How does the overseas visitor’s health cover (OVHC) work for out-of-hospital services?
In Australia, most minor health issues can be treated by a local doctor, also called a general practitioner or GP. You should only go to the hospital if you have a medical emergency or are in a major accident.
Is this an emergency?
An emergency is any medical problem that causes extreme pain, severe blood loss, or could cause death or permanent injury if not treated quickly. An example of an emergency is struggling to breathe, going into labour (childbirth) or being hit by a car.
If you have an emergency call 000
If you’ve been hurt or are feeling sick but it’s not life-threatening, then it is not an emergency. For example, you’ve twisted your ankle, or have a minor cough or cold, then it’s not an emergency.
If you hold an Overseas Worker Base Hospital health cover, you are not covered when you seek medical services from a doctor as an outpatient. You are only covered when you are admitted into the hospital as inpatient. If you seek services from the emergency department of a public hospital, this is classified as ‘outpatient’ services and you are not covered to receive a benefit.
- Visit your local doctor to seek treatment. Local doctors can be found in medical centres within a shopping centre or private practice within your community.
- When you make an appointment, ask how much the consultation will cost so you are aware of the charges before you see the doctor.
Visiting your local doctor will save you from paying high and unnecessary costs, compared to seeing a doctor at the local hospital.
- Speak to a fully qualified doctor based in Australia from the comfort of your own home or office via your smartphone or desktop. Access virtual doctor services here.
National GP Network
- If you prefer to see a doctor face-to-face, click here or call 1300 174 537 to locate a doctor within CBHS International Health network nearest to you.
- Call and book an appointment with a doctor within the GP network (let them know you're a CBHS International Health member).
- If you're seeing this doctor for the first time, arrive a few minutes early to fill in some paperwork.
- Remember to take your CBHS International Health membership card and photo identification with you and the medical centre will bill us directly.
Visit any doctors from CBHS International Health Recognised Online Health Consultation Services (virtual doctors) or within our GP network, we’ll cover the full cost of your visit up to the relevant service limit.
Outside of the National GP Network
You can you visit a medical centre or other medical service provider that is not part of the CBHS International Health network. This will attract out-of-pocket expenses. When you call to book an appointment, ask how much it will cost. After paying for the consultation, ask for a receipt and submit a claim to CBHS International Health by taking a photo of your membership card and the receipt, then email it to: email@example.com.
For all above services, refer to your level of cover for eligibility, service limits and any applicable waiting periods.
How do medical payments work?
The Australian Government has set a recommended fee for most medical services, such as visiting your doctor which is called the Medicare Benefits Schedule (MBS). If your doctor charges the recommended MBS fee, we will provide you with a benefit* of the full amount. However, if the doctor charges more than the recommended fee, you will have to pay the difference. We call this an ‘out-of-pocket expense’ or ‘gap’ payment.
If you use any of our doctors from CBHS International Health Recognised Online Health Consultation services (virtual doctors) or from our National GP Network, we’ll cover the full cost of your visit up to the relevant service limit.
If you visit a doctor in medical centre or other medical service provider that is not part of the CBHS International Health network, this will attract out-of-pocket expenses. When you call to book an appointment, ask how much it will cost. After paying for the consultation, ask for a receipt and submit a claim to CBHS International Health by taking a photo of your membership card and the receipt, then email it to: firstname.lastname@example.org.
*Refer to your level of cover for eligibility, service limits and any applicable waiting periods.
What if my doctor prescribes medication?
Sometimes your doctor will prescribe medicine as part of your treatment. A prescription is a piece of paper that details the name or type of medication the doctor would like you to take.
Take the prescription to the pharmacy or chemist and they will supply you with the right medicine. If you're not sure how to use the medicine, ask the pharmacist before you go home.
What if it’s after hours and my medical centre is closed?
All public hospitals in Australia have a 24-hour emergency and casualty department where you can get help after hours and on the weekend.
If you go to a public hospital for non-emergency treatment, you could be charged more than $1,000 as services provided in the emergency department of a public hospital are ‘outpatient’ services and not ‘inpatient’ hospital services. Furthermore, we do not pay benefits for facility fees.
If you hold an Overseas Worker Base Hospital health cover, you are not covered when you seek services from the emergency department of a public hospital as this is classified as ‘outpatient’.
If you hold an Overseas Worker Mid Hospital & Medical or Overseas Worker Top Hospital & Medical, you can only claim on services* provided if there is a MBS number or a description of the services on the receipt. If the receipt states your treatment as ‘Medicare ineligible’ and no other details, then the maximum benefit will be $160.
* Refer to your level of cover for eligibility, service limits and any applicable waiting periods.
How does your cover (OVHC) work for in-hospital services?
When you’re treated in hospital by a doctor, surgeon or anaesthetist, you will be charged a fee. If the practitioner charges you the MBS fee (and the service is included in your health cover) you will be covered for the service. If they choose to charge above the MBS fee, then you will have to pay the difference.
Before you go to hospital, you should ask your doctor and the hospital if there will be any additional costs that might be higher than those covered by your OVHC. It is also highly recommended that you contact us before you go to hospital so that we can inform you if there are any exclusions, restrictions or limits on the treatment you're seeking.