Entry Hospital (Basic Plus) will cover you for:

• Accommodation for overnight, same day and intensive care for a shared room in a public hospital. We will also pay an amount for accommodation in shared room in a public hospital - this amount will be the minimum amount specified by applicable legislation 
• Theatre and labour ward fees are not raised in a public hospital
• Medical expenses related to providers for services while admitted in hospital e.g. fees from doctors, surgeons, anaesthetists, pathology, imaging, etc covered for all services eligible for benefits from Medicare up to Medicare Benefits Schedule (MBS) Fee. Members have their choice of doctor/surgeon in a public or private hospital. CBHS Corporate Health 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 Corporate Health 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
• Emergency ambulance transport for an accident or medical emergency by approved ambulance providers

• Hospital Substitute Treatment means the possibility of receiving rehabilitation treatment or the care of a registered nurse at home.

Limited cover for private hospital accommodation: If a member is admitted to a private hospital under Entry Hospital (Basic Plus) cover members may only receive benefits similar to a public hospital shared room rate which can result in substantial out-of-pocket expenses.

Entry Hospital (Basic Plus) will not cover you for:

• If member is admitted into an agreement or non-agreement private hospital, benefits are payable
  at the minimum rate specified by law - accordingly substantial out of pocket expenses can be incurred
• Hospital services received within policy waiting periods
• Nursing home type patient contribution, respite care or nursing home fees
• High cost, experimental or non TGA approved drugs
• Take home/discharge drugs (non-PBS drugs may be eligible for benefits from your Extras cover)
• Treatments where no medicare benefits are available
• Aids not covered in hospital agreement (may be eligible for benefits from your 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
• Labour ward fees in an agreement and non agreement private hospital
• Ambulance transfers between hospitals (for residents in VIC, SA and NT)

Exclusions:

For treatment listed as an exclusion there is no benefit payable and member will incur significant out of pocket expense for these services. Please review the exclusions on this cover and always check with CBHS Corporate Health to see if you are covered before receiving treatment. The following services are excluded from this cover:

• Podiatric surgery (provided by a registered podiatric surgeon)
• Cosmetic services
• Services for which a Medicare benefit is NOT payable

Note: Entry Hospital (Basic Plus) cover is not sufficient for private hospital treatment as you may incur significant out-of-pocket expenses.

Waiting periods:

Waiting periods apply to those who are new to private health insurance or those who already have cover with CBHS Corporate Health or another fund, and choose to upgrade to a higher level of cover.

Parts of waiting periods served within one health fund can be completed in another when a person transfers funds. If you upgrade your level of cover waiting periods may apply to benefits not previously included within your original cover.

Excess:

Entry Hospital (Basic Plus) includes an excess of $500 or $750. This means that when you go into hospital you will pay the first $500 or $750 in respect to charges raised by the hospital. This excess is per person (including dependants) up to a maximum of $1000 or $1500 per family membership per calendar year.