Top Hospital Cover H3

Top Hospital cover provides optimum benefits for in-hospital treatment.

Benefits

At contracted private hospitals, or as a private patient in a
public hospital, your benefits are:

• Overnight accommodation
In Intensive care, surgical or general wards, in a private room (where available and/or required) or shared ward.

• Same day in-patient accommodation

• Theatre and Labour Ward fees

• In-hospital boarder accommodation benefit of up to $120 per Membership year.

• Early hospital release health services benefit of 80% of the cost up to $500 per person, 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:

• 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 sameday procedure clinics throughout Australia. For more information, visit our website or contact our office.

Important Conditions

• 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.

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