H4

Our top, comprehensive cover gives you 100% cover Australia wide with or without an excess option, no restrictions or exclusions. We have contracts with more than 435 private hospitals Australia wide, to give you peace of mind knowing that you will be covered.

Effective 1 April 2019

What you're covered for:

If you would prefer to pay a lower premium and still have the most comprehensive cover, our Five Star Gold cover has a choice of five different excess amounts that you can choose to pay.

It is the same top cover with no exclusions but with a known upfront excess amount to pay. The higher the excess, the lower the premium.

Clinical categories

Hospital services/treatments are classified by Clinical Category in order to make it easier for you to know exactly what you are covered for, and what you are not covered for, should you be admitted to hospital.

Youth Discount

The Youth Discount is available to persons aged 18 to 29 inclusive who join a Five Star Gold level of cover.

Waiting Periods
  • None for accidents
  • 2 months for general illness
  • 12 months for pre-existing conditions
  • 12 months for pregnancy and birth related services
  • 2 months for psychiatric, rehabilitation and palliative care

Detailed information can be found here.

What else is covered?

Gap Medical Benefits

When you are admitted to hospital you will be charged separately for medical fees by your doctor, medical specialist, surgeon, anaesthetist, radiologist or pathologist.

These fees will be in addition to your accommodation and theatre fees, and are always negotiable between you and your health care provider. You will receive 100% of the Medicare Benefit Schedule (MBS) fee, the Medicare benefit, plus the Fund Benefit for inpatient services. Detailed information can be found here.

No gap medical Benefits at MHPH

Mildura Health Fund has no gap medical agreements with a number of medical specialists, doctors and surgeons who operate at Mildura Health Private Hospital (MHPH). The current list of no gap medical providers can be found here.

Prostheses

A prosthesis is a surgically implanted medical device or artificial body part, such as a hip or knee joints or a cardiac pacemaker.

Other costs you may incur

Depending on the procedure you are having whilst an inpatient in hospital, your doctor may need to use high cost items that are not normally covered.

H1

Our Basic Plus hospital cover will give you shared room accommodation in a public hospital with your choice of doctor. It is designed to provide full cover against the cost of shared room accommodation in public hospitals as a private patient with the choice of doctor or specialist. Even though default benefits are paid against the cost of private hospital treatment, this cover is not recommended for people wanting comprehensive private hospital cover.

Effective 1 April 2019

What you're covered for:

Basic Plus gives you shared ward accommodation in public hospitals across Australia with your choice of doctor. Should you be admitted to a private hospital or day facility, restricted benefits only will be payable leaving you with sometimes large out of pocket costs.

Excess

An excess of $750 will apply to this level of cover as from 1 July 2019.

Clinical categories

Hospital services/treatments are classified by Clinical Category in order to make it easier for you to know exactly what you are covered for, and what you are not covered for, should you be admitted to hospital.

Waiting Periods
  • None for accidents
  • 2 months for general illness
  • 12 months for pre-existing conditions
  • 12 months for pregnancy and birth related services
  • 2 months for psychiatric, rehabilitation and palliative care

Detailed information can be found here.

Restrictions

Hospital treatment in a private hospital in day facility are restricted to default public hospital benefits.

Exclusions

None

Co-payments

None

What are my options if I am admitted to a public hospital?

When you are admitted to a public hospital, you can to choose whether to be treated as a public patient or as a private patient. If you choose to be a public patient, you will be treated by a doctor appointed by the hospital and not be charged for your care.

You can choose to be treated as a private patient in a public hospital to have your choice of treating doctor, or to have a private room. However, this may not necessarily guarantee the doctor of your choosing or that a private room will be available, nor does it guarantee a higher level of care.

There is no difference in the level of care you receive at a public hospital if you elect to be a private patient, you may however be charged some out-of-pocket costs.

What else is covered?

Gap Medical Benefits

When you are admitted to hospital you will be charged separately for medical fees by your doctor, medical specialist, surgeon, anaesthetist, radiologist or pathologist.

These fees will be in addition to your accommodation and theatre fees, and are always negotiable between you and your health care provider. You will receive 100% of the Medicare Benefit Schedule (MBS) fee, the Medicare benefit, plus the Fund Benefit for inpatient services. Detailed information can be found here.

No gap medical Benefits at MHPH

Mildura Health Fund has no gap medical agreements with a number of medical specialists, doctors and surgeons who operate at Mildura Health Private Hospital (MHPH). The current list of no gap medical providers can be found here.

Prostheses

A prosthesis is a surgically implanted medical device or artificial body part, such as a hip or knee joints or a cardiac pacemaker.

Other costs you may incur

Depending on the procedure you are having whilst an inpatient in hospital, your doctor may need to use high cost items that are not normally covered.

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(03) 5023 0269

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