CoreElect vs Mid Hospital/Essential Extras

CoreElect vs Mid Hospital/Essential Extras

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* Based on an Australian Government Rebate of %, % LHC loading, $ excess for a in . Please note the amount quoted may vary after 1 April due to base price changes and rounding adjustment.

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Your new hospital cover - Mid Hospital (Basic Plus)

Effective 1 April 2019

Our CoreElect product will be discontinued from 1 April 2019. As CoreElect is a combined hospital and extras product, you’ll be transferred to the product combination of Mid Hospital (Basic Plus) and Essential Extras on 1 April 2019 - it’s almost the same as your CoreElect cover, except for the differences highlighted below.

Depending on whether you have a $300 or $500 excess now, we’ll transfer you to Mid Hospital (Basic Plus) with the same level of excess. And the good news is, on Mid Hospital (Basic Plus) there’s no excess for child dependants under 21. To add to this, we’ll waive all waiting periods for the services you weren’t previously covered for.

 

What does Basic Plus mean?

As part of the Federal Government’s Private Health Insurance Reforms, all health funds are required to align their hospital products to the new Standard Clinical Categories and Gold/Silver/Bronze/Basic product tiers. We’re also required to include the tier in the names of all Hospital products, so from 1 April 2019 we’ll refer to Mid Hospital as Mid Hospital (Basic Plus).

Mid Hospital (Basic Plus), like CoreElect, has restrictions – meaning that for some clinical categories you’re covered as a private patient in a public hospital.

Under the new rules, only Basic policies are allowed to have restrictions (besides rehabilitation, hospital psychiatric services and palliative care). We wanted to make as few changes to our products as possible which means that the only tier Mid Hospital can fit into is ‘Basic Plus’. The 'Plus' just means that we’ve exceeded the minimum requirements for the ‘Basic’ tier.

CoreElect compared to Mid Hospital Basic +

Legend

Covered
Not Covered
Restricted

Scope of cover

Additional Information
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Increased cover. Major eye and eye lens surgery were previously Restricted. From 1 April 2019, these services will be Covered.
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Increased cover. Female sterilisation was previously Restricted. From 1 April 2019, this service will be Covered.
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Increased cover. Male sterilisation was previously Restricted. From 1 April 2019, this service will be Covered.
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Detrimental change. Hospital admissions for vascular system are changing from Covered to Restricted. This is due to the grouping of the new clinical categories - Heart and Vascular system are grouped together. If we had chosen to cover this service, it would have had a significant impact on premiums.
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect
Current
1 April 2019
Same as CoreElect

Note: Restricted cover - For restricted services provided in a public hospital, we pay for accommodation in a shared room (as long as the hospital doesn’t charge more than the default rate set out by the Federal Government), and medical costs.

For a definition of each clinical category, visit the Department of Health website.

For more information on Mid Hospital please see here.

Your new Extras Cover - Essential Extras

Effective 1 April 2019

With the Federal Government’s Private Health Insurance Reforms coming into effect on 1 April 2019, we’ve taken the opportunity to review our product range to ensure it aligns with the new legislation, as well as with our members’ changing needs.

Essential Extras is the default Extras cover that you’ll be transferred to on 1 April 2019. It’s almost the same as your CoreElect cover, except for the differences highlighted below.

And the good news is, we’ll waive all waiting periods for your new cover.

All limits below are annual limits unless stated otherwise.*

General Dental

CoreElect: $500 per person/$1,000 per family

Essential Extras: $500 per person

Optical

CoreElect: $165 per person/$330 per family

Essential Extras: $200 per person

Healthy Lifestyle

CoreElect: $150 per person/$300 per family

Essential Extras: $150 per person

Pharmaceuticals

CoreElect: $400 per person/$800 per family

Essential Extras: $300 per person

Elect Extras

Under CoreElect, you get up to $250 for each Elect-Extras service, up to an overall limit of $1,100 per person ($2,200 per family).

Under Essential Extras, there’s no ‘Elect-Extras’ umbrella. The individual annual limits for Essential Extras are as follows:

  • Major Dental/Orthodontia - $300 per person ($2,500 lifetime limit for Orthodontia)
  • Chiro/Osteo - $250 per person
  • Physio/Exercise Physiologist - $300 per person
  • Podiatry - $200 per person
  • Psychology - $250 per person
  • Natural therapies - $400 per person. Please note that from 1 April 2019, health insurers will not be permitted to cover some Natural Therapies.

We’re required to remove some Natural Therapies

Due to the Federal Government’s Private Health Insurance Reforms, we are no longer permitted to cover some natural therapy services from 1 April 2019.

See below for information on what will be removed and what will still be covered after 1 April 2019.

If you claim for a service that will be removed, we encourage you to make the most of your benefits while they’re available. The service must be provided by 31 March 2019, but you can submit your claim up to two years after the service date.

 

Removed:

  • Alexander technique
  • Aromatherapy
  • Bowen therapy
  • Buteyko
  • Feldenkrais
  • Homeopathy
  • Kinesiology
  • Naturopathy
  • Reflexology
  • Shiatsu
  • Western herbal medicine

You can still use your Natural Therapies limit to claim for:

  • Remedial massage
  • Acupuncture
  • Chinese herbal medicine
  • Myotherapy

Healthy lifestyle

Removed:

  • Pilates (including Pilates classes run by a physiotherapist or exercise physiologist)
  • Yoga

You can still use your Healthy Lifestyle limit to claim for:

  • Gym membership**
  • Recognised weight management programs**^
  • Disease management subscriptions/memberships
  • Recognised health screening services/preventative screenings (where a Medicare benefit is not payable)