Private Health Information Statement - Combined policy

Bronze Plus Essential Hospital $350 Excess Combined Cover

RT Health - a division of The Hospitals Contribution Fund

Monthly Premium

$186.78 #

(before any rebate, loading or discount)

Covers only one person

Available in NSW & ACT

Closed to new members

# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading or an insurer discount. Check with your insurer for details.

Hospital cover

This policy exempts you from the Medicare Levy Surcharge.

This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.

This policy includes cover for

Hospital Cover Legend
BloodGastrointestinal endoscopyPain management with device
Bone, joint and muscleGynaecologyPalliative care
Brain and nervous systemHernia and appendixPlastic and reconstructive surgery (medically necessary)
Breast surgery (medically necessary)Implantation of hearing devicesPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
Chemotherapy, radiotherapy and immunotherapy for cancerJoint reconstructionsSkin
Dental surgeryKidney and bladderSleep studies
Diabetes management (excluding insulin pumps)Lung and chestTonsils, adenoids and grommets
Digestive systemMale reproductive systemHospital psychiatric services
Ear, nose and throatMiscarriage and termination of pregnancyRehabilitation
Eye (not cataracts)Pain management

This policy does not include cover for

Hospital Cover Legend
Assisted reproductive servicesDialysis for chronic kidney failureJoint replacements
Back, neck and spineHeart and vascular systemPregnancy and birth
CataractsInsulin pumpsWeight 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 $350 per admission. This is limited to a maximum of $350 per person 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
  • 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 lets you find out more about the cost of specialist medical services.

General Treatment Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: 100% back on a range of no-gap services through our More for Teeth program, and no-gap network providers, subject to your cover, waiting periods and annual limits. Find out more: https://www.rthealth.com.au/health-services/find-a-dental-clinic.
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental*2$300 per service up to $600 per policy
(combined limit for general dental, major dental, endodontic, optical, physiotherapy, chiropractic, remedial massage, osteopathy, vaccinations & other services)
Periodic oral examination - 70% of charge
Scale & clean - 70% of charge
Fluoride treatment - 70% of charge
Major dental12Surgical tooth extraction - 70% of charge
Full crown veneered - 70% of charge
Endodontic12Filling of one root canal - 70% of charge
Optical2Single vision lenses & frames - 70% of charge
Multi-focal lenses & frames - 70% of charge
Physiotherapy2Initial visit - 70% of charge
Subsequent visit - 70% of charge
Chiropractic2Initial visit - 70% of charge
Subsequent visit - 70% of charge
Remedial massage2Initial visit - 70% of charge
Subsequent visit - 70% of charge
Osteopathy2Initial visit - 70% of charge
Subsequent visit - 70% of charge
Vaccinations2Per service - 70% of charge
RT Health members pay no gap on a range of popular dental services through HCF Dental Centres and the More for Teeth provider network. Annual, service and sub limits apply.

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

General treatment legend
AcupunctureNon PBS pharmaceuticalsPsychology
Blood glucose monitorsOrthodonticOther treatments - check with your insurer
Hearing aidsPodiatry

Other features of this general treatment cover

A $180 sub-limit applies for optical services.

Ambulance cover

In NSW & ACT this policy provides:

Emergency: Unlimited with a waiting period of 1 day.

Call-out fees:  will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover

Unlimited cover for emergency ambulance attendance and transportation, and medically necessary, non-emergency ambulance transportation. The service must be provided by a state government operated, authorised, or approved ambulance scheme. Cover applies anywhere in Australia.

Disclaimer

The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.

Not Covered

These categories are not covered by this policy.