HealthStarter (Basic Plus)

Hospital cover highlights

An affordable package cover for the fit and healthy, because accidents do happen! Get covered for the things you may need like dental and optical, without the things you don’t, like pregnancy.

  • Private hospital cover for the most commonly claimed services
  • Restricted benefits for services you're less likely to need
  • Excess options of $250, $500 or $750 helps keep the premium down
  • Emergency ambulance transport

What's covered?

HealthStarter (Basic Plus) hospital cover will cover you for:

  • Private or Public Hospital accommodation & services includes overnight, same day, intensive care* and theatre fees. Cover is provided for a private or shared room in a private or public hospital for the following services:
    • Accident related treatment after joining^
    • Tonsils, adenoids and grommets
    • Joint reconstructions
    • Hernia and appendix
    • Dental surgery
    • Bone, joint and muscle
  • All other services in any hospital are eligible for restricted benefits#. Restricted benefits are payable only at the minimum rate specified by law and may only provide a benefit similar to a public hospital shared room rate. Restricted benefits may not be sufficient to cover admissions in a private hospital. Restricted services are covered for a shared room in a public hospital.

*Theatre and Labour ward fees are not charged in a public hospital

  • 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. Members have their choice of doctor/surgeon in a public or private hospital. CBHS Corporate Health will cover the difference between the Medicare benefit and the MBS fee for services provided as an admitted patient to a hospital
  • Access Gap Cover is where a provider chooses to participate under an arrangement with the fund. CBHS Corporate Health covers 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, pathologists, 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 an agreement private hospital
  • Emergency ambulance transport for an accident or medical emergency by approved ambulance providers
  • 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.

  • ^Accident related treatment means treatment provided in relation to an Accident that occurs after a Member joins the Fund and the Member provides documented evidence of seeking treatment from a Health Care Provider within 7 days of the Accident occurring. If Hospital Treatment is required, the Member must be admitted to a Hospital within 180 days of the Accident occurring. Any additional Hospital Treatment (after the initial 180 days) will be paid as per the level of Benefits payable on the Member’s chosen level of cover (if applicable).

    # All hospital services provided in a public hospital are eligible for Minimum Default Benefits. These benefits are stipulated by the department of Health and listed in the relevant Private Health Insurance (Benefit Requirement) Rules. Some hospitals may charge above the Minimum Default Benefit for shared room accommodation. Please note that fees charged in excess of Minimum Default Benefits are an out-of-pocket expense and are not eligible for reimbursement under CBHS Corporate Health policies.

    *A benefit is not payable in respect of a service that was rendered to a Member if the services can be claimable from any other source.

What's not covered

HealthStarter (Basic Plus) hospital cover will not cover you for

  • If a member is admitted into a private hospital for restricted services, benefits are payable only at the minimum rate specified by law. These benefits may only provide a benefit similar to a public hospital shared room rate. These benefits may not be sufficient to cover admissions in a private hospital
  • Nursing home type patient contribution, respite care or nursing home fees
  • Take home/discharge drugs (non-PBS drugs may be eligible for benefits from your 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 member 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:

  • Podiatric surgery (provided by a registered podiatric surgeon)
  • Cosmetic services
  • Services for which a Medicare benefit is NOT payable

Waiting periods

Waiting periods apply to those who are new to private health insurance or those who already have cover with CBHS Corporate Health or another fund, and choose to upgrade to a higher level of cover.

Parts of waiting periods served within one health fund can be completed in another when a person transfers funds. If you upgrade your level of cover waiting periods may apply to benefits not previously included within your original cover.

Hospital waiting period Calendar month
Pre-existing conditions* (except for hospital psychiatric services, rehabilitation and palliative care) 12 months
Pregnancy and birth 12 months
Hospital psychiatric services**, rehabilitation and palliative care 2 months
Accidents***, emergency ambulance transport 1 day
All other treatments 2 months

 

* If a member has a pre-existing condition, a waiting period of 12 months will apply before we will pay hospital or medical benefits towards any treatment for that condition.

** Note that upon serving the two month waiting period, members can choose to upgrade their cover (once in a lifetime) and access the higher benefits for hospital psychiatric treatment associated with that cover, without serving an additional waiting period. For more details contact us on 1300 586 462 or by sending an email to help@cbhscorp.com.au.

*** Accident means an unexpected or unforeseen event caused by an external force or object resulting in an injury to the body which requires treatment by a medical practitioner, Hospital or dentist (as the context requires) but excludes pregnancy.

Excess

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. You can choose from one of these excess options available - $250, $500 or $750.

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 apply to all members on the policy.

Extra cover highlights

  • Generous limits on services including optical, physio, chiro and other therapies
  • Cover for some major dental services
  • Unlimited preventative dental annual limits
  • High per service benefits every time you claim

Benefits

Dental

  • Preventative Dental (2 months waiting period) 100% of the cost up to the per service benefit below Overall Limit Benefit Period
    Oral examinations (011, 012, 013) $27.50-$40 Unlimited Calendar year
    X-ray (022) $23
    Removal of plaque (111) $30
    Removal of calculus (114,115) $42-$55
    Fluoride application (121) $20
    Mouthguard (151,153) $62-$65
    Fissure sealing (161) $30
    General Dental (2 months waiting period) 100% of the cost up to the per service benefit below Overall Limit Benefit Period
    Fillings $49-$115

    $675

    Calendar year
    Consultation & Examinations $28.50-$35.50
    X-rays $20-$45
    Extraction or Surgical Dental $50-$200
    Major Dental (6 months waiting period)
    Periodontics (gum treatment) $24-$190
    Endodontic (root canal treatment) $35-$180

Prescribed optical

  • Prescribed Optical
    (6 months waiting period)
    100% of the cost up to the per service benefit below Overall Limit Benefit Period
    Frames 100% $230 Calendar year
    Lenses
    Contact lenses

Therapies

  • Therapies
    (2 months waiting period)
    100% of the cost up to the per service benefit below Overall Limit Benefit Period
    Physiotherapy (Initial/Subsequent) $40/$30 $250 Calendar year
    Chiropractic (Initial/Subsequent) $40/$40
    Osteopathy (Initial/Subsequent) $40/$30
    Clinical Psychology $50 $250
    Dietitian $15-$75 $100
    Alternative Therapies
    (2 months waiting period)
    Oriental therapies $26 $200 Calendar year
    Acupressure, Acupuncture
    Chinese Herbal Medicine Consultation, Chinese Massage,
    Traditional Chinese Medicine Consultation
    Massage therapies
    Deep Tissue Massage
    Lymphatic Drainage, Myotherapy, Remedial Massage
    Sports Massage, Swedish Massage
    Therapeutic Massage

General Health

  • General Health (2 months waiting period) 100% of the cost up to the per service benefit below Overall Limit Benefit Period
    Blood Glucose Accessories 100% $100 Calendar year
    Non-Pharmaceutical Benefits Scheme drugs requiring a prescription by law 100% less the current prescribed PBS co-payment for general patients up to $75 per prescription. $200

Wellness Benefits

  • Wellness Benefits
    (2 months)
    Overall Limit Benefit Period
    90% of the cost up to the overall limit below
    Health Checks $100 Calendar year
    Breast examinations (i.e. mammograms/x-rays)
    Bone density tests
    Skin cancer screening*
    Bowel/prostate cancer screening
    Eye Screenings
    Health Management  $100  Calendar year
    Quit smoking programs1
    Weight management programs1
    Stress management courses1
    Gym membership/Personal training2 $115 ($100 sub limit on personal training) Calendar year

    * Examples of skin cancer screening include mole mapping or digital mole photography.
    1 Must be approved by CBHS Corporate Health.
    2 CBHS Corporate Health can only pay a benefit for gym membership/personal trainer where the gym/personal trainer service is provided as part of a health management program, certified by your GP or a recognised provider confirming that the gym/personal trainer program is a health management program. Approval form is available from CBHS Corporate Health. Please note that GP consultations are not covered by CBHS Corporate Health.


A benefit is not payable in respect of a service that was rendered to a Member if the services can be claimable from any other source.

Benefit Period

Each group of services within Extras and Package covers have an overall limit on the amount you can claim. Most limits are based on per person per calendar year, unless otherwise stated in our Extras table.

Benefits which attract a 3 and 5 year period are entitled to have the benefit renewed on the same date which the service was performed respectively.

Benefits which attract a 'lifetime' period; lifetime means the period commencing on the date the member was first insured and ceases to be insured by CBHS Corporate Health (irrespective of any suspension of membership or other period without cover).

Per Service Benefit

Extras per service benefits for HealthStarter (Basic Plus) are based on 100% of the cost the provider charges you, up to a maximum claimable amount (the set benefit per service) which is capped by an overall limit.

Extras Waiting Period

Extras waiting period Calendar months
Crowns and bridges, orthodontia, artificial aids, healthcare appliances, oxygen apparatus and hearing aids 12 months
Prescribed optical appliances, periodontics, endodontics, inlays/onlays, facings, dentures and implants 6 months
All other services 2 months

Call Now

Download HealthStarter (Basic Plus) Product Sheet

HealthStarter (Basic Plus) will be available to join online very soon! In the meantime if you are interested in taking up this policy please contact our Member Care team on 1300 586 462. When deciding if this product is right for you, please refer to the CBHS Corporate Health Benefit Fund Rules. This information should be read carefully and retained.