Value Plus Hospital Cover
Our most extensive hospital product
Value Plus Hospital cover is our most extensive hospital product – it’s most popular with people who want greater peace of mind, paying benefits for a wide range of inpatient hospital services like pregnancy, heart related procedures, major eye surgery and joint replacement surgery.
Best suited for couples, singles and families wanting our highest level of hospital cover.
- Our highest level of hospital cover
- Cover for private hospital accommodation^
- Doctors’ fees for services provided in a hospital^
- Cover for most major surgeries^
- Choose from a $250 or $500 excess
- Access to our Care Navigation service
- Excellent benefits for mechanical aids and appliances
- Combine with any of our extras products
^ Once all applicable waiting periods have been served. Some services are excluded or restricted on this level of cover; for these services there is no benefit payable (excluded services) or reduced benefit entitlement (restricted services). See below for further details.
What you're covered for
Your choice of doctor or 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 other inpatient procedures not listed as a restricted or excluded service.
Fees that a hospital charge for the usage of the operating room and equipment.
Surgically implanted prostheses
Surgically implanted stents, screws and plates (for fractures) and pacemakers. Prosthesis benefits as per the Government listing.
For time required to be spent in intensive care.
Tonsils and adenoids removal
Surgery to remove the adenoids and tonsils.
Removal of the appendix.
Cover for colonoscopies, which is a prodedure to examinate the colon (large intestine or bowel).
Grommets in ears
For treatment of conditions affecting the middle ear.
Cover for gynaecological treatments in hospital.
Treatment for hernias provided in hospital.
Reconstructive surgeries for shoulders, knees, etc.
Including herniated discs and vertebral fusion surgeries.
Including biopsies and craniotomy.
Plastic and reconstructive surgery
Surgical specialty involving the restoration, reconstruction, or alteration of the human body (excludes cosmetic surgery).
In-hospital rehabilitation treatment
Rehabilitation for hospital services with a restricted benefit entitlement will have reduced benefit eligibility. Rehabilitation services for hospital services with that are excluded will receive no benefit.
Access Gap cover
A benefit over and above the Medicare Benefits Schedule for participating doctors on inpatient services.
We'll do our best to avoid the jargon to help make your cover easy to use and understand, but there's some that are ticky to ignore. We recommend getting to know the difference between 'inpatient' Vs 'outpatient' services. Hospital accommodation and medical costs can only be paid if you're an 'inpatient' and admitted to hospital or day surgery at the time of treatment.
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 in a shared room
If you need to have treatment in a public hospital, you'll be treated as a private patient in a shared room.
Pregnancy and birth-related services
Obstetric related services
Assisted reproductive services
Includes services such as IVF.
Heart related surgeries
Cardiac and cardiac related services, for example, open heart surgery.
Major eye surgery
Includes cataract surgery and surgery for other major eye conditions. Does not include laser surgery to restore vision.
Treatment for kidney failure, for example, chronic renal failure.
Hip and knee joint replacement surgey
Surgery that involves complete removal of the damaged joint and tissues to be replaced with an artificial prosthesis.
Mechanical appliances and artificial aids and appliances
Under our mechanical aids and appliances benefit on our Value Plus Hospital cover, we pay up to 85% of the cost of a selected range of mechanical aids and appliances approved by Queensland Country, such as a blood pressure monitor, glucometer, tens machine, crutches, walking frames, wigs etc.
A limit of $2,000 per person per Membership Year applies. Sublimits may apply to benefits for some aids or appliances.
Benefits are not available on second hand equipment or on consumables. For some mechanical aids, the benefit is for short term hiring (up to 3 months). The purchase of some machines and monitors are limited to once every 3 years from the initial date of purchase (see the next section on benefit replacement periods).
A letter of referral from your doctor or practitioner and/or evidence of a recent medical episode or hospitalisation may be required to accompany a claim for benefits.
Please contact us before purchasing an aid or appliance to check these requirements and what benefits may be payable. Cover for mechanical aids and appliances is not available on our Value Hospital.
Benefit replacement period
A benefit replacement period applies to certain mechanical aids and appliances. This
means once you’ve been paid a benefit for a particular aid, you’ll need to wait a period of
three years from the date of purchase of the item before you’re entitled to a benefit for the
replacement of that item. Benefit replacement periods apply per Member.
|BENEFIT REPLACEMENT PERIOD||ITEMS|
Blood glucose monitors (glucometer)
Blood pressure monitor
Tens machine (not circulation booster)
Mammograms and bone density test
Benefit up to $75 limited to 2 services for each of the these tests, only if not claimable from another source. The Membership Year limit is $300 per person covered.
A benefit amount is provided to use over three Membership Years based on the date of which the purchase of a hearing aid/s is made. The benefit limit applies based on your length of membership with Queensland Country.
- up to 10 years $1,000,
- 10-15 years $1,500, and
- 15 years+ $2,000.
Benefits are per person and are calculated at 85% of purchase cost up to the appropriate benefit limit.
Australian Hearing Services
Benefit of $25 per Membership Year per eligible person for the cost of a Hearing Services Card.
A benefit up to $50 per visit or $150 per day, up to $1,000 per person per membership year is payable for:
- Bush nursing services provided by a registered nurse employed at a public hospital or bush nursing centre where there is no resident medical practitioner
- Home nursing services provided by a registered nurse in private practice
A benefit up to $150 per day, up to $750 per person per membership year is payable for clinically relevant special nursing provided by a registered nurse in private practice.
Benefits up to $35 per day to a maximum of four days per person, where such accommodation is necessary for the wellbeing of the patient.
Care Navigation provides assistance immediately following a period of time in hospital or for those living with one or more chronic diseases.