Gold Hospital

Gold Hospital will cover you for:

• Accommodation for overnight, same day and intensive care for private or shared room in agreement private and public hospitals. 
• Theatre and labour ward fees covered in agreement private hospitals (excluding restricted services*).
• Medical expenses related to providers for services while admitted in hospital e.g. fees from doctors, surgeons, anaesthetists, pathology, imaging etc. Covered for all services eligible for benefits from Medicare up to Medicare Benefits Schedule (MBS) Fee. You can choose your doctor/surgeon in a public and private hospital. We will cover the difference between the Medicare benefit and the MBS fee for services provided if you’re admitted to hospital.
• Access Gap Cover is when a provider chooses to participate in an arrangement with us. We cover up to 100% of an agreed amount in excess of the MBS fee which reduces or eliminates your out-of-pocket medical expenses (i.e. surgeons, anaesthetists, pathology, imaging fees etc).
• Surgically implanted prostheses to at least the minimum benefit specified in the prosthesis list issued under Private Health Insurance legislation.
• Pharmacy covers most drugs related to the reason for your admission in agreement with private hospitals.
• Boarder accommodation covers 100%, up to $160 per admission, if not included in hospital agreement. This applies to a member assisting with the care of another member on the same membership.
• Emergency ambulance transport for an accident or medical emergency by approved ambulance providers.
• Hospital Services where a Medicare benefit is payable (excluding restricted services*).
• Better Living programs to help you manage your health and wellness.
• Hospital Substitute Treatment means the possibility of receiving rehabilitation treatment or the care of a registered nurse at home.

Gold Hospital will not cover you for: 

• Hospital services received within policy waiting periods. 
• Nursing home type patient contribution, respite care or nursing home fees. 
• Take home/discharge drugs (non-PBS may be eligible for benefits from Extras cover).
• Aids not covered in a hospital agreement (may be eligible for benefits from Extras cover).
• Services claimed over 24 months after the service date.
• Services provided in countries outside of Australia.
• Prostheses used for cosmetic procedures, where no Medicare benefit is payable.
• Ambulance transfers between hospitals (for residents in VIC, SA and NT).

Exclusions: 

For treatment listed as an exclusion there is no benefit payable and you will incur significant out of pocket expense for these services. Please review the exclusions on this cover and always check with CBHS Corporate Health to see if you are covered before receiving treatment.  

The following services are excluded from this cover:

• Cosmetic services

An excess is the amount you pay towards the cost of your hospital admission before any benefit is payable. By paying an excess you can reduce the cost of your hospital cover. Excess levels included: $250, $500 or $750. 

If you choose an excess, it means that when you go into hospital (same-day or overnight) you will pay the chosen excess amount directly to the hospital. The excess is only payable once per person up to a maximum of twice per couple/family membership per calendar year. Excesses do not apply to any dependent children on the policy.