Acceptance of Terms – Aussie Health Insurance
Before acting on the information and guidance provided by the consultant, you should evaluate your own individual needs, objectives, and situation and which products are suitable for you, and if necessary seek independent advice before making a decision to acquire. You should always read the policy documentation from the relevant Supplier before making any decision to acquire or hold insurance.
We make no personal recommendations, suggestions or advice about the suitability of a product or service for you and your needs, and do not take into account your individual circumstances.
We are not responsible or liable for any loss or damage you or any third party may suffer or incur in connection with any product you obtain from us due to any acts, omissions, errors or defaults of any third party in connection with
that product.
Please make sure you read the policy documentation and also understand the most common private insurance terms.
Private Insurance Terms Waiting periods: When you take out or upgrade a policy, you may have to wait for a set period before you can claim certain benefits.
Annual limits:
Your annual limit is, quite simply, the maximum amount per calendar year (from 1st January – 31st December) that your policy will cover for specific goods or services. Inclusions and exclusions: Inclusions refer to everything covered as part of your policy, and exclusions are those that aren’t. These will vary depending on your level and type of cover.
Restricted benefit:
If certain services are restricted in your policy you may only be covered for some of the cost in certain situations. For example, if you go to a private hospital for treatment that is a restricted service or benefit on your hospital policy, you will have a higher gap payment than if you receive treatment as a private patient in a shared ward of a public hospital.
Hospital excess:
This is the amount you have to pay upon admission to hospital and it will vary depending on your policy.
Gap:
It means an out-of-pocket expense, that is, an expense that isn’t covered by your policy. This could include accommodation costs at a non agreement hospital or medical fees above what’s covered by the MBS (Medicare Benefits Schedule). The gap will be billed to you by your provider, and it’s best to check up-front what the potential out-of-pocket expenses may be.
Out-patient medical costs:
In the lead up to a hospital admission there will be appointments with GP’s and/or specialist/s and there may also be pathology and/or radiology tests. Under Health Insurance legislation, health
funds are not permitted to cover these outpatient appointments. You will need to check with your GP or Specialist for any out-of-pocket costs you may need to pay.
It is important prior to a pre-booked admission or at the earliest possible time after an emergency admission that Informed Financial Consent is provided to you so you can understand any out-of-pocket costs that you may incur. If you
require further clarification regarding out-of-pocket costs you should contact the hospital, specialist or other medical provider for additional information.
Medicare Levy Surcharge:
If you are an Australian tax payer who doesn’t have private hospital insurance, and you earn over a certain amount, you may have to pay extra. We’re talking 1% to 1.5% per year. The ATO has a private health insurance rebate calculator as well as a Medicare levy calculator to help you work out how much that is, based on your income.
Government rebate:
If you take out private health insurance, the federal government may contribute towards some of your premium; this contribution is called the Australian Government Rebate on private health insurance. The percentage of this rebate is set each year and varies according to age and income.
Lifetime Health Cover (LHC):
If you wait until after the first of July following your 31st birthday to take out hospital cover, you’ll pay a 2% loading on top of your premium for every year you wait and the loading applies for 10 years of continuous hospital cover. The maximum loading for LHC is 70%. Informed Financial Consent: You should be informed in writing about the cost of treatment before you are admitted to hospital or treated by your specialist.
Transfer Certificate:
This certificate shows your age when you took up the cover, the length of your membership, the level of cover, any waiting periods you have served and claims made in the previous 12 months. This certificateis required when you move from one health fund to other. These are just a few of the common terms, but if you are unsure about the language in your policy, you can always contact us or call the insurer whose product you wish to purchase. How we are paid We receive commission from the insurer when you use our service to
purchase products from them.