Alphabet Soup

We know health funds tend to throw around a few terms that can make understanding private health cover hard. And we forgive anyone for being confused when it comes to the number of acronyms used across the market.

RT Health, HCF… and the rest. It seems we’re always looking for a shortcut to explain often complex topics and themes. So, what does it all mean? We’re committed to making it simple for our members, so we’ve put together this handy reference to explain some of the trickier terms you’ve probably seen before.

PBS

PHARMACEUTICAL BENEFITS SCHEME

The Pharmaceutical Benefits Scheme (PBS) is funded by the federal government and makes subsidised prescription medicines available to Australian residents.

MLS

MEDICARE LEVY SURCHARGE

A surcharge that applies to people earning over a certain income when they don’t have hospital cover. If you’re single and earn more than $90,000, or a family or couple earning more than $180,000 a year (increasing by $1,500 for each dependant child after the first), you can avoid any additional Medicare Levy Surcharge by having hospital cover

PHI

PRIVATE HEALTH INSURANCE

Insurance to provide hospital cover outside of the public system and/ or cover for services not covered by Medicare such as physiotherapy, optometry, general dental and podiatry services.

HICAPS

HEALTH INDUSTRY CLAIMS AND PAYMENT SERVICE

HICAPS is an electronic health claims system that allows health fund members to easily make claims on the spot at their health service provider.

LHC

LIFETIME HEALTH COVER

Lifetime Health Cover is a federal government initiative that rewards people for taking out hospital cover at an early age and maintaining that cover throughout their lifetime

PHIS

PRIVATE HEALTH INFORMATION STATEMENT

A high-level overview of your cover; it outlines the key features of your cover and the general waiting periods.

MBS

MEDICARE BENEFITS SCHEDULE

Set benefits for specified medical services that Medicare (the government) will pay for through the Medicare system.

APRA

AUSTRALIAN PRUDENTIAL REGULATION AUTHORITY

The Australian Prudential Regulation Authority (APRA) is an independent statutory authority that supervises institutions across banking, insurance and superannuation, and promotes financial system stability in Australia.

PHIO

PRIVATE HEALTH INSURANCE OMBUDSMAN

The Private Health Insurance Ombudsman provides an independent service to help consumers with health insurance problems and enquiries.