Health Insurance Coverage

The CAA health and dental insurance offers you favourable rates and flexible options.

How much does my health insurance cover?

As a rule, personal health insurance is subdivided into general health insurance for hospitals, general health insurance (also known as additional or extra cover) and protection for ambulances. Unlike most insurance types, in Australia there is no such thing as "risky" health insurance. There is no way for personal health insurance companies to deny insurance to a single individual and they must calculate the same premiums for the same coverage levels for everyone, despite their own health risks and probability of receiving health care.

Insurances are of different kinds and provide different services. Ask your health insurance company to know exactly what you are insured for. Hospitals insurance gives you the right to select your own physician and determine whether you will be admitted to a government clinic or a privately owned clinic attended by your physician.

When you are a privately insured person in a privately owned clinic, you may also have more options as to when you are hospitalized. When you are a privately insured person in a government clinic, the queue of the government clinic will continue to be used. If you are hospitalized, you can decide whether you want to be hospitalized in the Medicare system or in the home system:

Personal health insurance covers you against some or all of the extra expenses you incur if you are a privately insured person in a government or privately insured clinic. The Medicare Medicare Benefits Schedule (MBS) covers 75% of the Medicare Benefits Schedule (MBS) charge for the associated healthcare expenses. If you have the appropriate health insurance, your health insurance company will pay the other 25% of the MBS-charge.

You may also be billed for some or all of the cost of your personal coverage, including medical accommodations, drama expenses, critical medical supplies, medication, bandages and other supplies, prosthetics (surgically implanted), diagnostics, medication and extra medical charges. However, some mutual insurance schemes also provide "gap coverage" to partially or fully meet the cost of the medical treatment charge for hospitals and the Medicare combination and health insurance benefits.

There are also some who offer coverage for alternative forms of medical care known as extended health insurance. Like any other insurance, you can administer your coverage by opting for a fully all-risk insurance with higher premium rates or paying lower premium rates for lower coverage. Can' what be insured? Health insurance that you buy has some restrictions on your ability to receive care in hospitals that may involve the following:

Exceptions - special service not included at all. Limitations - Minor scope of coverage of services, which means you will have higher outlays. Reduced care is not enough to meet the total costs of hospitalization and you have to bear the balance.

Limitations - which provide one or more flat-rate payments for one or more contracted service (s) for a specified amount of consecutive months after the limit has expired and provide full service after that date. Medicare does not provide care for surgical or inpatient care - Medicare provides care for all health care necessary to keep you healthy, but does not provide coverage for options such as an elective plastic surgery. However, Medicare does not provide care for any other health care needs.

Long-term care home survivors - If you have been in hospitals for more than 35 consecutive nights, you will be considered a long-term care or long-term care home unless your physician determines otherwise. That means that after the start phase you will have to spend more on the costs of your treatment in hospitals.

However, the 1973 Health Insurance Act does not allow health insurers to pay these costs. Singles vs. Multi-bed rooms - some hospitals guidelines provide full coverage for a multi-bed room, but no singles. According to your directive, this restriction may be applied in a privately owned clinic, a publicly owned clinic or both.

When you are accepted into a private room and your insurance does not fully meet the expenses, the host institution should notify you that you will have to make a payment for the balance between the fund's benefits and the hospital's burden. You can also ask your health insurance company for more information about your insurance. The general coverage of medical care (also known as supplementary insurance) provides insurance against some or all of the expenses of medical care provided by healthcare professionals.

Your coverage will depend on the nature of the insurance you choose and may comprise the following services: dentistry, surgery, home care, pediatrics, physical therapies, ergotherapy, speech therapies, ophthalmology, prostheses etc. Can' what be insured? Almost all general care related activities are only partially included.

A number of certain types of provision may not be included at all. Read the Standard Information Statement for each insurance in which you are interested and ask your insurance company for further information on these restrictions. The Medicare does not pay for the costs of emergencies or other rescue work. Insurance for this type of care can be organised as part of your general care programme or as a separate insurance scheme.

Your health insurance policy varies according to the country you are in. Further information can be found in the Outpatient Clinic section of the website.