From
30.50

per week

Price quoted is for Top Hospital only cover for a single, including 25.934% government rebate and $500 excess.

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Top Hospital cover

Our highest level of hospital cover

If you’re worried about public hospital waiting times, and want to ensure you and your family can see the doctor of your choice, then Top Hospital cover is for you.

With our Top Hospital cover, you’ll get comprehensive insurance that covers you for things like accommodation in a private or public hospital, theatre fees, intensive care and many surgical events, plus you can choose the excess level that suits you and your family that you pay towards any in-patient treatment.

What you're covered for

Everything you're covered for under our Top Hospital Cover
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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.

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Private hospital accommodation

Accommodation in a private hospital for surgeries and procedures not listed as a restricted or excluded service. 

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Intensive care

For time required to be spent in intensive care.

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Surgically implanted prostheses

Benefits for surgically implanted stents, screws and plates (for fractures) and pacemakers.

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Medical gap

Cover for the 25% of cost between the 75% Medicare Benefit and the Medicare Benefits Schedule fee for inpatient services.

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Colonoscopies

Cover for colonoscopies

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Grommets in ears

For treatment of conditions affecting the middle ear.

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Gynaecological services

Cover for gynaecological treatments in hospital.

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Hernia repair

Treatment for hernias provided in hospital.

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Joint reconstructions

Reconstructive surgeries for shoulders, knees, etc.

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Assisted reproductive services

Includes services such as IVF.

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In-hospital psychiatric treatment

A benefit limitation period (BLP) of two years (24 months) applies to in-hospital psychiatric treatment for all policies commencing on or after 1 December 2015.

Hospital benefits payable on these hospital services during the designated benefit limitation period will be the minimum benefit declared by the Minister for Health and Ageing, except when a waiting period hasn't been fully served, in which case no benefit applies.

BLPs don't apply to new Members transferring from another private insurer, or for existing Members changing your level of hospital cover, as long as you transfer within 63 days of ceasing your previous cover. If you hadn't fully served your waiting periods under your previous cover, you'll be required to finish serving these waiting periods before you'll be entitled to benefits in a private or public hospital.

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Heart related surgeries

Cardiac and cardiac related services, e.g. open heart surgery.

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Major eye surgery

Includes cataract surgery and surgery for other major eye conditions. Does not include laser surgery to restore vision.

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Gastric banding and obesity surgery

A benefit limitation period (BLP) applies.

A BLP of two years (24 months) applies to bariatric surgery (weight loss surgery) including but not limited to gastric banding, gastric sleeving/diversion and gastric bypass surgery, including replacement, repair of adjustments.

Hospital benefits payable on these hospital services during the designated BLP will be the minimum benefit declared by the Minister for Health and Ageing, except when a waiting period hasn't been fully served yet, in which case no benefit applies.

BLPs don't apply to new Members transferring from another private insurer, or for existing Members changing your level of hospital cover, as long as you transfer within 63 days of ceasing your previous cover. If you hadn't fully served your waiting periods under your previous cover, you'll be required to finish serving these waiting periods before you'll be entitled to benefits in a private or public hospital.

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Access Gap Cover

The Access Gap benefit, for in-patient services, is a benefit over and above the Medicare Benefits Schedule for participating doctors.

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Most pharmaceuticals relating to your admission

Most pharmaceuticals (prescribed medications) relating to your surgery, procedure or hospital admission.

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Nursing home type patients

We pay a benefit towards a nursing home patient. This amount is determined by the Federal Government. Certification is required.

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Mechanical aids and appliances

Benefit up to 85% of the cost or hire of approved mechanical appliances and artificial aids.

Mechanical aids and appliances are covered on our Top Hospital product. Covered products include: blood pressure monitors, glucometers, tens machines, crutches, walking frames, wigs etc. A limit of $2,000 per person per Membership Year applies. Benefit replacement periods apply on certain mechanical aids.

Benefits are not available on second hand equipment or on consumables. A benefit is payable for short term hiring (up to 3 months) of some mechanical aids and the purchase of some machines and monitors is limited to once every three years.

* Excluding repairs and consumables (mask and tubing) for CPAP machines which are paid at 85% of cost up to $250 once every 12 months, within the $2,000 per person per Membership Year limit for mechanical aids and appliances.

Tens machine (not circulation booster): Sub limit of 85% of cost up to $250 per person per membership year.

Pleaset note: A letter of referral from your doctor or practitioner may be needed. Please contact us before purchasing an aid or appliance to check these requirements and what benefits may be payable.

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Mammograms and bone density test

Mammograms and bene density tests are covered on our top Hospital product. A benefit up to $75, limited to 2 services for each of these tests. Claims are subject to there being no Medicare benefit payable. The Membership Year limit is $300 per person covered.

Also includes benefits for digital mammography and breast tomosynthesis.

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Hearing aids

 

Hearing aids are covered on our Top hospital product.  A benefit amount is provided to use over a period of three (3) Membership Years based on the date of which the first purchase of a hearing aid/s is made.

The benefit limit is applied based on your length of membership with Queensland Country Health Fund:

  • Up to 10 years: $1,000
  • 10-15 years: $1,500
  • 15+ years: $2,000.

Benefits are per person and calculated at 85% of purchase cost up to the appropriate limit of benefit.

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Nursing

Benefits are paid for nursing on our Top Hospital product, as follows:

  • Special – Benefit of up to $150 per day limited to $750 per person covered.
  • Home – Benefit up to $15 per visit or $60 per day limited to $600 covered.
  • Bush – Benefit up to $15 towards the cost of treatment with an annual limit of $300 per person.

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Hospital boarder

Benefits up to $35 per day to a maximum of four days per person listed on the membership.

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Renal dialysis

Treatment for kidney failure, e.g. chronic renal failure.

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Hip and knee joint replacement surgery

A benefit limitation period (BLP) of two years (24 months) applies to hip or knee joint replacements.

Hospital benefits payable on these hospital services during the designated BLP will be the minimum benefit declared by the Minister for Health and Ageing, except when a waiting period hasn't been fully served, in which case no benefit applies.

BLPs don't apply to new Members transferring from another private insurer, or for existing Members changing your level of hospital cover, as long as you transfer within 63 days of ceasing your previous cover. If you hadn't fully served your waiting periods under your previous cover, you'll be required to finish serving these waiting periods before you'll be entitled to benefits in a private or public hospital.

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Public hospital accommodation as a private patient

If you need to have treatment in a public hospital, you'll be treated as a private patient.

Hospital cover FAQ

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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.

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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 levelMaximum excess per Membership year
  SingleCouple/Family
$250 $250 $500
$500 $500 $1000

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.

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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.

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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.

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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.

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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.