healthslips.com.au Policy Information

Queensland Country Health Fund

Top Hospital (Gold) $500 excess & Select Care Extras

$648.4 / 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: One adult & dependants, including non-student dependants (2 or more people, only one of whom is an adult).

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/2L1B/SPMU1Y

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 $500 per admission. This is limited to a maximum of $500 per person and $1000 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_select_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
Chiropractic* 2

$500 per person up to $1,000 per policy

combined limit for chiropractic & remedial massage

  • Initial visit: $44
  • Subsequent visit: $28
Endodontic* 12

$600 per person up to $1,200 per policy

combined limit for endodontic & major dental

  • Filling of one root canal: $119
General dental* 2

$400 per person up to $800 per policy

  • Fluoride treatment: $19
  • Scale & clean: $71
  • Periodic oral examination: $44
Health management / Healthy lifestyle* 2

$125 per person up to $250 per policy

  • Health management: $125
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
Major dental* 12

$600 per person up to $1,200 per policy

combined limit for endodontic & major dental

  • Surgical tooth extraction: $126
  • Full crown veneered: $560
Non PBS pharmaceuticals* 2

$400 per person up to $800 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per eligible prescription: $55
Optical* 2

$245 per person up to $490 per policy

  • Multi-focal lenses & frames: $245
  • Single vision lenses & frames: $245
Orthotics (podiatric orthoses) 2

$400 per person up to $800 per policy

combined limit for orthotics (podiatric orthoses) & podiatry

sub-limits apply

  • Orthotics supply & fit: 100% of charge
Physiotherapy* 2

$500 per person up to $1,000 per policy

sub-limits apply

  • Initial visit: $44
  • Subsequent visit: $37
Podiatry* 2

$400 per person up to $800 per policy

combined limit for orthotics (podiatric orthoses) & podiatry

  • Initial visit: $32
  • Subsequent visit: $32
Remedial massage* 2

$500 per person up to $1,000 per policy

combined limit for chiropractic & remedial massage

  • Initial visit: $33
  • Subsequent visit: $33
Vaccinations* 2

$400 per person up to $800 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: $55

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}

Chiropractic*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $1,000 per policy}

{combined limit for chiropractic & remedial massage}

Examples of maximum benefits

{Initial visit: $44}

{Subsequent visit: $28}

Endodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: $119}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

Examples of maximum benefits

{Fluoride treatment: $19}

{Scale & clean: $71}

{Periodic oral examination: $44}

Health management / Healthy lifestyle*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$125 per person up to $250 per policy}

Examples of maximum benefits

{Health management: $125}

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}

Major dental*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Surgical tooth extraction: $126}

{Full crown veneered: $560}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per eligible prescription: $55}

Optical*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$245 per person up to $490 per policy}

Examples of maximum benefits

{Multi-focal lenses & frames: $245}

{Single vision lenses & frames: $245}

Orthotics (podiatric orthoses)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for orthotics (podiatric orthoses) & podiatry}

{sub-limits apply}

Examples of maximum benefits

{Orthotics supply & fit: 100% of charge}

Physiotherapy*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $1,000 per policy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: $44}

{Subsequent visit: $37}

Podiatry*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for orthotics (podiatric orthoses) & podiatry}

Examples of maximum benefits

{Initial visit: $32}

{Subsequent visit: $32}

Remedial massage*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per person up to $1,000 per policy}

{combined limit for chiropractic & remedial massage}

Examples of maximum benefits

{Initial visit: $33}

{Subsequent visit: $33}

Vaccinations*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: $55}

Hearing aid limit increases with length of membership – up to 10 years $1,000, 10-15 years $1,500, and 15 years + $2,000. Benefits on the purchase (or hire where applicable) of Health Appliances and Services approved by Queensland Country Health Fund with a limit of $2,000 per person per Membership Year (sub-limits and benefit replacement periods apply to some items). Please contact Queensland Country Health Fund regarding benefit availability prior to purchasing an Appliance or Service.

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

Acupuncture
Ante-natal/Post-natal classes
Audiology
Chinese medicine
Dietetics/dietary advice
Exercise physiology
Eye therapy (orthoptics)
Occupational therapy
Orthodontic
Osteopathy
Psychology
Speech therapy

Other features of this general treatment cover: Health management (Healthy Living benefit) provides benefits towards the costs of metabolic dieticians or nutritionists consultations to assist with weight management, diabetes education consultations, quit smoking programs, skin checks for skin cancers (except where there is a Medicare benefit), bowel screening and bone density tests, a second yearly prostate specific antigen test not covered by Medicare, supermarket tours conducted by a dietitian or other allied health professional qualified to provide nutrition advice, and gym memberships/personal training sessions provided under an approved health management or chronic disease management program. Please contact the insurer for full details.

For further information about this policy see: https://www.queenslandcountry.health/siteassets/product-factsheet-download/top_select_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) $500 excess & Select Care Extras

$648.4 / 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/2L1B/SPMU1Y

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