap For hospitals TUH does not have a contract with, default benefits will apply. No benefit is payable for hospital procedures that are not listed in the Medicare Benefit Schedule and/or do not meet the eligibility criteria for the payment of Medicare benefits.* Any applicable to your cover will be charged even where a default benefit only is paid. TUH may also provide benefits for alternatives to hospital treatment (see Home Care Programs on tuh.com.au for details). Please refer to the Important Information Guide for more information. EXCESS: By paying an towards the cost of your in-patient hospital services the amount of annual premium you pay is reduced. The is paid on admission into hospital, and only applies once per adult on the policy in any calendar year, regardless of how many times they are admitted into hospital or a day facility. The does not apply to dependent children, including full-time students and extended dependants. * subject to TUH paying benefits as required by legislation. 2

3 TOTAL CARE HOSPITAL With no restrictions or exclusions, TUH s Total Care Hospital gives you premium hospital cover in the event of a pregnancy, planned procedure, or for an accident. TUH offers you a choice of having Total Care Hospital without or with an. No $300 per adult on the policy $500 per adult on the policy $ PREMIUMS Total Care Hospital without Australian Government Rebate on Private Health Insurance deducted Total Care Hospital with maximum Australian Government Rebate on Private Health Insurance available for people under 65* Single Single No S/parent No S/parent Family Family Single Single $300 S/parent $300 S/parent Family Family Single Single $500 S/parent $500 S/parent Family Family * depending on your individual circumstances, and if you are over 65 different rebates may apply. Please contact us for a quote. 3

4 BUDGET HOSPITAL Budget Hospital can cover you for private hospital care at an affordable price. For the healthy who are not planning a family yet, this cover has exclusions on services such as pregnancy and hip/knee replacements which are generally not relevant until later in life. RESTRICTIONS: Plastic and reconstructive surgery. Podiatric surgery Psychiatric services Rehabilitation Gastric banding and bariatric/ obesity surgery, including reversal For services listed as restrictions we will pay the default benefit for accommodation as determined by the Government. The default benefit covers the cost of: a. Shared accommodation at a public hospital; or b. A reduced level of accommodation benefits; plus i. Medical gap ii. Access Gap Cover with participating doctors iii. Surgically implanted prostheses we will cover the full cost of any no gap prostheses and the minimum benefit for gap permitted prostheses. The default benefit does not cover theatre or labour ward fee benefits. EXCLUSIONS: Labour ward Sterility reversals Infertility investigations, assisted reproductive services Obstetrics (pregnancy and birth related treatment) Hip, knee and joint replacements Eye surgery e.g. cataracts Dialysis For services listed as exclusions no benefit is payable. EXCESS: $250 per adult on the policy. $ PREMIUMS Budget Hospital without Australian Government Rebate on Private Health Insurance deducted Budget Hospital with maximum Australian Government Rebate on Private Health Insurance available for people under 65* Single Single Single parent Single parent Family Family * depending on your individual circumstances, and if you are over 65 different rebates may apply. Please contact us for a quote. The premiums are applicable for members who have a certified age of entry of 30 or less, or for anyone born on or before 1 July A signed rebate application form must be submitted to receive a reduced premium. This is included with your new member pack. Please refer to the Important Information Guide for more information. 4

5 $ PREMIUM PAYMENT OPTIONS debit - s can be debited fortnightly, monthly, quarterly, half-yearly and yearly. 2.5% discount applies to direct debit payments. Credit card - s can be charged monthly, quarterly, halfyearly and yearly. 1.5% discount applies to credit card payments. Accounts - Accounts are sent out monthly, quarterly, half yearly or yearly. options include: BPAY Member Services Online (credit card only) In person (at our Health Care Centre) By telephone By mail 5

6 438 St Pauls Terrace Fortitude Valley Queensland 4006 PO Box 265 Fortitude Valley Queensland 4006 Phone: For more information about: Products and services Government initiatives Privacy Policy Complaints process Private Health Insurance Code of Conduct Fund Rules please visit tuh.com.au or contact us on QUEENSLAND TEACHERS UNION HEALTH FUND LIMITED ABN

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