Document ID: chunk:federal_register_of_legislation:F2024L00144:reg:65:p33
Version: federal_register_of_legislation:F2024L00144
Segment Type: reg
Provision Reference: reg 65 (pt 33/38)
Character Range: 138434–143634

Meaning of general treatment

general treatment      (1)       General treatment is treatment (including the provision of goods and services) that:
                          (a)     is intended to manage or prevent a disease, injury or condition; and
                          (b)     is not hospital treatment.

                    (Division 121, Private Health Insurance Act 2007)

                    Further information about general treatment can be found in the Private Health Insurance (Health Insurance Business) Rules 2018.

General Treatment categories (HRF 601.1 headings)

These are examples only based on the types of services covered under General Treatment Products. This is not a comprehensive listing of all services.

Under the new legislation some of the items historically collected in this section are considered to be excluded from General Treatment.  Therefore, insurers can only provide benefits for them as part of a complying health insurance product under the provisions of the Private Health Insurance Act 2007 paragraph 69-1 (1) (b) and the Private Health Insurance (Complying Product) Rules 2015 Rule 7. Some of them will be considered health related business rather than health insurance business.

Accidental Death/Funeral Expenses                              Funeral parlour, burial or cremation expenses. These benefits are being phased out under paragraph 69-1 (1) (b) of the Private Health Insurance Act 2007 and Rule 7 of the Private Health Insurance (Complying Product) Rules 2015.

Acupuncture/Acupressure                                        Acupuncture.
                                                               Acupressure.

Ambulance                                                      Emergency ambulance transport, anywhere in Australia to the nearest appropriate hospital able to provide the level of care required, provided by an Ambulance Service

                                                               OR

                                                               Non-emergency ambulance transport, anywhere in Australia, provided by an Ambulance Service.

Chiropractic                                                   Chiropractic, Chiropractic X-Rays

Community, Home, District Nursing                              Treatment for illness, disease, incapacity or disability when the purpose of treatment is dependent on nursing care excluding hospital-substitute treatment.

Dental                                                         Comprehensive examination or consultation.
                                                               Dental X-ray.
                                                               Clean, polish, Fluoride treatments.
                                                               Scale & clean.
                                                               Custom-made mouthguard.
                                                               Tooth fillings.
                                                               Crowns and bridges.
                                                               Full upper or lower Denture.
                                                               Major dental work.
                                                               Periodontics, endodontics, dentures and surgical extraction of teeth.

Dietetics                                                      Dietitian and nutritionist.

Domestic Assistance                                            A benefit for home assistance provided by councils.

Ex gratia Payments                                             Payments for services not covered under the rules of the insurer. For example, the insurer may pay for drugs not normally covered as a gesture of good will.

Preventative health products/Health management programs        Weight loss/ Weight management programs.
                                                               Quit smoking, nicotine replacement therapy.
                                                               Disease management association fees (Asthma, Diabetes, Heart, Arthritis and Coeliac).
                                                               Cancer Council UV products (30+ sunscreen, rash vests and suits, hats, wrap sunglasses).

Hearing Aids and Audiology                                     Hearing Aids, Hearing Aid repair.
                                                               Cochlear Speech Processor.

Hypnotherapy                                                   Hypnotherapy.

Maternity Services                                             Pre and post-natal consultation and classes.
                                                               Midwife delivery services.

Natural Therapies                                              Alexander technique, Aromatherapy, Naturopathy, Biochemist, Bowen Therapy, Feldenkrais, Herbalist, Homeopathy, iridology, Kinesiology and One on One Pilates, Rolfing, Reflexology, Remedial Massage, Shiatsu.

Occupational Therapy                                           Occupational Therapy.

Optical                                                        Single