Document ID: chunk:federal_register_of_legislation:F2024C01114:clause:3_8
Version: federal_register_of_legislation:F2024C01114
Segment Type: clause
Provision Reference: sch 3 cl 8
Character Range: 92573–94317

8                                                           Examples of maximum benefits—other
                                                            For each treatment covered by the policy, other than the treatments covered by item 7—examples of the maximum benefits that are payable when an insured person visits a practitioner who is not a preferred service provider, expressed using whichever of subparagraphs (b)(i) and (ii) of item 7 is applicable.

                                                            For this item:
                                                             (a) if examples are given for initial and subsequent visits, examples must be for
                                                             individual sessions; and
                                                             (b) if:
                                                             (i) optical treatment is covered; and
                                                             (ii) benefits for frames and lenses are paid separately;
                                                              the example must be expressed as the sum of the benefit for each component.
                                                            Note 1: If treatments are listed for the purposes of paragraph (o) of item 3, examples of maximum benefits for those treatments must be given.
                                                            Note 2: This item does not limit the information that a private health insurer may give to an insured person.
                                                            Note 3: The insurer may provide information about the benefits that apply if treatment is through a preferred provider.