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1 Product Brochure JUNE

2 Contact us CBHS Health Fund Limited ABN A Registered Private Health Insurer Call CBHS Member Care Monday to Friday, 7.00am 7.00pm (AEST) Go to cbhs.com.au 24 hours, 7 days a week Post to CBHS Health Fund Limited Locked Bag 5014 Parramatta NSW 2124 Level 5, 79 George Street, Parramatta, NSW, 2150 Fax to to Like us at facebook.com/cbhshealthfund Contents Who is CBHS 4 Who can join 4 Why join 5 CBHS Wellness Benefit 5 CBHS Choice Network 5 Member Discounts 5 3 Products overview 7 Package options 8-9 Prestige 8 StepUp 8 KickStart 9 FlexiSaver 9 Hospital options 11 Comprehensive Hospital 11 Limited Hospital 11 Basic Hospital 11 Extras options 13 Top Extras 13 Intermediate Extras 13 Essential Extras 13 Hospital comparison chart Extras comparison chart Understanding Hospital Cover Understanding Extras Cover Government incentives 28 Additional information 29

3 4 Who is CBHS? We all want to be healthier and have happier lives for our family and ourselves and CBHS takes pride in delivering high-quality health insurance that offers peace of mind at every life stage. CBHS was set up in 1951 as a shared, not for profit cooperative after the Commonwealth Bank decided it wanted to provide its employees with access to affordable health insurance. We have now been serving past and current employees and their families for over 60 years. Current/past CBA Group employees, including contractors and franchisees Why join? Who can join? CBHS is a restricted health fund setup to cover current and former CBA Group employees, contractors and franchisees and their eligible family members. This includes partners, siblings, children, parents and grandchildren. If you leave the CBA Group you re eligible to remain a member or join CBHS. Not sure if you re eligible to join? Call our friendly Member Care team and find out more. Immediate family (partner, parents, siblings, children) Extended family (grandchildren, niece/nephew) CBHS is a not for profit health fund run solely for the benefit of our members. We pride ourselves on our ability to provide our members with the best service, exceptional value and competitive products that offer better benefits. CBHS is not just for when you are sick, we provide information and benefits to help keep you healthy. Benefits of being a member Being part of the CBHS family gives you access to our wide array of exclusive programs. Hospital Substitute Treatment This program is aimed at reducing the time you spend in hospital, often cutting it out altogether. It allows you to receive specialised treatment from a private nurse, physiotherapist and occupational therapist in the comfort of your own home. This program is available at no cost to CBHS members who hold an appropriate level of hospital cover or package product and the medical services to be provided are an appropriate substitute for treatment that would be fully covered in a hospital under that product. Chronic Disease Management Program If you suffer from a chronic disease, it can impact every aspect of your life. CBHS offers a series of telephone based Chronic Disease Management Programs aimed at providing education and support to better understand your situation. Trained professionals will assist you with medication management, identifying risk factors, provide guidelines for maintenance of your health and ultimately, help you improve your quality of life. For more information visit our website cbhs.com.au or Exclusive to Prestige package members, the international program Best Doctors provides access to leading medical minds from around the world. The Best Doctors network has more than 53,000 experts in over 450 specialties and subspecialties and is designed to complement the care you receive from your own doctor. CBHS Wellness Benefits cover you for a variety of health checks and programs designed to assist you in better managing your health and wellbeing. CBHS Wellness Benefit programs are a part of all our extras policies and each of our package covers excluding FlexiSaver. Member Discounts Another benefit of being a CBHS member is access to a wide range of exclusive discounts from selected providers. You can find a full list of providers and discounts at cbhs.com.au/memberdiscounts 5 Joining the CBHS family means you can: Be a member of the Roy Morgan Private Health Insurer of the Year! Utilise our Choice Network of preferred providers Access an array of wellness programs and member benefits Enjoy exclusive Member Discounts Choice Network The CBHS Choice Network is a group of over 3,000 dental and optical providers who are committed to providing exceptional treatment to our members while reducing or removing the gap for Extras services on selected preventative dental treatments, optical frames, lenses and contact lenses. For more information about the CBHS Choice Network and to find a provider, visit cbhs.com.au/choicenetwork Claim online 24 hours a day Have confidence with a 30-day cooling off period on all new policies Switching from another fund is easy, just tell us the fund name and policy details - we ll take care of the rest! 2014 Recognised providers In addition to our choice network, we pay benefits for services provided by recognised providers in accordance with the CBHS Health Benefit Rund Rules and the applicable Government regulations. Various types of providers are deemed to be recognised providers based on the services which they offer. For more information about this criteria, please visit cbhs.com.au/recognisedproviders

4 6 What are my options? CBHS offer a wide range of Hospital, Extras and Ambulance cover that you can mix and match to meet your lifestyle. You can also choose from our range of Package options to ensure you have the appropriate health cover. Package Cover Package cover provides both Hospital and Extras cover. 7 Prestige Offers the highest benefits in the CBHS product suite. StepUp A mid-level cover includes pregnancy services and extras to suit a young or growing family. KickStart An affordable cover for the fit and healthy. FlexiSaver An entry level cover for the young and healthy single or couple looking to take up their own first cover. or Hospital Cover Provides benefits towards admitted hospital services. Comprehensive Hospital For complete peace of mind in case the unexpected arises. Limited Hospital For a sense of security but without things you are less likely to need. Basic Hospital Provides treatment as a private patient in a shared room of a public hospital. Extras Cover Provides benefits towards services not usually covered by Medicare like dental, optical, physio, chiro etc. + Top Extras Wide range of services and benefits for security and peace of mind. Intermediate Extras Provides benefits for popular general services and treatments. Essential Extras Essential services for those who maintain a healthy lifestyle. Ambulance Cover or Provides cover for ambulance costs including treatments at the scene arising from medical emergencies.

5 8 9 CBHS has made choosing your health cover even easier, by packaging our Hospital and Extras Covers. Hospital Cover Level Extras Cover Level Prestige CBHS premium level of cover, offering an extensive range of hospital and medical services, and generous extras benefits plus more. No co-payment or excess The option to keep a non-student dependant up to the age of 25 Access to Best Doctors and other Wellness Benefits Highest extras benefits including unlimited preventative and general dental Access Gap Cover (with participating doctors) plus Gap Assist which will help you with additional out-of-pocket medical expenses Hospital Cover Level Extras Cover Level KickStart An affordable package cover for the fit and healthy, because accidents do happen! Get covered for the things you may need like dental and optical, without the things you don t, like pregnancy. $70 daily co-payment A great range of extras benefits Wellness benefits for health management Access Gap Cover (with participating doctors) Package Cover Hospital Cover Level Extras Cover Level StepUp A mid-level cover which includes pregnancy services and extras to suit a young or growing family. Pregnancy related services $70 daily co-payment (does not apply for dependant children on the policy) Access Gap Cover (with participating doctors) plus Gap Assist which will help you with additional out-of-pocket medical expenses Cover for dental, optical, physio, chiro and other therapies Hospital Cover Level Extras Cover Level FlexiSaver An entry level package covering only selected hospital and extras services, while excluding things you may not need at this stage of life. $500 excess on hospital admission helps keep premiums low Flexibility in using extras overall limit Gives 55% of the provider charges back in benefits Access Gap Cover (with participating doctors) For more information on coverage, see page 14 (Hospital) and page 17 (Extras).

6 10 11 As every member s lifestyle and situation is different, our selection of hospital and extras cover allows you to select a combination to suit your individual needs. Hospital Cover Level Hospital Cover Level Hospital Cover Level Comprehensive Hospital Our highest level of hospital cover for services or treatments, aimed at providing peace of mind in case the unexpected arises. No restrictions on treatments covered by Medicare, received as an admitted patient Daily co-payment option for reduced premiums (co-payment does not apply for dependent children on the policy) Access Gap Cover (with participating doctors) Access to private hospitals (for non-restricted services) Limited Hospital A hospital cover designed to cover most eventualities with some restricted benefits on services and treatments for things you are less likely to need. Daily co-payment option for reduced premiums (co-payment does not apply for dependent children on the policy) Access Gap Cover (with participating doctors) Access to private hospitals (for non-restricted services) Basic Hospital A basic level of hospital cover, designed for those who just want the basics. It gives you the choice of your own doctor or specialist when receiving treatment as a private patient in a shared room of a public hospital. Excess option for reduced premiums Choice of doctor or specialist Access Gap Cover (with participating doctors) Hospital For more information on Hospital coverage see page 14.

7 12 13 Extras cover provides benefits towards services like dental, optical, physio, chiro and alternative therapies. Top Extras Designed for members who want to be covered for an extensive range of extras services Extras Cover Level Extras Cover Level Extras Cover Level Generous per service benefits on a wide range of services Unlimited preventative and general dental High overall limits on major dental, optical, physio, chiro and therapies Cover for hearing aids and other health care aids and appliances Wellness benefits for health management Intermediate Extras Allows you to be covered for a wide range of popular extras required for day-to-day health management Benefits for preventative and general dental Benefits towards optical, physio, chiro and some therapies Wellness benefits for health management Essential Extras Helps you maintain a healthy lifestyle at an affordable level of cover Benefits for preventative dental Basic benefits towards general dental, optical, physio and chiro Wellness benefits for health management Extras For more information on Extras coverage see page 17.

8 14 Hospital cover PACKAGE Prestige StepUp KickStart FlexiSaver Comprehensive Hospital HOSPITAL Daily co-payment Nil $70 $70 - Nil, $70, Nil, $70, - Limited Hospital Basic Hospital Excess $ Nil, $500 Non-student dependant option Example hospital procedures at participating private hospitals Accident related treatment after joining (relevant to level of cover) R Removal of wisdom teeth, tonsils, adenoids, appendix R Investigation, repair or reconstruction of bones and tissues of a knee, hip or shoulder R Removal of kidney stones & gall stones R 8 R Colonoscopies, gastroscopies R 8 R Cancer treatment (e.g. radiotherapy, chemotherapy) R 8 R Brain surgery R 8 R Back surgery (e.g. spinal fusion, discectomy) R 8 R Cochlear implant surgery & bone anchored hearing devices R 8 R Ambulance Cover Ambulance costs are expensive and are not covered by Medicare. CBHS Ambulance Cover protects you from emergency ambulance costs. You are automatically covered for emergency ambulance transport (air, land and sea within Australia) if you have any level of Hospital cover with CBHS. Ambulance cover pays the cost of emergency ambulance services if you are transported directly to a hospital or treated at the scene, due to a medical emergency. Transport must be provided by a State Government ambulance service or a private ambulance service recognised by CBHS (e.g. Royal Flying Doctors Service). This includes transportation from the scene of an accident or the scene of a medical event such as a heart attack or stroke, but does not include transportation to hospital for the routine management of ongoing medical conditions or transfers between hospitals. If you require cover for non-emergency services please contact your state ambulance scheme for further information. You can take Ambulance Cover as a stand-alone option. *Residents of QLD and TAS are covered by state based Ambulance schemes 16 Insulin pump procedures R 8 R Renal dialysis R 8 R Major eye surgery (including cataract surgery, glaucoma surgery and corneal grafts/transplants) R R 8 R R Hip & knee joint replacement R R 8 R R Other joint replacement R R 8 R R Pregnancy & birth related services R 8 R R R Covered in a private agreement hospital and public hospitals. Restricted benefits only. Restricted benefits are payable only at the minimum rate specified by law. Restricted benefits may only provide a benefit similar to a public hospital shared room rate. Restricted benefits may not cover procedures in a private hospital. No benefit for theatre or labour ward fees is payable. Not covered. Assisted reproductive services (e.g. IVF, GIFT) R 8 R R Cardiothoracic services (heart and lung related) R R 8 R R Bariatric services all including revision and reversal procedures (e.g. gastric banding, sleeve gastrectomy) R R 8 R R Psychiatric services R R R R R Rehabilitation and palliative care services R R R R R Sterilisation and reversal of sterilisation R R 8 R R Plastic and reconstructive surgery services R R 8 R R Cosmetic surgery R R R 8 R R R Waiting periods Pre-existing conditions, pregnancy related services Psychiatric, rehabilitation, palliative care, all other treatments or services Accidents^ injuries and emergencies, 12 months 2 months 1 day Services for which a Medicare benefit is NOT payable R R R 8 R R R All other inpatient services where a Medicare benefit is payable R 8 R ^ Accident means an injury as a result of unintentional, unexpected actions or events that require treatment by a registered practitioner, but excludes pregnancy.

9 17 Extras cover 70% of the cost up PACKAGE Prestige StepUp KickStart FlexiSaver Top Intermediate Essential 70% of the cost up 100% of the cost up Service description* Preventative dental (2 month waiting period) Oral examinations (011, 012, 013) $35-$45 $35-$45 $23-$40 $35-$45 X-ray (022) $28 $28 $23 $28 Removal of plaque (111) $41 $41 $30 $41 Removal of calculus (114, 115) $65-$70 unlimited $65-$70 unlimited $42-$47 unlimited 55% of cost $65-$70 unlimited $230 $210 calendar year Fluoride application (121) $30 $30 $18.50 $700 $30 Mouthguard (151, 153) $130-$150 $130-$150 $62-$65 (combined for $130-$150 Fissure sealing (161) $27 $27 $23 dental, optical $27 General dental (2 month waiting period) Fillings $61-$140 $61-$140 $49-$115 and physio) $61-$140 Consultations and examinations $28-$40 $28-$40 $28.50-$35.50 $28-$40 unlimited $350 55% of cost X-rays $21-$42.80 $21-$42.80 $20-$36.50 $21-$42.80 unlimited $500 $170 calendar year Extractions or surgical dental $50-$255 $50-$255 $50-$180 $675 $50-$255 Major dental (6 month waiting period) Periodontic (gum treatment) $24-$260 $700 $24-$260 $24-$ $24-$260 $630 Endodontic (root canal treatment) $7.50-$180 $700 $7.50-$180 $35-$ $7.50-$180 $660 $400 calendar year Inlays/onlays/facings $360 $1,440 $ $360 $1,440 - Dentures and implants $20-$810 $1,500 $20-$810 $ $20-$810 $1,350 - any 5 years Occlusal therapy $17-$260 $920 $17-$ $17-$260 $920 lifetime Major dental (12 month waiting period) Crowns and bridges $10-$720 $3,500 $10-$ $10-$720 $3,000 $700 any 5 years - Orthodontia 70% $3,200 70% $1, % $2,800 - lifetime Prescribed optical appliances (6 month waiting period) Frames $140 $90 $140 $90 $70 Single vision lens pair (212) $130 $70 $130 $70 $70 Bifocal lens pair (312) $140 $60 $150 sublimit $140 $60 $60 $450 $ % $230 55% of cost (combined with dental $375 $250 Trifocal lens pair (412) $150 $90 and physio) $150 $90 $60 calendar year Multifocal lens pair (512) $210 $210 $70 Contact lenses (852) $220 $160 $220 $160 $140 Therapies (2 month waiting period) (combined with dental Physiotherapy (initial/subsequent) $61/$43 $900 $61/$43 $40/$30 55% of cost $61/$43 $720 $300 and optical) Chiropractic (initial/subsequent) $61/$40 $61/$40 $40/$30 $ $61/$40 $720 $1,000 $600 $250 Osteopathy (initial/subsequent) $61/$35 $61/$35 ($300 sublimit per $40/$ $61/$35 $720 Occupational therapy (initial/subsequent) $61/$35 $800 $61/$35 therapy) $61/$35 $ Speech therapy (initial/subsequent) $95/$46 $1,850 $95/$ $95/$46 $1, Clinical psychology $30-$140 $500 $30-$140 $50 $ $30-$140 $ Ante natal/post natal physiotherapy 70% $105 70% (combined with physiotherapy) % $ calendar year Hypnotherapy $80 $ $80 $ Podiatry (excl. artificial aids: e.g. orthotics) $30-$50 $400 $30-$50 $ $30-$50 $400 $250 - Audiology $60 $ $60 $ Eye therapy $60 $ $60 $ Dietician $15-$75 $360 $15-$75 $15-$ $15-$75 $360 55% of the cost of provider charge 70% of the cost up EXTRAS Benefit period 19 * A Benefit is not payable in respect of a service that was rendered to a Member if the services can be claimable from any other source.

10 20 Extras cover 70% of the cost up Prestige StepUp KickStart FlexiSaver Top Intermediate Essential 70% of the cost up 100% of the cost up Service description* Alternate therapies (2 month waiting period) Natural therapies Buteyko, Herbal Medicine Consultations, Homeopathy, Naturopathy, Nutrition $450 Oriental therapies Acupressure, Acupuncture, Chinese Herbal Medicine Consultation, Chinese Massage, Kinesiology, Reflexology, Shiatsu, Traditional $450 Chinese Medicine Consultation $33 $1,000 $33 $400 $ $33 Massage therapies $300 calendar year Alexander Technique, Aromatherapy, Bowen Therapy, Deep Tissue Massage, Feldenkrais, Lymphatic Drainage, Myotherapy, Remedial $450 Massage, Rolfing, Sports Massage, Swedish Massage, Therapeutic Massage General health (2 month waiting period) Blood glucose accessories 70% $320 70% 100% % $320 Home visits by registered nurse Non-pharmaceutical benefits scheme drugs requiring a prescription by law. Travel and accommodation + $120 (>4 hrs) $80 (<4 hrs) 100% less the current government prescribed co-payment up to $150 per prescription. 50% of the cost for accommodation (on single room rate), airfare, train, bus or 15c per km for car. 55% of the cost of provider charge $2, $1, % less the current government prescribed co-payment up to $75 per prescription. $ % less the current government prescribed co-payment up to $75 per prescription. - - $ % of the cost up $120 (>4 hrs) $80 (<4 hrs) 100% less the current government prescribed co-payment up to $75 per prescription. 50% of the cost for accommodation (on single room rate), airfare, train, bus or 15c per km for car. $2, $1,000 $300 $ Health care aids (12 month waiting period)- referred by a doctor and recognised by CBHS Artificial aids $10-$1,500 $1,500 $10-$150 $ $10-$1,000 $1,000 $350 - Hearing aids 70% $2, % $1, Blood pressure monitor, nebuliser, glucometer 70% $ % $500 $300 - Wellness benefits (2 month waiting period) Benefits are 90% of the cost up to maximum category limit Benefits are 90% of the cost up to maximum category limit Benefits are 90% of the cost up to maximum category limit Benefits are 90% of the cost up to maximum category limit Health checks Breast examinations (e.g. mammograms/x-rays) Bone density tests Skin cancer screening Bowel/prostate cancer screening Eye screenings Health management Quit smoking programs 1 Weight management programs 1 Stress management courses 1 Yoga 2 Pilates 2 $300 $ calendar year calendar year Gym membership 2 $230 $115 $115 $115 $230 $115 $115 Personal training 2 $115 $115 $115 Benefit period calendar year per membership per calendar year any 3 years 22 A Benefit is not payable in respect of a service that was rendered to a Member if the services can be claimable from any other source. * + Travel is only payable for a patient who requires essential medical and dental treatment, where it is not available at a facility within a 160km round trip of the member s home. In order to claim travel a patient must be visiting a specialist and will require a referral letter. Excludes Ronald McDonald house. 1 Must be approved by CBHS 2 CBHS can only pay a benefit for gym membership/personal trainer/pilates/yoga where the gym/personal trainer/yoga/pilates service is provided as part of a health management program, certified by your GP or a recognised provider confirming that the gym/personal trainer/yoga/pilates program is a health management program. Approval form is available from the CBHS website. Please note that GP consultations are not covered by CBHS.

11 23 Understanding Hospital Cover 25 Private hospitals CBHS holds agreements with an extensive range of Australian private hospitals and day surgeries. These agreements ensure hospital fees including bed fees, theatre and labour ward fees, intensive and coronary care fees are covered when admitted as a patient to hospital (subject to your level of cover). For charges incurred in a non-agreement hospital members may only receive benefits similar to a public hospital shared room rate. To check if your hospital holds an agreement, visit our website cbhs.com.au/hospitalsearch or contact Public hospitals All CBHS hospital covers provide benefits for treatment with your choice of doctor in a public hospital. No benefits are payable if the service or treatment is an exclusion. Admitted hospital medical services* CBHS will pay up to 25% of the Medicare Benefit Schedule (MBS) fee, while Medicare pays the other 75%. If charges are more than the MBS fee, then a gap payment arises. Services that do not attract a benefit from Medicare will be subject to restricted benefits only or excluded (depending on level of cover) resulting in significant out-of-pocket expenses for both hospital and medical services. * A member will incur substantial out of pocket expenses if they are not entitled to Medicare Benefits (i.e Non-Australian Residents). Gap Assist To further help you reduce your out-of-pocket expenses from a hospitalisation, Prestige and StepUp include a Gap Assist benefit of for Prestige and for StepUp per calendar year. Access Gap Cover Many people admitted to hospital as private patients can find themselves faced with out-of-pocket expenses or gaps. CBHS has arrangements with some doctors that are designed to minimise or eliminate out-of-pocket expenses altogether. Members have access to these arrangements on all Hospital levels of cover. Go to cbhs.com.au/agcsearch for more information on AGC or to search for AGC participating doctors. Daily co-payment options^ You can reduce the cost of your Comprehensive or Limited Hospital cover by agreeing to pay a daily co-payment for a maximum of 6 days or 12 days per family, per calendar year. See table below. Excesses An excess is a nominated amount you agree to pay upfront in respect to charges raised by a hospital for overnight or same day admission. The total excess is payable once per calendar year up to a maximum of twice for a couple, family or sole parent policy. FlexiSaver package cover has a fixed $500 excess, while for Basic Hospital cover you can choose $500 excess to reduce the cost. Cover Comprehensive Hospital^ Limited Hospital^ Basic Hospital Prestige StepUp^ KickStart FlexiSaver Co-payment or Excess Nil, $70 or co-payment Nil, $70 or co-payment Nil or $500 excess Nil $70 co-payment $70 co-payment $500 excess ^ Daily co-payment does not apply to dependent children on Comprehensive Hospital, Limited Hospital or StepUp Restricted benefits Members can elect to pay a lower contribution for their private health insurance cover and take out a hospital cover that only pays a minimum level of benefits for certain conditions, i.e. that has restricted benefits. If a member selects a hospital cover with restricted benefits for certain services and they choose to go into a private hospital to receive any of these services, they will be faced with significant out-of-pocket expenses. CBHS will pay up to the Minimum Default Rate for the accommodation, however the member will be liable to pay the full cost of theatre or labour ward fees, intensive care units and coronary care units. Hospital benefits however are payable for services that attract restricted benefits when performed in a public hospital with the doctor of your choice. Exclusions For treatment listed as an exclusion there is no benefit payable and the member will incur significant out of pocket expense for these services. Please review the exclusions and check with CBHS to see if you are covered before receiving treatment. Waiting periods Waiting periods apply to those who are new to private health insurance or choose to upgrade to a higher level of cover. If you choose to transfer your policy to CBHS any waiting periods already served at your previous fund can be honoured. Upgrading your level of cover may cause additional waiting periods to apply. Hospital waiting periods (calendar months) Pre-existing conditions, pregnancy related services 12 months (refer to page 29 for definitions) Psychiatric, rehabilitation, palliative care, all other treatments or services 2 months Accidents 1, injuries and emergencies, 1 day 1 Accident means an injury as a result of unintentional, unexpected actions or events that require treatment by a registered practitioner, but excludes pregnancy. What s covered? Depending on the level of cover: Accommodation for overnight, same day and intensive care for private or shared room in agreement private and public hospitals Theatre and labour ward fees covered in agreement private hospitals (excluding restricted services) Medical expenses related to providers for services while admitted in hospital e.g. fees from doctors, surgeons, anaesthetists, pathology, imaging etc. Covered for services eligible for benefits from Medicare up to Medicare Benefits Schedule (MBS) fee. Members have their choice of doctor/surgeon in a public and private hospital. CBHS will cover the difference between the Medicare benefit and the MBS fee for services provided as an admitted patient to a hospital Access Gap Cover is where a provider chooses to participate under an arrangement with the fund. CBHS covers up to 100% of an agreed amount in excess of the MBS fee which reduces or eliminates your out-of-pocket medical expenses (i.e. surgeons, anaesthetists, pathology, imaging fees etc.) Surgically implanted prostheses to at least the minimum benefit specified in the prosthesis list issued under Private Health Insurance legislation Pharmacy covers most drugs related to the reason for your admission in agreement private hospitals Boarder accommodation covers 100%, up to $160 per admission, if not included in hospital agreement for an accident or medical emergency by approved ambulance providers Hospital Services where a Medicare benefit is payable (excluding restricted services) Chronic Disease Management Programs information available under the membership/ services and benefits tab at Hospital Substitute Treatment information available under the membership/services and benefits tab at What s not covered? Depending on the level of cover: No benefits are payable for hospital or medical treatment and associated costs for excluded services If member is admitted into a private hospital for restricted services or into a non-agreement hospital, benefits are payable only at the minimum rate specified by law. These benefits may only provide a benefit similar to a public hospital shared room rate. These benefits may not be sufficient to cover admissions in a private hospital or a non-agreement hospital. Hospital services received within policy waiting periods Nursing home type patient contribution, respite care or nursing home fees Take home/discharge drugs (non-pbs drugs may be eligible for benefits from Extras cover) Aids not covered in hospital agreement (may be eligible for benefits from Extras cover) Services claimed over 24 months after the service date Services provided in countries outside of Australia Prostheses used for cosmetic procedures, where no Medicare benefit is payable or for excluded services Ambulance transfers between hospitals Fees raised by public hospitals that exceed Minimum Default Benefits set by the Department of Health for shared room accommodation CBHS benefits vary depending on the level of cover and services covered. Please refer to the individual product sheet or call us and check before getting treatment or going to hospital.

12 26 Understanding Extras Cover CBHS Extras benefits are based on a percentage benefit of the providers fee up to a CBHS limit per service capped by a sub-limit or overall limit. Examples of how the Extras benefits work Dentist Fee $60 27 Extras cover Prestige and StepUp; Top, Intermediate and Essential KickStart FlexiSaver Benefit 70% of the cost the provider charge, up to a per service benefit 100% of the cost the provider charge, up to a per service benefit 55% of the cost the provider charge 70% service fee = $42 which is more than the per service benefit ($36) FlexiSaver 55% of service fee = $33 CBHS Benefit payable = $36 CBHS Benefit payable = $33 Dentist Fee $40 70% service fee = $28 which is less than the per service benefit ($36) FlexiSaver 55% of service fee = $22 CBHS Benefit payable = $28 CBHS Benefit payable = $22 Benefit period Each group of services within Extras and Package covers have an overall limit on the amount you can claim. Most limits are based on, per calendar year entitlement, unless otherwise stated. Benefits which attract any 3 or 5-year period are entitled to have the benefit renewed on the same date which the service was performed respectively. Extras waiting periods (calendar months) Crowns, bridges, orthodontia, artificial aids, healthcare appliances, oxygen apparatus and hearing aids Prescribed optical appliances, periodontics, endodontics, facings, occlusal therapy, implants and dentures All other services 12 months 6 months 2 months

13 28 29 Government incentives The Australian Government Rebate on private health insurance All Australians eligible for Medicare have access to the Australian Government Rebate on private health insurance, which is a subsidy on the cost of private health insurance. This rebate is income tested against a person s level of assessable income for tax purposes, with the rebate being paid by the Australian Government, directly to the health fund. From 1 April 2014, contribution to an individual s private health insurance rebate is indexed annually by the lesser of the Consumer Price Index (CPI) or the actual average increase in the premium charged by insurers. If you are eligible for the rebate this change effectively means that the rebate percentage you receive today is going to be reduced every year that the average increase of premiums for all insurers is higher than the CPI. If you are not eligible for rebate this change does not affect you. Your rebate percentage is calculated based on your income level and your age. Please visit the Government website to see the latest rebate details: Medicare Levy Surcharge The Medicare Levy Surcharge is charged to individual high-income earners who do not have an appropriate level of private hospital cover. To avoid the Medicare Levy Surcharge, simply choose any CBHS hospital cover. For more information on the Medicare Levy Surcharge, contact the Australian Taxation Office on Lifetime Health Cover loading On the 1st July following your 31st birthday, for every year you delay taking out hospital cover, the government adds a 2% loading. This loading continues to increase each year you are without cover. For people who are currently paying a Lifetime Health Cover Loading, it will be removed after 10 years of continuous paid hospital cover. Further details on the Lifetime Health Cover Loading can be found at: Additional information Pre-existing condition If a member has a pre-existing condition, a waiting period of 12 months will apply before we will pay hospital or medical benefits towards any treatment for that condition. A pre-existing condition is defined as an ailment, illness, or condition where the signs or symptoms existed at any time in the period of 6 months ending on the day on which the person became insured by a policy. It is the opinion of the CBHS appointed doctor that determines whether the signs or symptoms were in existence that doctor, however, will have regard to any information provided by the member s doctor. Members must also wait for 12 months to be covered for pre-existing conditions where they upgrade their cover. Complaints handling and dispute resolution policy CBHS respects your right to make a complaint and recognises the value of complaints as an important tool in monitoring and responding to customer expectations. To obtain a copy of the CBHS Complaints and Dispute Resolution Policy visit our website or contact our Member Care team on You may also contact the Private Health Insurance Ombudsman on or by writing to: Suite 2, Level 22, 580 George St, Sydney, NSW 2000 for free and independent advice. Privacy Statement CBHS respects your privacy. Protecting personal information is important to CBHS and is required by law. CBHS handles personal information in accordance with the provisions of the Commonwealth Privacy Act 1988 and the National Privacy Principles under that Act. To obtain a copy of the CBHS Privacy Policy visit our website cbhs.com.au or contact Member Care on Private health insurance code of conduct The Private Health Insurance Code of Conduct is a self-regulatory code to promote informed relationships between private health insurers and consumers. As a signatory to the Code of Conduct, CBHS has made a commitment to ensuring: Consumers receive the correct information on private health insurance from appropriately trained staff Consumer awareness of the internal and external dispute resolution process Clear and complete policy documentation Ensuring that all information between the consumer and CBHS is protected in accordance with privacy principles. Detailed information on the Private Health Insurance Code of Conduct can be obtained at privatehealth. com.au/codeofconduct, by visiting our website or by contacting Member Care on Cooling off period If you are not satisfied with your health insurance for any reason, you have 30 days from the receipt of your CBHS policy to cancel your membership and receive a refund provided you have not made a claim or have no pending claims. Health benefit fund rules There are rules and conditions surrounding membership of CBHS. Many are regulated by Commonwealth law. For information regarding the Health Benefit Fund Rules visit cbhs.com.au.

14 Notes: This brochure offers an overview of complex information. Reading it will help you identify any areas of particular concern and will enable you to seek further clarification before making your decision to join CBHS. This brochure should be read carefully in conjunction with the CBHS Health Benefit Fund Rules before joining. A copy of the Health Benefit Fund Rules can be downloaded from cbhs.com.au. This information should be read carefully and retained. The information contained in this brochure is true and correct at the time of printing - June 2015.

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