healthslips.com.au Policy Information

Queensland Country Health Fund

Top Hospital (Gold) $250 excess & Pure Care Extras

$689.98 / month

(Before Rebate, Discount & Loading)

Available in SA

You may be entitled to an Australian Government Rebate on the above premium. Your premium may also include a Lifetime Health Cover Loading, an Age-based Discount or an insurer discount. Check with your insurer for details.

This policy covers: Two adults & dependants, including non-student dependants (3 or more people, only 2 of whom are adults).

Children (0 - 17), non-classified* dependant (18 - 20), students (21 - 31) and non-students (21 to 31), as well as persons with a disability who qualify as a child, non-classified* dependant, student and non-student in these age ranges. *Non-classified dependant: Still allowed on a Family Policy

Policy ID: QCH/21A/SPGY2Y

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy provides accident cover - check with insurer for details.
  • This policy provides benefits for travel or accommodation outside of hospital - check with insurer for details.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Assisted reproductive services
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Insulin pumps
Joint reconstructions
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
Weight loss surgery

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess of $250 per admission. This is limited to a maximum of $250 per person and $500 per policy per year.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

No excess applies for Dependent Children up to and including 21 years

For further information about this policy see: https://www.queenslandcountry.health/siteassets/product-factsheet-download/top_pure_care.pdf

Extras Cover

By using this health insurer's "preferred providers" you will have lower out-of-pocket costs on selected allied health services and have access to more "no gap" services. See https://www.queenslandcountry.health/provider-search/premier-provider-network/.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Blood glucose monitors* 12

$2,000 per person 1 appliance(s) every 3 years (combined limit for blood glucose monitors & other services, Sub-limits apply)

  • Per monitor: 100% of charge
Hearing aids* 12

$1,000 limit renews every 3 Membership Years

  • Hearing aid: 100% of charge
Home nursing 12

$1,000 per person Sub-limits apply

  • Initial visit: $50
  • Subsequent visit: $50

Blood glucose monitors*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$2,000 per person 1 appliance(s) every 3 years (combined limit for blood glucose monitors & other services, Sub-limits apply)}

Examples of maximum benefits

{Per monitor: 100% of charge}

Hearing aids*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 limit renews every 3 Membership Years}

Examples of maximum benefits

{Hearing aid: 100% of charge}

Home nursing

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person Sub-limits apply}

Examples of maximum benefits

{Initial visit: $50}

{Subsequent visit: $50}

This policy does not include General treatment (Extras) cover for

Acupuncture
Ante-natal/Post-natal classes
Audiology
Chinese medicine
Chiropractic
Dietetics/dietary advice
Endodontic
Exercise physiology
Eye therapy (orthoptics)
General dental
Health management / Healthy lifestyle
Major dental
Non PBS pharmaceuticals
Occupational therapy
Optical
Orthodontic
Orthotics (podiatric orthoses)
Osteopathy
Physiotherapy
Podiatry
Psychology
Remedial massage
Speech therapy
Vaccinations

For further information about this policy see: https://www.queenslandcountry.health/siteassets/product-factsheet-download/top_pure_care.pdf

Ambulance cover

In SA this policy provides:

Emergency: With a waiting period of 1 day, limited to 1 service per year.

Call-out fees: Will not be paid.

Other features of this ambulance cover: This product provides cover for one emergency ambulance transport service or on-the-sport emergency treatment per person per Membership Year Australia wide. Other conditions apply – for more information please visit https://www.queenslandcountry.health/cover-options/ambulance-cover/.

For further information about this policy see: https://www.queenslandcountry.health/cover-options/ambulance-cover/

Insurer Details

Queensland Country Health Fund

Top Hospital (Gold) $250 excess & Pure Care Extras

$689.98 / month

(Before Rebate, Discount & Loading)

Available in SA

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/QCH/21A/SPGY2Y

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