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Private health cover. What's in it for me?
Peace of mind
Nobody has a crystal ball. Be prepared for whatever happens.
Avoid long waitlists
Receive elective medical treatment sooner rather than later.
Freedom to choose
Choose the doctor or surgeon who treats you in hospital.
Avoid Financial Penalties
Avoid paying the MLS and LHC if you have Hospital cover.
Stay Well Blog
What's a PHIS? Why do I need one?
What’s a Private Health Information Statement (PHIS)?
Your Private Health Information Statement (PHIS) is a high-level overview of the health cover you’ve selected.
It outlines the key features of your cover and the general waiting periods.
When you first join us, or if you change your level of cover, we send you access to your Private Health Insurance Statement. It’s commonly called a PHIS (fizz!) and it’s got lots of details that are important for you to check in on.
So, what’s a PHIS and why do I need it?
The PHIS is designed to help you understand what’s covered by your policy and to help you to be able to compare it easily with others available across the market.
It’s a standardised government template to ‘explain’ your health cover.
Every PHIS for any private health insurance policy in Australia can be found and compared on the privatehealth.gov.au website.
So, if you’ve got Hospital or Extras cover (or both), you’ll be able to look at yours to make sure the cover you have is still the right one for you.
What your PHIS will tell you
This is the info you’ll be able to find in your PHIS:
Any inclusions, restrictions and exclusions on your Hospital cover.
Your excess amount (if you need to go to hospital).
Waiting periods for the cover (but not if you’ve served them or not).
Whether your cover may exempt you from paying the Medicare Levy Surcharge.
What’s covered by your Extras cover and some examples of the benefits.
Any inclusions on your Extras cover, and some examples of benefits.
What you won’t find in your PHIS
PHIS documents are a standard government template, so they don’t go into the whole detail of your specific cover as it relates to being a member of RT Health.
For the best view of your cover and what’s included, read your PHIS in conjunction with your RT Health cover guide(s) and current Annual Policy Statement (you’ll be able to access this at the same time as your PHIS each year).
The following info isn’t available on the PHIS.
Your actual (net) premium. Keep in mind that the premiums outlined in PHIS documents are general and don’t consider your personal circumstances (like where you live, any LHC loading you need to pay, any Australian Government Rebate on Private Health Insurance you claim or any discounts you receive).
How you pay and how often you pay (e.g., monthly, quarterly, yearly).
Who’s covered by your membership.
The level of government rebate you’re claiming (if any).
If you have any Lifetime Health Cover loading.
We’re here to help
We’re always here to help if you need a hand. We can talk you through your PHIS, or help you make sure the cover you’re on is the one that’s best for you.
Just call our friendly team us on 1300 886 123 (Monday to Friday, 8:30am-5:00pm AEDT/AEST) or reach out via email to help@rthealth.com.au
Meet our member. Di Elsom
Meet our Member. Di Elsom
When it comes to fitness, the common adage is ‘use it or lose it’. That’s something RT Health member Di Elsom is keeping in mind in her quest to stay fit, strong and active in her 80s.
We met Di recently at one of our Sydney Branch2U events.
A larger-than-life character, Di was only too happy to share her fitness story, as well as some tidbits about her interesting life and her time with RT Health.
Fit and healthy – at any age
Twice every week you’ll find a group of committed and strong ladies taking part in the Balmoral Baby Boomers sessions.
Ladies in their 60s, 70s and 80s joined together with a strong purpose in mind. Staying fit, active and strong.
Against the backdrop of the picturesque Balmoral Oval, they’re taken through their paces, with the united aim to stay ‘fit, strong and straight’.
RT Health member Di Elsom is a passionate attendee.
She’s also an advocate (and some may also say an advertisement) for maintaining fitness and health in maturity.
RT Health connections
Di became an RT Health member back in 2004 when her late husband, a pilot, joined up.
And, she’s always been pleased with the service and benefits she’s received.
Since then she’s retained her membership, seeing no reason to move from the fund that has served her well.
And she’s received great comments from providers and friends when discussing the benefits she receives.
“I remember when I was getting two pairs of glasses, sunglasses and something else, they said, ‘Oh, your health fund pays out well; pays out more than a lot of health funds.’
Plus, Di says it’s easy to get in touch with the RT team when she has a question.
“If ever I want to make an enquiry, I just call up. It’s pretty simple.”
Avoiding out-of-pocket costs when going to hospital
Avoiding out-of-pocket costs when going to hospital
We all hope our hospital stays are few and far between. But at RT Health, we like to make things simple. And, we want you to get great value from your cover. That means avoiding as many out-of-pocket costs and unexpected bills as you can.
With just a few simple questions at stages throughout the planning for hospital process, you’ll be able to get the info you need to be prepared for your hospital stay.
As an RT Health member with private hospital cover, you can choose to be treated in either a private or public hospital. Your choice will depend on your level of cover and the type of treatment you’re having.
Keep in mind that even as a private patient in a public hospital, it’s possible you’ll be placed on a waiting list.
TALKING TO YOUR DOCTORS
Visit your GP
You might know the drill. You need a referral from your GP to see a specialist doctor (like a surgeon, for instance) to kick off the whole planned procedure process.
Finding a specialist
Finding the right specialist for you is important when it comes to managing your health and avoiding or limiting your out-of-pocket costs. Your treating doctor is really your choice.
You have the right to ask your GP for another referral if you’re not happy with the specialist they’ve suggested, or you can also ask for an ‘open referral’. This means you can choose from a list of appropriately qualified specialists and select the one who suits you best.
(Remember, any specialist consultations or treatments you receive outside of hospital can’t be claimed under your private hospital insurance. Hospital insurance only applies once you are admitted as an inpatient to hospital.)
Our Find a Doctor tool can help you see if your doctor/specialist has previously participated in our Medicover program.
DON’T BE AFRAID TO ASK QUESTIONS
It’s important to make sure you fully understand your planned procedure. Knowing all the relevant information is part of informed clinical consent. You want to get the best value from your private hospital cover as well, so asking your specialist about any out-of-pocket costs is vital.
RT Health’s Medicover program can help curb out-of-pocket costs. It’s a ‘gap cover scheme’ that helps us provide benefits to cover some or all of any gap payments.
Doctors can elect to participate on a case-by-case basis, so you’ll need to check in with your treating specialists to see if they’ll participate for your treatment (more on this below).
GET INFORMED
When you visit your specialist, you’ll learn about the treatment options recommended for you. Now’s the time to gather information, so make sure you receive an itemised quote to help guide your decision making.
Your doctor should be able to give you a breakdown of the cost of your treatment. This is known as informed financial consent. You should also ask about any out-of-pocket costs that you may incur from other treating specialists or care providers (like assisting surgeons, anaesthesiologists or pathology testing).
Here are some questions to ask your specialist when it comes to your medical costs.
What are the MBS item numbers for my treatment and what will be the charge for each of these items?
Can I have a written quote or advice on costs of my procedure (and any out-of-pocket costs), including fee estimates for any other treating doctors, so I can review before agreeing to the treatment?
Will you treat me under RT Health’s Medicover program?
How and when will I be billed for any out-of-pocket costs?
Talking to your hospital
If you choose to go to a public or private hospital that’s contracted with RT Health, your hospital fees should generally be covered (as long as you’re covered for the treatment you’re having). However, it’s always good to ask some specific questions of the hospital before your admission.
Here’s a few handy questions that will help you find out if you’ll be up for additional hospital costs:
Will I have to pay a gap for my hospital accommodation?
What costs will I have to pay out of my own pocket during my time in hospital? (It’s good to know that things like TV, internet, parking, magazines, newspapers aren’t included).
If you have an excess, when does it need to be paid, and how?
Give RT Health a call
As soon as you know that you’ll be having a hospital stay, give us a call. We’ll be able to confirm with you that your hospital fees will be covered, depending on how you’re being treated (public vs. private).
We’ll also be able to help you have peace of mind knowing what bills you may expect to get from your treatment (hopefully very few!). We’ll chat with you about:
the treatment/procedure you’re having and making sure you’re covered
any restrictions you may have on your cover
making sure the hospital you’re booked in with is contracted with RT Health
any waiting periods and/or pre-existing conditions (if you’re a newer member or have recently changed your cover)
making sure your membership is paid up-to-date and any payments you’ll need to make before your treatment
your excess (if you have one).