HealthStarter (Basic Plus)

• Private or Public Hospital accommodation & services includes overnight, same day, intensive care^* and theatre fees. Cover is provided for a private or shared room in a private or public hospital for the following services:
  • Accident related treatment after joining^
  • Tonsils, adenoids and grommets
  • Joint reconstructions
  • Hernia and appendix
  • Dental surgery
  • Bone, joint and muscle

• All other services in any hospital are eligible for restricted benefits^#. Restricted benefits are payable only at the minimum rate specified by law and may only provide a benefit similar to a public hospital shared room rate. Restricted benefits may not be sufficient to cover admissions in a private hospital. Restricted services are covered for a shared room in a public hospital.

*Theatre and Labour ward fees are not charged 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, pathologists, imaging fees etc)
• Surgically implanted prostheses to at least the minimum benefit specified in the prosthesis list issued under Private Health Insurance legislation
• Pharmacy covers most drugs related to the reason for your admission in an agreement private hospital
• Emergency ambulance transport for an accident or medical emergency by approved ambulance providers
• Better Living programs to help you manage your health and wellness.
• Hospital Substitute Treatment means the possibility of receiving rehabilitation treatment or the care of a registered nurse at home.



^Accident related treatment means treatment provided in relation to an Accident that occurs after a Member joins the Fund and the Member provides documented evidence of seeking treatment from a Health Care Provider within 7 days of the Accident occurring. If Hospital Treatment is required, the Member must be admitted to a Hospital within 180 days of the Accident occurring. Any additional Hospital Treatment (after the initial 180 days) will be paid as per the level of Benefits payable on the Member’s chosen level of cover (if applicable).

# All hospital services provided in a public hospital are eligible for Minimum Default Benefits. These benefits are stipulated by the department of Health and listed in the relevant Private Health Insurance (Benefit Requirement) Rules. Some hospitals may charge above the Minimum Default Benefit for shared room accommodation. Please note that fees charged in excess of Minimum Default Benefits are an out-of-pocket expense and are not eligible for reimbursement under CBHS Corporate Health policies.

*A benefit is not payable in respect of a service that was rendered to a Member if the services can be claimable from any other source.