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  • 8/14/2019 Hi Templatedfgd

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    Dear $

    "n %e&al' (' $ ) certi'y t&at t&e '(ll(+in, pers(n-s.

    Primary Applicant/ >Sec(ndary Applicant -2./ >Sec(ndary Applicant -./ >

    is3are$ (r +ill immediately *p(n t&eir arrival in A*stralia %e$ c(vered %y ins*rance t&at is at least as c(mpre&ensive as t&e minim*m level (' ins*rance re5*ired %y t&eA*stralian Department (' )mmi,rati(n and #iti6ens&ip set (*t at Attac&ment A7 T&e ins*rance

    pr(d*ct s*pplied %y is and +ill %epr(vided '(r t&e peri(d 8

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    Attachment A

    Insurance benefits at least equivalent to:

    a. Public hospital admitted patient treatment$ a %ene'it e5*al t( t&e State and Territ(ry &ealt&a*t&(rity ,a6etted rates '(r ineli,i%le patients '(r/

    (verni,&t and day (nly &(spital acc(mm(dati(n -all c(sts incl*din,/ all t&eatre$ intensivecare$ la%(*r +ards$ +ard dr*,s.=

    emer,ency department 'ees t&at lead t( an admissi(n= admitted patient care and p(st (perative services t&at are a c(ntin*ati(n (' care ass(ciated

    +it& an early disc&ar,e 'r(m &(spital7

    N(te/ '(r t&e p*rp(se (' clarity t&is incl*des all admitted treatments c(vered %y t&e edicare Bene'it Sc&ed*le7

    %. Surgically implanted prostheses n( ,ap pr(st&eses and ,ap permitted pr(st&eses as listed int&e Private 4ealt& )ns*rance -Pr(st&eses. *les 2??@/ Bene'it at least e5*al t( 1?? ('minim*m %ene'it am(*nt listed7

    c. Pharmacy all PBS listed dr*,s t&at are prescri%ed acc(rdin, t( t&e PBS appr(ved indicati(ns$t&at are administered d*rin, and '(rm part (' an admitted epis(de (' care 8 a %ene'it e5*al t( t&ePBS listed price in e:cess (' t&e patient c(ntri%*ti(n7

    N(te/ F(r t&e p*rp(se (' clarity$ t&is de'initi(n is intended t( incl*de t&e c(st (' PBS listed dr*,s administeredp(st disc&ar,e i' t&ey '(rm part (' t&e admitted epis(de (' care7

    d. Medical services admitted medical services +it& an BS item n*m%er 1?? (' t&eedicare Bene'its Sc&ed*le 'ee$ (r less i' t&e patient is c&ar,ed less7

    e. Ambulance services 1?? (' t&e c&ar,e$ t&at is n(t (t&er+ise c(vered %y t&ird partyarran,ements$ '(r transp(rt %y am%*lance pr(vided %y$ (r *nder an arran,ement +it&$ a,(vernment appr(ved am%*lance service +&en medically necessary '(r admissi(n t( &(spital$emer,ency treatment (n8site$ (r inter8&(spital trans'er '(r emer,ency treatment7

    N(te/ F(r t&e p*rp(se (' clarity$ t&is de'initi(n is intended t( incl*de inter8&(spital trans'ers t&at are necessary%eca*se t&e (ri,inal admittin, &(spital d(es n(t &ave t&e re5*ired clinical 'acilities7 )t d(es n(t e:tend t( trans'ersd*e t( patient pre'erences7

    Other minimum health insurance policy features

    '. Informed Financial Consent)ns*rers +ill ma;e availa%le mem%ers&ip eli,i%ility c&ec;in, t( &(spitals t( ena%le t&e

    pr(visi(n (' in'(rmed 'inancial c(nsent t( mem%ers (n admissi(n7

    ,. aiting periodsT( c(mply +it& t&e minim*m level (' &ealt& ins*rance$ t&e (nly +aitin, peri(ds t&at may%eimp(sed are/ 12 m(nt&s '(r pre,nancy related c(nditi(ns= 12 m(nt&s '(r pre8e:istin, c(nditi(ns applied in a +ay t&at is c(nsistent +it& Secti(n @81 ('

    t&ePrivate Health Insurance Act 20077 2 m(nt&s '(r psyc&iatric$ re&a%ilitati(n and palliative care$ re,ardless (' +&et&er (r n(t t&e

    c(nditi(n is a pre8e:istin,7

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    &. !"cluded treatmentsT( c(mply +it& t&e minim*m level (' &ealt& ins*rance$ t&e (nly admitted patient treatments t&atmay %e e:cl*ded are/ Assisted repr(d*ctive treatments= !lective c(smetic treatments= B(ne marr(+ and (r,an transplants=

    )ns*rance p(licies may als( e:cl*de t&e '(ll(+in,/ Treatment rendered (*tside (' A*stralia incl*din, treatment necessary en r(*te t( (r 'r(m

    A*stralia= Treatment arran,ed in advance (' t&e ins*reds arrival in A*stralia= Services and treatment +&ic& are c(vered %y c(mpensati(n and dama,es pr(visi(ns (' any ;ind

    N(te/ ins*rers are n(t re5*ired t( e:cl*de t&ese treatments7 A decisi(n t( c(ver t&em is at t&e discreti(n (' t&e ins*rer7

    i. #lobal annual benefit limitsT( c(mply +it& t&e minim*m level (' &ealt& ins*rance$ t&e per pers(n per ann*m$ %ene'it m*st n(t

    %e less t&an C1 milli(n d(llars7

    9. PortabilityT( c(mply +it& t&e minim*m level (' &ealt& ins*rance$ +&en determinin, +aitin, peri(ds$ ins*rersm*st rec(,nise previ(*s len,t& (' mem%ers&ip (n a p(licy &eld +it& an(t&er A*stralian ins*rer t&atmeets t&e minim*m standards7 T&at is/

    &en trans'errin, %et+een A*stralian %ased ins*rers +&ere t&e c*st(mer &as %een a mem%er ('

    t&e previ(*s '*nd '(r ,reater t&an 12 m(nt&s$ +aitin, peri(ds (' n( ,reater t&an 12 m(nt&s +illapply t( t&e &i,&er level (' %ene'its7

    &en trans'errin, %et+een A*stralian %ased ins*rers +&ere t&e c*st(mer &as %een a mem%er ('t&e previ(*s '*nd '(r less t&an 12 m(nt&s$ any *nserved +aitin, peri(ds +ill need t( %ec(mpleted +it& t&e ne+ '*nd and i' increasin, t&e level (' c(ver (r %ene'its$ additi(nal +aitin,

    peri(ds (' n( ,reater t&an 12 m(nt&s +ill apply t( t&e &i,&er level (' %ene'its7 T&ese +aitin,peri(ds are served c(nc*rrently7

    T( c(mply +it& t&e minim*m level (' &ealt& ins*rance an ins*rer m*st a,ree t(/ ,rant a mem%er +&( see;s t( trans'er %et+een A*stralian %ased ins*rers$ c(ntin*ity (' c(ver '(r

    *p t( 0? days 'r(m t&e date t&ey leave t&e previ(*s ins*rer= and pr(vide mem%ers$ +&( terminate t&eir p(licy$ +it& a clearance certi'icate$ appr(ved %y t&e

    Department (' )mmi,rati(n and #iti6ens&ip$ +it&in 1 days (' t&e date (' terminati(n (r t&e

    date (' n(ti'icati(n (' t&e terminati(n$ +&ic&ever is t&e later7

    ;. $uy out clausesT( c(mply +it& t&e minim*m level (' &ealt& ins*rance$ a p(licy m*st n(t c(ntain a %*y (*t cla*set&at &as t&e e''ect (' terminatin, t&e ins*rers lia%ilities in e:c&an,e '(r a pre8determined l*mp s*m

    payment7

    l. Arrears

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    T( c(mply +it& t&e minim*m level (' &ealt& ins*rance an ins*rer +ill all(+ '(r acceptance ('premi*ms '(r E? days 'r(m t&e last 'inancial date (' mem%ers&ip +it&(*t terminatin, t&emem%ers&ip7 )ns*rers are n(t (%li,ated t( pay '(r treatments received d*rin, any arrears peri(d*ntil and *nless t&e arrears are paid '(r t&e relevant peri(d7Attachment $

    ) a*t&(rise t( ded*ct per 'r(m my +a,es '(r &ealt& ins*rance premi*ms t( %e paid t( and '(r it t( %e paid int( t&e '(ll(+in, acc(*nt (n my %e&al'/

    Si,nat*re (' Primary Applicant/