Top Hospital with co-payment
Our Top Hospital with co-payment offers comprehensive hospital cover at an affordable price. A co-payment is applicable to this cover.
Benefits
At contracted private hospitals, or as a private patient in a
public hospital, you are covered for the following after the
co-payment is deducted:
• Overnight accommodation Private Hospital
- a co-payment is payable for intensive care, surgical or
general wards, in a private room (where available and/or
required) or a shared ward.
- A co-payment is also payable in a private ward of a
public hospital.
- No co-payment payable in a shared ward of a
public hospital.
• Sameday accommodation (no excess payable)
• Theatre and Labour Ward fees
• Early hospital release health services benefit of 80% of
the cost up to $500 per person, per Membership year.
• In-hospital boarder accommodation benefit of up to $120
per Membership year.
• Pharmaceuticals
In-patient medication used while in hospital is normally
covered within hospital charges. However, high cost
medication as listed in the exceptional drug list (EDL)
requires the Hospital to obtain Fund approval prior to
dispensing. The cost of Pharmacy medication taken home
on discharge from the hospital is payable by the Member.
• Prostheses
Cover for surgically implanted prostheses as listed in the
Government Schedule. Gap costs may be incurred for
some items.
• Rehabilitation
• Physiotherapy (while in hospital)
• Psychiatric Therapy (while in hospital)
• Emergency Ambulance Transport
• CPAP Machine benefit of up to $750 maximum.
• Medical Gap
The 25% difference between the Schedule Fee for
medical services and the 75% Medicare benefit payable
for in-hospital treatment.
• Access Gap
Provides benefits for medical services charged in excess
of the Schedule Fee, where the doctor chooses to
participate.
Limited benefits are available for the following:
• A 12 month Benefit Limitation Period (BLP) applies to psychiatric, rehabilitation & cardiac
inpatient medical treatment. BLP means that benefits are restricted to basic cover in the first
12 months of membership to new members or members upgrading their cover.
• Cosmetic Surgery, Sterilisation Reversals or services not
listed in the Medical Benefit Schedule (MBS).
Limited benefits are available but due to the complexity of
these procedures, please contact Transport Health before
commencing treatment.
• Non-contracted private hospitals
For details contact Transport Health.
Transport Health has contracts with most private hospitals
and same day procedure clinics throughout Australia. For
more information, visit our website or contact our office.
• Waiting periods ranging from 2 to 24 months may apply
to some services.
• If you have a Pre-existing Ailment or Condition, waiting
periods must be served before benefits are payable.
We encourage our members to contact us prior to
hospitalisation to obtain accurate information about what
benefits are payable according to their level of cover.
Co-Payments
Singles |
Families |
$100 per night up to a
maximum of $500 per
membership year. |
$100 per night up to a
maximum of $500 per
person with a family
maximum of $1000 per membership year. |
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Annual Report 2009
Australian Health System