What is Overseas Visitors Health Cover (OVHC)?

Overseas Visitors Health Cover (OVHC) is health insurance cover that is offered to anyone from overseas who is not eligible for full Medicare (Australian Government funded public health care) coverage and are in Australia as a Visitor or Worker.

 

Why do I need OVHC?

If you're planning to visit or work in Australia, getting an appropriate level of health insurance may be a requirement for your visa. Some visa sub-classes must purchase, and provide proof of acceptable OVHC when applying for their visa and maintain cover for the duration of their stay.

 

When will I receive my visa compliance letter?

Once you’ve purchased your OVHC cover, an email with your compliance letter will be immediately sent to you. Please make sure you provide a valid email address to avoid delays.

 

When does my OVHC start?

Your policy starts when you arrive in Australia or the day that your visa is granted – whichever is later – and ends when your visa expires, provided you maintain your policy payments. It’s important that you contact us when you arrive in Australia or when your new visa starts so that we can activate your cover. Note that you are not covered for treatment outside of Australia.

 

How do I pay for my OVHC?

Your OVHC needs to be paid and remain in advance at all times and you can pay up to 12 months’ premium in advance. Once you arrive in Australia there are two ways you can pay your premium:

  • Credit card payment: We accept Visa and Mastercard
  • Direct debit: A direct debit is an instruction from you to your bank or other financial institution to allow CBHS Corporate to collect your health insurance premiums from your account on the date that your premium is payable. The date will depend on the payment frequency (monthly, quarterly, yearly) you selected when you arranged for your OVHC

 

Why do overseas visitors need OVHC in Australia?

Overseas visitors are generally ineligible for Medicare; the public health insurance system for Australian residents. If you need medical attention while you’re in Australia and you don’t have health cover it can be very expensive, whether you’re treated in the public or the private healthcare system.

Your CBHS Corporate cover gives your peace of mind knowing that you’re covered if you have an accident or illness while you’re in Australia.

 

What is Medicare, the public healthcare system?

The public healthcare system is run by the government and is called Medicare. Medicare covers things such as:

  • Treatment by a doctor or general practitioner (also called GP’s)
  • Treatment by a Specialist
  • Prescription medication
  • Treatment in a public hospital

If you are entitled to Medicare and have a Medicare card you will receive benefit to help pay for these services. If you are not entitled to Medicare, then your OVHC can help pay for these services.

 

What are Reciprocal Health Care Agreements (RHCA)?

Australia has RHCA’s with the following countries:

  • United Kingdom
  • New Zealand
  • Italy
  • Belgium
  • Malta
  • Netherlands
  • Sweden
  • Finland
  • Norway
  • Slovenia
  • Republic of Ireland

Residents from these countries are entitled to Reciprocal Medicare for medically necessary treatment while in Australia.

 

Do I still need health insurance if I have access to reciprocal Medicare benefits?

RHCA’s vary from country to country, so it’s important to understand what you are and aren’t covered for before deciding on health insurance. Even if you are entitled to reciprocal benefits, Medicare does not cover you for everything and without health insurance you will need to pay for these services. The list below gives examples of services that are NOT covered under RHCA.

  • Ambulance cover
  • Dental care
  • Elective treatment
  • Funerals
  • Medical evacuation to your home country
  • Para Medical Services, for example blood tests
  • Treatment and accommodation in private hospitals, or as a private patient in a public hospital
  • Treatment that is not immediately necessary

 

What is the Medicare Levy Surcharge (MLS) ?

Most Australian taxpayers pay an annual Medicare Levy on their taxable income each year. This helps fund Medicare, the public healthcare system that provides free or subsidised cover for certain healthcare services to Australian citizens and permanent residents. On top of this, if you do not have private health insurance you may be charged the Medicare Levy Surcharge (MLS) of between 1-1.5% if you earn above a certain income. The base income threshold (under which you are not liable to pay the MLS) is $90,000 for singles and $180,000 for families.

 

Will you need to pay the MLS?

If you come from a country that has a RHCA with Australia, and your taxable income reaches the MLS threshold then you may have to pay the MLS. This could mean that you will need to pay an additional 1% - 1.5% in tax unless you have appropriate private hospital cover. To find out more about the MLS and tax you should seek independent tax advice or visit the Australian Taxation Office at www.ato.gov.au

 

What is the Australian Government Private Health Insurance Rebate?

Many Australians who take out Private Health Insurance cover can claim a rebate to help contribute towards the cost of their premiums. The rebate is income tested and applies to domestic hospital and ancillary (Extras) products. The rebate does not apply to OVHC. You could be eligible for the rebate if you have Medicare and an Australian domestic product such as Extras. For more information about the Australian Government Private Health Insurance rebate you can visit www.privatehealth.gov.au or the Australian Taxation Office at www.ato.gov.au

 

How does private healthcare fit into the health system for overseas visitors?

The private healthcare system complements the public healthcare system, or if you’re not eligible for Medicare, it replaces it. CBHS Corporate provides OVHC to overseas visitors to help with the cost of services provided in the private healthcare system. This includes emergency ambulance trips and a range of treatments in a private hospital.

 

Who is covered under a OVHC policy?

That will depend on the type of cover you buy. Your certificate will tell you what cover you have bought.

  • Single: covers for one person
  • Couple: covers for 2 adults
  • Family: covers for an adult spouse or de facto partner and one or more dependent children under the age of 18 years
  • Sole Parent: covers for one adult and one or more dependent children under the age of 18 years.

 

What are waiting periods under CBHS Corporate OVHC?

Sometimes you must wait for a period of time before you’re able to claim benefits for services under you CBHS Corporate policy – this is called a waiting period. The following waiting periods apply to CBHS Corporate policies:

  • Psychiatric treatment: 2 months
  • Palliative Care:2 months
  • Rehabilitation: 2 months
  • Pre-existing medical conditions: 12 months
  • Pregnancy and birth related services: 12 months

 

What is a pre-existing condition?

A pre-existing ailment means an ailment or illness, the signs or symptoms of which, in the opinion of a medical advisor appointed by CBHS Corporate, having regard to any information furnished by the Member’s Health Care Provider, existed at any time in the period  6 months before the person became insured under an OVHC policy. 

 

What are Exclusions?

Exclusions are services that are not covered under your policy. You can seek services for the exclusions, but CBHS Corporate will not pay any benefits. An example of exclusions under a CBHS Corporate policy are:

  • Outpatient psychiatric and psychology
  • Assisted reproductive services (e.g. IVF and GIFT)
  • Cosmetic surgery
  • Stem cell, bone marrow and organ transplant
  • Other services for which a Medicare benefit is not payable

 

How does it work for out of hospital services?

Most minor medical issues can be treated by a local doctor or General Practitioner (GP) who can prescribe medication. Usually you will only go straight to hospital if you have an emergency or major accident.

If you have a non-urgent injury or illness that needs to be treated, you may want to consider visiting a GP at a medical centre. In Australia, doctors can be either GPs or Specialist Physicians. To visit a Specialist Physician such as a Gastroenterologist, you must first visit a GP and obtain a referral.

When you see a doctor, there is a fee set by the government for consultations called the Medical Benefits Schedule or MBS fee for most medical services. If your doctor charges the MBS then your CBHS Corporate policy will pay the entire amount. If the doctor chooses to charge more than the MBS, then you will have to cover the difference known as an ‘out of pocket’ or ‘gap’ payment.

All public hospitals in Australia have a 24-hour emergency and casualty department where you can get help after hours and on the weekend. People waiting in emergency are assessed and treated based on the seriousness of their medical condition. The patients with the most urgent problems are seen and treated first. If you attend the emergency department with a less serious medical condition, you may need to wait a long time to be treated and you could have a large out of pocket expense.

 

How does it work for in hospital services?

When you’re treated in hospital by a doctor, surgeon or anesthetist the fee applied is the MBS fee. If the person treating you charges only the MBS fee (and the service is included in your policy) you will be covered for the service. If they choose to charge above the MBS fee then you will have to pay the difference. Before you go to hospital, you should ask your doctor and the hospital if there will be any additional costs that might be higher than those covered by your OVHC. It is also highly recommended that you contact CBHS Corporate before you go to hospital so that we can tell you if there are any exclusions, restrictions or limits on the treatment you are seeking.

 

What is the Pharmaceutical Benefits Scheme (PBS)?

The Pharmaceutical Benefits Scheme (PBS) is an Australian Government program that subsidises some prescription medicines to make them more affordable for residents. Generally, overseas visitors to Australia are not eligible for subsidised prescription medication under the PBS. Overseas visitors from countries with which Australia has a Reciprocal Health Care Agreement (RHCA) are also eligible to access the PBS.

 

What’s a gap fee?

You’ll have to pay a gap fee if the amount the medical provider charges is more than the benefit you’re entitled to under your cover. You’ll need to pay the gap fee yourself – you won’t be able to claim that amount. For example, if you have a standard consultation with a doctor and were charged the MBS fee of $37.05 your policy would pay 100% and you would have no gap. If the doctor charged $50 then your policy would pay $37.05 (equal to the MBS benefit) and you would have to pay $12.95 which is the ‘gap’ between the benefit your policy pays and the cost of the service.

 

What happens after I join?

It’s important that you contact us when you arrive in Australia so that we can start your cover correctly. After you arrive in Australia you’ll receive your membership cards and detailed information about your level of cover and what it includes.

 

How do I get in touch with CBHS Corporate?

If you need assistance with your cover or to help navigate the Australian health system then you can contact CBHS Corporate either by email at ovhc@cbhscorp.com.au or telephone our award-winning call centre on 1300 586 462.

Benefits for claims on services you’re covered for will either be paid directly to your medical provider or reimbursed to your bank account after you claim. For many services we offer a no-gap arrangement. Speak to us before claiming to find out more about this.

 

Can you give me some links to more information?

Medicare: www.humanservices.gov.au/customer/dhs/medicare

Private Health Insurance: www.privatehealth.gov.au

Product information: Overseas Visitors Health Cover with CBHS Corporate