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i understand better Medibank Comprehensive OSHC Membership Guide Effective May 2016 What’s inside Your guide to membership Welcome to membership of Medibank Comprehensive Overseas Student Health Cover (OSHC). This guide will tell you about your cover and what you can and cannot claim for. Your guide to membership 3 Ambulance services 12 It also includes a summary of the policies of Glossary of definitions 4 What is covered? 12 Medibank as they apply to OSHC membership. Your membership 6 What is not covered? 12 This Membership guide forms part of the terms and conditions of your Comprehensive Types of membership available Waiting periods 13 OSHC with Medibank. All members of and who can be covered 6 Other important membership Comprehensive OSHC are subject to the Expatriate Australian students 7 information 13 terms and conditions and policies contained Norwegian and Swedish students 7 Keeping your premiums up to date 13 in this guide, as varied from time to time. Belgian students 7 Lapsed cover 14 Please read the Membership guide carefully and contact Medibank if there is anything When does your cover start? 7 Changing your personal details 14 you do not understand or if you want more Your membership card 7 Adding your partner and children 14 information about your cover. What you are covered for 8 Adding a newborn to your cover 15 Keep this guide in a safe place together Public hospital 8 Changing your resident status 15 with your other Medibank documents. Private hospital 9 Transferring from another Long term hospital treatment 9 Australian OSHC insurer 15 Obstetrics and pregnancy-related Your premiums and length services 9 of membership 15 Medical services 9 Goods and Services Tax (GST) 16 What you are not covered for 10 Refunding premiums 16 Public and private hospital 10 Making claims 17 Online claims 17 Medical services you are not This guide applies to Medibank Comprehensive Overseas Student Health Cover only covered for 10 Postal claims 17 You should read this guide in conjunction with the Cover summary General items you are not covered for 10 Termination of membership 17 that you would have received when you joined or changed your cover. Prescription medicines 11 Medibank Online 18 If you did not receive, or no longer have, your Cover summary please contact What is covered? 11 Medibank OSHC Privacy Statement 18 Medibank on 134 148 or visit medibankoshc.com.au for more information. What is not covered? 11 Your feedback 19 Resolution of complaints 19 2 Membership guide Membership guide 3 Glossary of definitions The following definitions explain the meaning Inpatient Partner Same day admission of some of the words and phrases used A person who has been formally admitted A person who lives with the Policy holder An admission to, and discharge from, throughout this guide. to a registered hospital for the purpose in a marital or de facto relationship and is a hospital or day hospital facility on the Benefit of obtaining professional attention. a non-resident of Australia. same day (ie. where the stay does not This includes same day admissions. extend beyond midnight). An amount of money payable by Medibank Policy holder to, or on behalf of, a member for an expense Medicare A student in whose name an application for Surgically implanted prostheses approved by Medibank. Australia’s national health care system which membership of Medibank Comprehensive The Federal Government publishes a Calendar year provides permanent Australian residents OSHC has been accepted. This is usually the prostheses list that sets out the minimum with access to treatment as public patients in first-named person on the membership card. benefits health funds must pay to members A 12-month period commencing 1 January public hospitals and subsidised treatment by Unless approved by Medibank, a person aged with hospital cover for these items. and ending 31 December. doctors and other health care professionals. under 16 is not eligible to be a Policy holder. If you are going to be admitted to hospital Cosmetic treatment Medicare Benefits Schedule (MBS) Pre-existing condition for a procedure in which a prosthesis is A service that is not clinically necessary to be surgically implanted or applied, we A schedule that lists all the services for Medibank may refuse benefits for any claim that can’t be billed to Medicare. Under all recommend that, before admission, you ask which Medicare pays benefits, and the rules made in the first 12 months of membership Medibank covers, no benefits are payable your doctor to provide you with an estimate that apply to the payment of those benefits. where, in the opinion of a medical toward procedures or hospital costs for the cost of the prosthesis they will be Each service has a fee (the MBS fee) that practitioner appointed by Medibank, signs or associated with cosmetic treatment or using for your procedure. Once you know has been set by the Australian Government symptoms of an ailment, illness or condition procedures not recognised by Medicare. how much the prosthesis will cost you should for the purpose of calculating the Medicare related to that claim were in existence at then provide your doctor with Informed Department of Immigration benefit payable for that service. any time during the six months before the Financial Consent and it is preferable that and Border Protection (DIBP) commencement of that cover. Members’ Choice hospital this is in writing. You can obtain an Informed The Australian Government Department A private hospital: Prescription medicine Financial Consent form from your doctor. of Immigration and Border Protection A medicine that may be legally obtained You will need to speak with us, your doctor is responsible for, among other things, • with which Medibank has an agreement only where prescribed by a medical or and your hospital to confirm what your likely immigration and entry, stay and departure to provide greater value to our members dental practitioner to treat a particular out-of-pocket expenses are going to be. arrangements for non-citizens. by way of capped fees or higher benefits for accommodation or treatment, and medical condition. Benefits are not payable for any prosthesis Dependant • that is part of Medibank’s Members’ Prescription medicine co-payment associated with an excluded service under A person who is: your cover. Choice network. The amount you are required to pay towards • a partner of an Overseas Student, or To find a Members’ Choice hospital go to the cost of each prescription medicine Theatre fees • a child or a step-child of an Overseas medibank.com.au and click on Find a before benefits are payable by Medibank. Costs of procedures performed in an operating Student who is not married (or in a de facto Health Provider. This amount is reviewed each year. room of a hospital or day surgery facility. relationship) and has not turned 18. Non Members’ Choice hospital Professional attention Visa Length Health Cover Hospital treatment A private hospital that is not part of In relation to hospital treatment means: OSHC for which the Policy holder makes one This means: Medibank’s Members’ Choice network. • medical or surgical treatment by or under payment that covers the entire period of their the supervision of a medical practitioner student visa. • hospital accommodation and nursing care Outpatient for the purpose of permitting professional • obstetric treatment by or under the A patient who receives medical attention Waiting period attention, and supervision of a medical practitioner at a hospital outpatient department or or a registered nurse with obstetric The period of time a member must wait • the provision of a surgically implanted accident and emergency department, but qualifications, after taking out cover before they can prosthesis on the Australian Government’s is not formally admitted to the hospital. • dental treatment by or under the receive a benefit for services or items Prostheses List. An outpatient may be charged both hospital supervision of a dental practitioner, or included on their cover. No benefits are fees and doctors’ or specialists’ fees. • podiatric treatment by or under the payable for any items or services obtained supervision of a podiatrist who has while serving a waiting period. been accredited by the Minister of Health. 4 Membership guide Membership guide 5 Your membership Types of membership available Expatriate Australian students When does your cover start? and who can be covered A dependant child is not eligible to remain If you are an expatriate Australian coming • if you pay your premium before you arrive It is a condition of most student visas to have on a Comprehensive OSHC family to Australia on a student visa to undertake in Australia: your cover starts from the private health cover for the duration of your membership from the date of his/her formal studies, and you are not eligible for date of your arrival. If you arrive on a date visa. Medibank Comprehensive OSHC is eighteenth (18th) birthday. Medicare, you are required to take out OSHC other than your expected date of arrival, please contact us so that our records designed for people who are the holders Your Partner and/or dependants can for the full length of your student visa. can be changed to reflect the appropriate of a student visa or: be covered under a couple or family commencement date. You will need to membership only if they: Norwegian and Swedish students • is an applicant for a Student Visa; and bring your passport and membership card Most Norwegian and Swedish students • is the holder of a Bridging Visa; and • are authorised to enter Australian (if you already have one) with you to make under your Student Visa; and studying in Australia are covered by health this change • was, immediately before being granted the insurance arrangements provided by their Bridging Visa, the holder of a Student Visa.

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