Private Hospital Cover can only provide benefits towards services received when you are admitted into hospital, or where the fund has arrangements with providers for services such as Chronic Disease Management and Obstetric programs.

There are some services that your hospital cover does not provide benefits for:

• Treatment received while not admitted into hospital – i.e. outpatient services, GP and Specialists visits,
• Treatment received in the Emergency Department of a hospital, including emergency department facility fees,
• Treatment that does not have a Medicare item number,
• Services rendered in conjunction with a hospital stay where an Extras item number is raised – for example, where you are admitted into hospital for dental surgery (ie. wisdom teeth removal) and a dental item number is billed. The hospital stay and any medical and theatre items will be paid under Hospital Cover, but a relevant level of Extras cover is required to receive any benefit on the Dental items billed, and
• Pharmaceuticals and medications provided on discharge from hospital.

An Excess is an amount you agree to pay towards your treatment if you are hospitalised, usually to reduce the premium of your cover without compromising what you are covered for.

The Excess is payable on admission to hospital once per person, per calendar year, regardless of how many times you may need to go to Hospital and does not apply to dependant children on a policy.

Excess example: You have ExtrasJar Health Bronze Plus Essentials Hospital with a $750 Excess.

On admission to hospital you pay your $750 excess to the hospital for your first admission.

If you are re-admitted in the same calendar year, you will not have to pay your excess again.

A Co-payment is an amount in addition to your nominated Excess, that is payable by you every time you are admitted to hospital for a minimum of one night (ie. not day surgery).

Co-Payments do not apply to day admissions or to dependant children listed on a policy.

Here’s an example of how the co-payments work:

Co-payment example: You have a hospital cover with a $250 excess and $300 co-payment

On admission to hospital you pay your $250 excess and where you stay for a minimum of one night, you will also be required to pay your $300 co-payment.

If you’re re-admitted in the same calendar year (again for a minimum of one night), you will not have to pay your excess, however you will still be required to pay your $300 co-payment.

If you’re admitted again before the end of the calendar year and stay overnight you’ll continue to be required to pay your $300 co-payment each time for each admission.

At ExtrasJar, looking after your health and wellbeing is about more than supporting you while you’re unwell.

This is why we offer a range of Health Management Programs with all ExtrasJar Hospital covers with no additional or out-of-pocket cost to eligible members.

Our Health Management Programs are designed to provide support to members living with chronic conditions such as Diabetes, Cardiovascular Disease, or bone conditions as well as those preparing for, or recovering from a hospital admission. What is included in each program is unique depending on your individual needs.

If you’re interested in learning more about any of the above programs or would like to enroll, please call our hospital cover partner Phoenix Health Team on 1800 028 817 or email enquiries@phoenixhealthfund.com.au – looking after you is what we’re here for and what we love to do!