Transport Health Does Not Cover:

• Claims made two years or more after date of service.

• When you or your dependants have the right to recover costs from a third party other than us, including an authority, another insurer (eg. Traffic accident schemes, workers compensation or public liability), or under an employee benefit.

• Treatment for pre-existing ailment or conditions (within the first 12 months).

• Goods and services received during any period where your payment is in arrears, your membership is suspended or you are within waiting periods.

• Treatment that we deem inappropriate, after receiving independent medical or clinical advice.

• Services that are not delivered face to face, such as online or telephone consultations, unless you are participating in one of our health improvement programs. 

Transport Health Extras Cover does not include: 

• Psychological and developmental assessments. Where psychology is included in your cover, psychology treatment is only payable when Medicare
  Medicare is the Australian Government's universal health insurance scheme, which covers all eligible citizens and residents for hospital treatment in

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   Australia entitlements are exhausted.

• No benefit is payable under extras where there is an entitlement to claim a Medicare
  Medicare is the Australian Government's universal health insurance scheme, which covers all eligible citizens and residents for hospital treatment in

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   benefit. e.g. Allied Health Services.

• Goods and services while a hospital patient except for oral surgery.

• Pharmacy items that are not on our Approved Pharmacy list, eg. Items listed on the PBS, items prescribed without an illness, items that are available without prescription, or items that are not TGA approved.

• Goods and services that have not been provided at time of claim eg. Pre-payment. To claim on these pre-paid goods and services the claim cannot be made until the actual date of the consultation occurs, or the goods have been received.

• Fees for completing claim forms and/or reports.

• Goods and/or services received overseas or purchased from overseas including items sourced over the internet.

• More than one therapy service performed by the same provider in any one day.

• Co-payments and gaps for government funded health services eg. The Co-payment
  Co-payments under Top Hospital cover are an amount payable by the member and applicable to each hospital admission during a calendar year. Top Hospita

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   for PBS items.

• Where a provider is not in private practice.