What are limitations to cover?
• Where you choose to be treated at a non-participating private hospital, you may not be fully covered. • A person who is classified as a “nursing home type patient” (as defined in the Health Insurance Act) may receive limited benefits. In such cases patients are required by law to make a personal contribution towards their care. • Cosmetic surgery and sterilisation reversal have restricted benefits based on the Medicare benefits payable. • Benefits are not payable for outpatient treatment in a private hospital if you are not admitted to hospital. • Medical costs for surgical procedures performed in hospital by a dentist or podiatrist or any other practicioner that is not eligible for the Medicare rebate. • Benefits are not payable for pharmaceuticals supplied on discharge from hospital, unless covered under your extras benefits. • Excess Bonuses cannot be used towards the cost of excesses when claims are made for services during a period of Lifetime Restricted Benefits.
