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.
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.
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.