Document ID: chunk:federal_register_of_legislation:F2024L00144:reg:65:p35
Version: federal_register_of_legislation:F2024L00144
Segment Type: reg
Provision Reference: reg 65 (pt 35/38)
Character Range: 147427–150857

121, Private Health Insurance Act 2007 and Private Health Insurance (Health Insurance Business) Rules 2018).

Speech Therapy                                                 Speech therapy.

Theatre Fees                                                   Procedure room.
                                                               Outpatient theatre fee.
                                                               Medical gases (such as oxygen).

Travel and Accommodation                                       Accommodation expenses for parent/partner to accompany a patient who is an in-patient of a public or private hospital.

                                                               Travel costs where a patient receives treatment at a hospital more than a specified distance from a patient's home. In circumstances where the patient chooses not to be an in-patient.

Part 10 Lifetime Health Cover

Lifetime Health Cover           A private health insurer must increase the amount of premiums payable for hospital cover in respect of an adult if the adult did not have hospital cover on his or her lifetime health cover base day.

Lifetime health cover           The amount of the increase is worked out as follows:

Lifetime health cover age       In relation to an adult who takes out hospital cover after his or her lifetime health cover base day, means the adult's age on the 1 July before the day on which the adult took out the hospital cover.

Lifetime health cover base day  Is generally the 1 July following the adult's 31st birthday.

                                (Division 34, Private Health Insurance Act 2007)

                                Except for Norfolk Island residents for whom it is the later of 1 July 2017 or the 1 July following the resident's 31st birthday

base rate                       Means the amount of premiums that would be payable for hospital cover before any discounting.

                                If the person was born on or before 1 July 1934 then Lifetime health cover does not apply to the person.

                                (Division 34, Private Health Insurance Act 2007)

Certified age of entry          Is the lifetime health cover age.

Loading                         Is the percent above the base rate that the adult must pay for membership   up to a maximum of 70%.

Loading removed                 A private health insurer must stop charging premiums above the base rate for hospital cover in respect of an adult, if the adult has had hospital cover:

                                   (a)        for a continuous period of 10 years; or
                                   (b)       for a period of 10 years that has been interrupted only by permitted days without hospital cover (none of which count towards the 10 years).

                                (Division 34, Private Health Insurance Act 2007)

                                   (c)        Note: permitted days without hospital cover is defined in 34-20 of the Private Health Insurance Act 2007.

Part 11 Total Hospital Treatment Medical Services Statistics

Agreement                Means an agreement entered into between a medical practitioner, within the meaning of that term in subsection 3 (1) of the Health Insurance Act 1973, and an insurer under which the practitioner agrees to accept payment by the insurer in satisfaction of the amount that would, apart from