Intermediate Hospital cover
Medium level hospital cover
If you're looking for a medium level of cover, if you haven't started planning for a family and still feel fit and healthy, or just want cover just in case, our Intermediate Hospital Cover is for you.
With our Intermediate Hospital cover, you’ll be covered for things like accommodation in a private or public hospital, theatre fees, intensive care and many surgical events, but leaves out certain services that you may not need yet.
What you're covered for
Your choice of doctor/hospital
With private hospital cover, you'll avoid potentially long public hospital waiting times and can choose to be treated by your preferred doctor.
Private hospital accommodation
Accommodation in a private hospital for surgeries and procedures.
Reconstructive surgeries for shoulders, knees, etc.
Tonsil and adenoids removal
Hospital admission for removal of tonsils and/or adenoids.
Cover for colonoscopies
Grommets in ears
For treatment of conditions affecting the middle ear.
Cover for gynaecological treatments in hospital.
Treatment for hernias provided in hospital.
For time required to be spent in intensive care.
Surgically implanted prostheses
Benefits for surgically implanted stents, screws and plates (for fractures) and pacemakers.
Medically necessary plastic and reconstructive surgery
Medically necessary cosmetic procedures, such as for burns or major injuries.
Cover for the 25% of cost between the 75% Medicare Benefit and the Medicare Benefits Schedule fee for inpatient services.
Access Gap Cover
The Access Gap benefit, for in-patient services, is a benefit over and above the Medicare Benefits Schedule for participating doctors.
Most pharmaceuticals relating to your admission
Most pharmaceuticals (prescribed medications) relating to your surgery, procedure or hospital admission.
Nursing home type patients
We pay a benefit towards a nursing home patient. This amount is determined by the Federal Government. Certification is required.
Public hospital accommodation as a private patient (intermediate)
If you need to have treatment in a public hospital, you'll be treated as a private patient.
For Members with Intermediate Hospital cover, benefits are available for all included services, as well as restricted services, up to the public hospital default rate.
Hospital cover FAQ
What is Access Gap Cover?
The Access Gap Cover scheme is designed to reduce your out-of-pocket expenses when you receive a service in a hospital.
Under the Access Gap Cover scheme, participating medical practitioners can decide to accept up to the Queensland Country Health Fund fee as full settlement of the account. This means you don’t have to make any additional payments for that particular service.
The doctor can also accept the fee as part of the payment and will inform you of any gap – called the known gap. The known gap is the additional out-of-pocket expenses you will need to pay.
If your doctor doesn’t participate in access gap, we will only cover the 25% between the 75% Medicare Rebate and the Medicare Benefits Schedule fee for inpatient services.
What is an excess?
An excess is the amount you agree to pay towards the cost of your hospital treatment when you're admitted to hospital, in exchange for a lower regular premiums.
When you choose private hospital cover, you can choose the level of excess you want to pay. The higher the level of excess, the lower your premium will be, as you agree to pay a larger sum towards your hospital costs.
At Queensland Country, you can choose an excess of $250 or $500 per person within any one membership year, regardless of the number of times you’re admitted to hospital.
Even on a family membership, regardless of the number of people covered, you’ll only pay the excess once per individual, to a maximum of two excess payments, for the entire family within your membership year. This means a maximum of $500 on a $250 excess option, or $1,000 for a $500 excess option.
|Excess level||Maximum excess per Membership year|
Also, under our Top Hospital cover, we don’t charge any excess on children aged 12 years or under if they need to be admitted to hospital for medical treatment.*
Your chosen excess applies to the full cost of hospitalisation at a public, private or day hospital facility. Once the excess has been paid, we take care of the rest, so you can enjoy the full benefits of your private health insurance.
Please note that if you do not have Extras cover and physiotherapy, for example, is required in hospital as part of your treatment, then you will not be covered for these services if they are invoiced separately by the physiotherapist. This is also the case for any allied services (exercise physiology, dietetic etc.) covered under one of our extras products.
*The excess exemption for children 12 years and under is NOT applicable under our Intermediate Hospital cover.
What is a pre-existing condition?
A pre-existing ailment, illness or condition is one where signs or symptoms of the condition were present at any time during the six months prior to applying for membership of Queensland Country Health Fund or an upgrade of your existing cover, determined by a Queensland Country appointed medical practitioner. You may have a pre-existing condition, ailment or illness without even being aware of it.
If we find that a pre-existing condition was present, you will need to serve a 12 month waiting period before claiming benefits for treatment. It isn’t necessary for the signs or symptoms to have been diagnosed by a doctor at the time of joining or upgrading your cover.
The 12 month waiting period for pre-existing ailments can be applied to all hospital (or hospital substitute) treatments for which we pay benefits. There are a couple of exceptions; a two month waiting period applies to the following services:
- Approved rehabilitation treatment
- Palliative care
A 12 month waiting period applies to obstetrics (pregnancy) related services. Surgery for assisted fertility programs such as IVF or GIFT, sterilisation or vasectomy and surgical extractions attract a 12 month waiting period.
The 12 month waiting period for the treatment of a pre-existing ailment can also apply to Extras services.
What are out-of-pocket expenses for hospital treatment?
Out-of-pocket expenses are the additional costs once all Medicare and private health insurance benefits have been expended. Usually, out-of-pocket expenses apply when you’re not fully covered for a particular treatment or service, or when a set benefit limit applies. Discovering you’ll be out of pocket can be a tough pill to swallow, especially after being discharged from hospital, or once your treatment is complete.
It’s your right to know if there are any out-of-pocket expenses that you might incur as part of your treatment, to avoid any surprises later. Knowing the cost of your medical treatment upfront is called Informed Financial Consent, and the Government has introduced a checklist, providing you with the questions you need to ask before going into hospital.
We recommend contacting us before going into hospital so that we can discuss what your policy provides cover for, and if any out-of-pocket expenses will apply. We’ll also supply you with a copy of the checklist. By talking to us before going into hospital, you’ll have the total picture and can avoid any unwanted surprises later.
What is public hospital cover?
Public hospital cover is exactly what its name suggests - cover for treatment in a public hospital.
Public hospital is our most basic level of hospital cover for people who want to be treated as a private patient in a public hospital. Basically this lets you choose your own doctor (if they're willing and able to treat you in a public hospital). We'll pay for the cost of shared ward accommodation (up to the level prescribed by the Minister for Health), if you're admitted as a private patient.
If you choose to be admitted in a private room, you'll have to pay further out-of-pocket expenses. It doesn't help with avoiding waiting times in the public system, and if you go to a private hospital or day surgery you'd also have high out-of-pocket expenses.
Public Hospital cover is not available for purchase online.
What is hospital cover?
Hospital cover protects you and your family if you need to go to hopsital, by covering most of the major expenses that come with hospital treatment.
Having hospital cover means you don't need to be concerned about public hospital waiting periods, as well as giving you access to your choice of hospital and your choice of doctor in most cases.