Cover Summary For Settled Families – …

1 Cover Summary Settled Families Comprehensive | 1 Services and TreatmentsIncluded, Restricted or Excluded Ambulance services Accident override Appendicitis treatment Removal of appendix Removal of tonsils and adenoids Knee reconstruction surgery and investigations Shoulder reconstruction surgery and investigations Surgical removal of wisdom teeth (hospital charges only) Palliative care Rehabilitation treatment Psychiatric treatment Colonoscopies Heart-related admissions Plastic and reconstructive surgery All joint replacement surgery Major eye surgery (including cataract and other lens-related services) Renal dialysis Surgery for slipped disc and scoliosis Spinal fusion surgery Cancer treatment* Weight loss surgery All other MBS items (includes thousands of additional in-hospital services) Obstetrics-related services (eg.)

2 Pregnancy) Fertility treatment (including IVF and GIFT programs) 100% for eligible services where immediate professional attention is required. 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 does it mean?Included service: We pay benefits towards overnight and same day hospital accommodation, intensive care and medical services where a Medicare benefit is payable.

3 It s important to know that if you are treated in a non-Members Choice hospital, the benefits we pay are generally lower than for a Members Choice hospital and you may incur significant out-of-pocket expenses. Members Choice providers are not available in all you are treated as a private patient in a public hospital, we ll pay benefits towards overnight and same day accommodation in a shared room. Restricted service: We pay limited benefits for Restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not be adequate to Cover all hospital costs and are likely to result in significant out-of-pocket expenses.

4 For Restricted services in a public hospital we will pay minimum shared room service: We won t pay any benefits towards the hospital, medical or other costs of Excluded treatment is an Excluded service on all Medibank coverHospital 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 (eg. GP or specialist visits) are not included under this 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 Summary For Settled Families ComprehensiveThis provides an important Summary of your Cover and we recommend that you read and retain it.

5 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 Cover is only available for couples and override means that Restricted and Excluded services will be treated as Included services where you require hospital treatment as the result of an accident that occurred after joining this Cover . Cover Summary Settled Families Comprehensive | 2 Waiting Periods2 monthsPsychiatric treatment, rehabilitation treatment, palliative care and ambulance treatment for conditions requiring hospitalisation that are not deemed pre-existing conditions.

6 12 monthsPre-existing conditionsA pre-existing condition is an ailment, illness or condition that in the opinion of a Medical Practitioner appointed by 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 periods 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 to pay the excess at the time of admission. It is payable per member per calendar excess does not apply to children on family memberships.

7 This means any child, student or adult dependant will not have to pay the excess if they re admitted to hospital. $250$500 The following excesses are available on this coverExcessA 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. 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 Waiting Period WaiverThe 2 month hospital treatment waiting periods are waived for injuries sustained in an accident after joining this features and benefitsGapCover available for eligible medical servicesMedibank s GapCover is a way to eliminate or reduce your out-of-pocket expenses for in-hospital doctor s charges.

8 Check with your doctor if they will participate in Medibank s GapCover. Find out more at implanted prosthesesFor an Included or Restricted service, we ll pay the minimum benefit as listed in the Australian Government s Prostheses ListMi Health servicesAs 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) Mobile Health Apps to help you make healthier decisions on the go, visit for more informationChoice of treating doctor or specialistYou can choose your doctor or specialist when you re treated in hospital as a private patientCPAP-type devicesUp to $500 benefit per member every 5 years towards the hire or purchase of an approved deviceCover Summary Settled Families Comprehensive | 3 Service categoryExample items and servicesWaiting periodAmount you can claimAnnual limit per memberMembers Choice providerNon-Members Choice providerAmbulance services For eligible services where immediate professional attention is required2

9 Months100%No annual limitOptical*Frames6 months100%$250 Prescription lensesContact lensesGeneral dental*Preventative treatment2 months70% (100% for kids^)Fixed benefitNo annual limitDental examinationsScale and cleanSurgical dental procedures (excluding hospital charges)12 monthsMajor dental*Endodontic services (eg. root canal)12 months70% (100% for kids^)Fixed benefit$800 (Increases by $50 per year up to $1,050)Periodontics (eg. treatment of gum disease)Crowns, dentures and bridgesMajor restorative fillings (eg. veneers)OrthodonticsBraces12 months100%$800 opening up of $400 per to a $2,400 lifetime limitPhysiotherapy*Consultations2 months70% (100% for kids^)Fixed benefit$600 (Increases by $50 per year up to $850)Group pilates Hydrotherapy sessionsChiropractic*Consultations only2 months70% (100% for kids^)Fixed benefitCombined limit of $400 (Increases by $50 per year up to $650)OsteopathyFixed benefitRemedial massage*Consultations only2 months70% (100% for kids^)

10 Fixed benefit$200 Extras coverThis table shows the extras services you can claim benefits for, annual limits and waiting periods that apply to these you visit a provider from our large Members Choice network you ll generally get better value for money. At Members Choice providers, you can take advantage of capped rates and receive a percentage of what you re charged back. When you visit a non-Members Choice provider, you ll get back a fixed amount regardless of what the provider charges. As long as the provider is a Medibank recognised provider, benefits are payable for services or items included under your Cover .