Private Health Information Statement - Combined policy

Basic Plus Public Hospital and Deluxe Extras

RT Health - a division of The Hospitals Contribution Fund

Monthly Premium

$427.82 #

(before any rebate, loading or discount)

Covers one adult & dependants (2 or more people, only one of whom is an adult)

Available in South Australia

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.

This policy covers children and other dependants up to and including the age of 21, students up to and including the age of 30, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.

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
Assisted reproductive servicesEye (not cataracts)Miscarriage and termination of pregnancy
Back, neck and spineGastrointestinal endoscopyPain management
BloodGynaecologyPain management with device
Bone, joint and muscleHeart and vascular systemPalliative care
Brain and nervous systemHernia and appendixPlastic and reconstructive surgery (medically necessary)
Breast surgery (medically necessary)Hospital psychiatric servicesPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
CataractsImplantation of hearing devicesPregnancy and birth
Chemotherapy, radiotherapy and immunotherapy for cancerInsulin pumpsRehabilitation
Dental surgeryJoint reconstructionsSkin
Diabetes management (excluding insulin pumps)Joint replacementsSleep studies
Dialysis for chronic kidney failureKidney and bladderTonsils, adenoids and grommets
Digestive systemLung and chestWeight loss surgery
Ear, nose and throatMale reproductive system

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: No excess

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 lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

This cover is only suitable for public hospital treatments. If you are treated in a private hospital, you will have significant out-of-pocket expenses.

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 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 and https://www.rthealth.com.au/health-services/find-an-optical-provider.
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental*2$800 per personPeriodic oral examination - 60% of charge
Scale & clean - 60% of charge
Fluoride treatment - 60% of charge
Major dental12$1,200 per person
(combined limit for major dental, endodontic & other services)
Surgical tooth extraction - 60% of charge
Full crown veneered - 60% of charge
Endodontic12Filling of one root canal - 60% of charge
Orthodontic12$1,000 per person
$2,500 lifetime limit
Braces for upper & lower teeth, including removal plus fitting of retainer - 100% of charge
Optical*2$300 per personSingle vision lenses & frames - 100% of charge
Multi-focal lenses & frames - 100% of charge
Non PBS pharmaceuticals2$400 per person up to $800 per policyPer eligible prescription - $50.00
Physiotherapy2$850 per person
(combined limit for physiotherapy, chiropractic, podiatry, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, speech therapy & other services)
Initial visit - $58.00
Subsequent visit - $48.00
Chiropractic2Initial visit - $47.00
Subsequent visit - $37.00
Podiatry2Initial visit - $42.00
Subsequent visit - $32.00
Psychology2$550 per personInitial visit - $75.00
Subsequent visit - $60.00
Acupuncture2$600 per person up to $1,200 per policy
(combined limit for acupuncture, remedial massage & chinese medicine)
Initial visit - $38.00
Subsequent visit - $31.00
Remedial massage2Initial visit - $40.00
Subsequent visit - $37.00
Hearing aids24$1,000 per person
1 appliance(s) every 3 years
(combined limit for hearing aids & audiology)
Hearing aid - $1,000.00
Blood glucose monitors12$200 per service up to $400 per policy
(combined limit for blood glucose monitors & other services - Sub-limits apply)
Per monitor - $200.00
Audiology2Combined limit - see Hearing aidsInitial visit - $70.00
Subsequent visit - $70.00
Chinese medicine2Combined limit - see AcupunctureInitial visit - $37.00
Subsequent visit - $27.00
Dietetics/dietary advice2Combined limit - see PhysiotherapyInitial visit - $50.00
Subsequent visit - $50.00
Exercise physiology2Combined limit - see PhysiotherapyInitial visit - $40.00
Subsequent visit - $40.00
Eye therapy (orthoptics)2Combined limit - see PhysiotherapyInitial visit - $42.00
Subsequent visit - $32.00
Health management / Healthy lifestyle2$300 per person up to $200 per service up to $600 per policy
(Sub-limits apply)
Health management - 70% of charge
Home nursing2$400 per person up to $800 per policyInitial visit - $22.00
Subsequent visit - $22.00
Occupational therapy2Combined limit - see PhysiotherapyInitial visit - $52.00
Subsequent visit - $45.00
Orthotics (podiatric orthoses)12$200 per personOrthotics supply & fit - 80% of charge
Osteopathy2Combined limit - see PhysiotherapyInitial visit - $51.00
Subsequent visit - $39.00
Speech therapy2Combined limit - see PhysiotherapyInitial visit - $65.00
Subsequent visit - $55.00
RT Health members pay no gap on a range of popular dental and optical services through HCF Dental or Optical Centres and the More for provider network. Includes mental health services (psychology, approved counselling, mental health social worker and OCBT courses). Health aids include blood pressure monitors, CPAP machines & masks, tens machines, wheelchairs, wigs (conditions apply). Annual, membership, service and sub limits apply.

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

General treatment legend
Other treatments - check with your insurer

Other features of this general treatment cover

Benefits available for Myotherapy. Health management / Healthy lifestyle includes approved weight loss, stress management and quit smoking programs, MRI Scans not claimable through Medicare & skin tests. Benefits for Tai Chi, Yoga and Pilates are payable at 100% of the cost, subject to applicable sub‑limits and conditions. Annual limits, sub‑limits and membership limits apply. Contact the fund for further details.

Ambulance cover

In South Australia this policy provides:

Emergency: with a waiting period of 1 day, limited to $5,000 per person per year.

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

Other features of this ambulance cover

Up to $5,000 per person per year for emergency ambulance attendance or transportation in the case of accident or illness. Cover applies anywhere in Australia. You can also purchase additional ambulance cover through a state government ambulance service.

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.