Document ID: chunk:federal_register_of_legislation:F2024L00146:front:0:p8
Version: federal_register_of_legislation:F2024L00146
Segment Type: other
Provision Reference: 
Character Range: 30644–36060

Policy Treatment Type                                                                       Means the type of treatment covered by a policy. The policy treatment types are:
                                                                                                   * General Treatment Only;
                                                                                                   * Hospital And General Treatment Combined; and
                                                                                                   * Hospital Treatment Only.

Policy Cover Type                                                                           Means the type and number of people covered by a policy.

                                                                                            The policy cover types are:
                                                                                                   * Single;
                                                                                                   * Family;
                                                                                                   * Single Parent;
                                                                                                   * Couple;
                                                                                                   * Two Plus Persons No Adults; and
                                                                                                   * Three Plus Adults.

Private Health Insured Person Age                                                           Means the age of the insured person at the date of treatment, or where no treatment is provided, the age of the person at the end of the reporting period.

                                                                                            Where an insured person changes age during an episode:

                                                                                            a)      the episode is to be reported in the age that the episode was finalised;
                                                                                            b)     the days and benefits are to be reported for the age in which they were incurred (e.g. a 20 day episode with an accommodation cost of $200 per day, where the insured person turned 50 on day 4, is reported as: 1 episode under 50, 3 days under 49 and 17 days under 50, $600 under 49 and $3,400 under 50)
                                                                                            Note: apportionment of benefits by the number of days in each age only relates to the case where the treatment covers more than one age, for example an invoice is received for accommodation for a period where the person had a number of days in one age and a number of days in another age. In the case where individual treatments are paid during a single episode where the person moves from one age to another the benefits paid for those treatments should be reported against the age of the person as at the date of the treatment. Do not sum all benefits paid over an episode spanning two ages and then apportion them over the ages; and
                                                                                            c)      services are reported under the age at the date of treatment.

Private Hospital Insurance Product Tier Type                                                Means the private hospital insurance product tiers as listed in Schedule 4 of the Private Health Insurance (Complying Product) Rules 2015.

                                                                                            The private hospital insurance product tier types are:
                                                                                                   * Basic;
                                                                                                   * Bronze;
                                                                                                   * Silver; and
                                                                                                   * Gold.

Medical Devices Or Human Tissue Products (hospital and hospital substitute treatment type)  Means a treatment related to medical devices or human tissue products of the kinds listed in the Rules made under item 4 of the table in section 333-20 of the PHI Act.

Risk Equalisation Jurisdiction                                                              Means the risk equalisation jurisdiction as defined in the Private Health Insurance (Prudential Supervision) Act 2015.

                                                                                            The jurisdictions are:

                                                                                                   * New South Wales (NSW);
                                                                                                   * Victoria (VIC);
                                                                                                   * Queensland (QLD);
                                                                                                   * South Australia (SA);
                                                                                                   * Western Australia