Member Guide - RACT

Quick hospital cover comparisonThis table provides a quick comparisonof the main features of RACT HealthInsurance's hospital covers and mustbe read in conjunction with the detailedinformation in this member guide.3 Cover provided in participating private hospital3 Public hospital cover as a private patient only.Not recommended for private hospital treatment✗ No benefits payable# Partial Coverage, a co-payment of $100 per day applies up to amaximum of $700 per admission^ Benefits for a single room in a public hospital will result in significantout-of-pocket expenses.Quick hospital cover comparison Platinum Hospital Gold Hospital Silver Hospital Bronze HospitalAccidents 3 3 3 3Single room guarantee a 3 ✗ ✗ ✗Accommodation – single room (where available) 3 3 # ^Accommodation – shared room 3 3 3 3Admission excess waiver for child dependantsaged under 213 3 ✗ ✗Broader health cover 3 3 3 3Cataract surgery and corneal transplants b 3 3 ✗ 3HOSPITAL COVERCosmetic surgery b (limited benefits - see page 57) 3 3 ✗ 3Delivery suite b 3 3 ✗ 3Dental Implants b 3 3 ✗ 3Gastric banding and all obesity surgeries b 3 3 e ✗ ✗a We will pay you $50 per day (up to maximum of $150 for 3 days) if youstay in a shared room when you requested a single room. See page 56for more details.b A pre-existing condition (PEC) is one where signs or symptoms of yourailment, illness or condition, in the opinion of a medical practitionerappointed by RACT Health Insurance (not your own doctor), existed atany time during the six months preceding the day on which youpurchased your hospital cover or upgraded to a higher level of hospitalcover and/or benefit entitlement. Please refer to pages 54 and 57 formore information.c Limited benefits may apply to high cost drugs. Drugs purchasedoutside the hospital are not included.d If the fund believes that a patient, following a review of the case (onthe basis of information provided by the hospital either internally orusing an agreed independent source), is not receiving acute care after35 days continuous hospitalisation, RACT Health Insurance benefits willbe reduced to nursing home type patients benefits and will be paid inaccordance with the default benefit determined by the HealthDepartment. All nursing home type patients are required to pay part ofthe cost of hospital accommodation.e During the first 24 months of cover (after the standard hospital waitingperiods have been served), benefits payable for these services will belimited to public hospital benefits only. See page 47 for moreinformation.Haemodialysis 3 3 e ✗ ✗Intensive and coronary care b 3 3 3 3IVF and related services b 3 3 ✗ 3Joint reconstruction e.g. knee b 3 3 3 3Joint replacement e.g. hip b 3 3 ✗ 3Medical gap cover 3 3 3 3Medical gap cover – increased benefit 3 ✗ ✗ ✗Nursing home type patients d 3 3 3 3Obstetrics b 3 3 ✗ 3Other agreed charges c 3 3 3 3Participating private hospital 3 3 3 ✗Psychiatric 3 3 e 3 e 3Rehabilitation 3 3 3 3Same-day treatment b 3 3 3 3Surgically implanted prostheses b(govt. prescribed benefits)3 3 3 3Theatre b 3 3 3 312 13