COVER SUMMARY BASIC HOSPITAL - Medibank

1 COVER SUMMARY . BASIC HOSPITAL . This provides an important SUMMARY of your COVER and we recommend that you read and retain it. You can find out more about your membership by referring to the Member Guide, which is a SUMMARY of our Fund Rules and terms and conditions, or by calling us on 132 331. HOSPITAL COVER HOSPITAL COVER provides benefits when you are treated as a private patient admitted to HOSPITAL . This means any related services that are provided when you're not admitted ( GP or specialist visits) are not included under this COVER .

2 Here are the services that are Included, Restricted and excluded under your HOSPITAL COVER . Before booking treatment, you should call us to ask about the benefits you can expect to receive and any out-of-pocket expenses you might incur. Included, What does it mean? Services and Treatments Restricted or excluded Included service: Ambulance services+ We pay benefits towards overnight and same day HOSPITAL accommodation, intensive care and medical Accident override services where a Medicare benefit is payable. Appendicitis treatment It's important to know that if you are treated in a Removal of appendix non-Members' Choice HOSPITAL , the benefits we pay are generally lower than for a Members' Choice HOSPITAL Removal of tonsils and adenoids.

3 And you may incur significant out-of-pocket expenses. Knee reconstruction surgery and investigations Members' Choice providers are not available in all areas. Shoulder reconstruction surgery and investigations Where you are treated as a private patient in a public Surgical removal of wisdom teeth HOSPITAL , we'll pay benefits towards overnight and same . ( HOSPITAL charges only) day accommodation in a shared room. Palliative care . Restricted service: Rehabilitation treatment R We pay limited benefits for Restricted services. Psychiatric treatment R This means that if you choose to be treated in a private Colonoscopies HOSPITAL the benefits we pay will not be adequate.

4 To COVER all HOSPITAL costs and are likely to result Heart-related admissions in significant out-of-pocket expenses. Plastic and reconstructive surgery For Restricted services in a public HOSPITAL Hip and knee joint replacement surgery we will pay minimum shared room benefits. All other joint replacement surgery excluded service: Major eye surgery We won't pay any benefits towards the HOSPITAL , (including cataract and other lens-related services).. medical or other costs of excluded services. Renal dialysis Cosmetic treatment is an excluded service on all Surgery for slipped disc and scoliosis Medibank covers.

5 Spinal fusion surgery . Cancer treatment* Accident override means that Restricted and excluded services will be treated as Included services where Weight loss surgery you require HOSPITAL treatment as the result of an All other MBS items (includes thousands of additional accident that occurred after joining this COVER . See Other . in- HOSPITAL services) features and benefits' on page 2 for more information. Obstetrics-related services (eg. pregnancy) . Fertility treatment (including IVF and GIFT programs) . +. 100% for eligible services where immediate professional attention is required.

6 QLD and TAS residents are covered by their state schemes. (Refer to the Member Guide for information.). * You are covered for cancer treatment where the service is an Included service. Where the service or item falls under an excluded or Restricted service, the service will remain excluded or Restricted. Your HOSPITAL COVER does not include non-PBS drugs. COVER SUMMARY BASIC HOSPITAL | 1. Waiting periods 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.

7 You're not able to receive benefits for any items or services you might have obtained while you are serving a waiting period or before you joined Medibank . Accident Waiting Period Waiver The 2 month HOSPITAL treatment waiting periods are waived for injuries sustained in an accident after joining this COVER . Waiting Periods Psychiatric treatment, rehabilitation treatment, palliative care and ambulance services+. 2 months HOSPITAL treatment for conditions requiring hospitalisation that are not deemed pre-existing conditions. Pre-existing conditions A pre-existing condition is an ailment, illness or condition that in the opinion of a Medical Practitioner appointed by 12 months Medibank , the signs or symptoms of which existed at any time in the period of six months before you either took out your new COVER , or transferred to a higher level of COVER .

8 CPAP-type devices. Excess An excess is an amount you must contribute towards your same day or overnight HOSPITAL treatment and is deducted from the benefits we pay. Some hospitals may require you The following $500. to pay the excess at the time of admission. It is payable per member per calendar year. excesses $250. are available The excess does not apply to children on family memberships. This means any child, on this COVER student or adult dependant will not have to pay the excess if they're admitted to HOSPITAL . Other features and benefits Accident override Your COVER also features Accident override which means that you'll be covered for excluded and Restricted services where treatment is required as the result of an accident after joining this COVER .

9 Benefits are payable for the initial HOSPITAL treatment for injuries resulting from the Accident, as well as ongoing treatment where the services form part of your initial course of treatment covered by Medibank under Accident override. You must see a medical practitioner within seven days of the Accident occurring GapCover available for eligible medical services Medibank 's GapCover is a way to eliminate or reduce your out-of-pocket expenses for in- HOSPITAL doctor's charges. Check with your doctor if they will participate in Medibank 's GapCover.

10 Find out more at Choice of treating doctor or specialist You can choose your doctor or specialist when you're treated in HOSPITAL as a private patient Surgically implanted prostheses For an Included or Restricted service, we'll pay the minimum benefit as listed in the Australian Government's Prostheses List CPAP-type devices Up to $500 benefit per member every 5 years towards the hire or purchase of an approved device Mi Health services As part of your HOSPITAL COVER , you have access to the Mi Health range of support services including: 24/7 Health Advice Line Medibank nurses can answer any health question, call 1800 Mi Health (1800 644 325).