Allianz OSHC

Allianz is a trusted name in the insurance industry, taking care of the insurance needs of millions of people in Australia and around the world. Allianz Global Assistance provides health cover to international students studying in Australia through its Overseas Student Health Cover (OSHC).

As a condition of their student visas, international students must have OSHC for the entire time they are in Australia and Allianz OSHC provides them with access to both in- and out-of-hospital medical services. Allianz Global Assistance is the preferred provider for more than 70% of Australian universities. This guide looks at what Allianz OSHC has to offer and what sets it apart from other similar insurance products.

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Who needs OSHC and how does it work?

Most visitors applying for a Student Visa Subclass 500 will be required to take out private health insurance as a condition of their visa. This is known as condition 8501, and it states that the visa holder must maintain "adequate arrangements for health insurance while in Australia." Although the law doesn't spell out what is meant by "adequate arrangements", various policy documents have come to interpret this as meaning a policy that:

• Is fully comprehensive, meaning it provides Medicare-equivalent cover
• Offers hospital, emergency, general practitioner, and pharmaceutical benefits

You do not need to use an Australian insurer as long as your local insurer can meet these requirements. However, Allianz and other Australian insurers would be better placed to understand local regulations.

What does Allianz OSHC cover?

Allianz Global Assistance OSHC provides the following cover for students:

• Out-of-hospital medical services. Allianz will pay 100% of the Medicare Benefits Schedule (MBS) fee for medical services such as GP visits and 85% of the MBS fee for other services such as specialist visits, pathology and radiology.
• In-hospital medical services. Allianz will pay 100% of the MBS fee for in-hospital medical services, 100% of the OSHC rate (varies by state) for shared-ward public hospital accommodation, same-day services, accident and emergency and outpatient medical and post-operative services and 100% of insurable costs in a contracted private hospital with a minimum of shared-ward accommodation.
• Prescription medication. Allianz will pay a benefit for expenses exceeding the Pharmaceutical Benefits Scheme (PBS) patient contribution limit up to $50 per prescribed item and up to a maximum annual amount of $300 for singles and $600 for families.
• Surgically implanted prostheses. Allianz will pay 100% of the cost of items that appear on the Federal Government’s Australian Prostheses list.
• Ambulance services. Allianz will pay 100% of the cost of ambulance transport by an approved ambulance service for admission to hospital or emergency treatment only.

Allianz Global Assistance OSHC does not provide cover for any of the following:

• Ancillary services. Allianz will not cover procedures provided by dentists, optometrists, physiotherapists, osteopaths, chiropractors or naturopaths, etc.
• Non-PBS medications. There is no cover for any pharmaceuticals not prescribed by a doctor or included on the PBS.
• Gaps and co-payments. Gap cover provides a benefit for any amount payable by you due to the provider charging more than the MBS fee.
• Additional service fees. Allianz will not cover any extra fees charged by a doctor or hospital that are not covered by your policy.

Are there any out-of-pocket costs for treatment?

It differs based on whether you're treated in-hospital or out-of-hospital:

In-hospital

If you are treated in a public hospital, there will not usually be any out-of-pocket costs, since public hospitals charge the exact fee stated in the Medicare Benefits Schedule (MBS) and Allianz covers 100% of your MBS fee.

However, you may face out-of-pocket costs in a private hospital. One major reason for this is the doctor's gap charge. Private hospitals and doctors are free to charge over and above the MBS fee (this additional amount is called the gap). Private health insurance doesn't usually cover this gap unless your insurer has a special arrangement in place with that doctor or hospital. The cost of accommodation, doctor's fees, blood work and prescriptions can also exceed the insurer's benefit amount in a private hospital.

Luckily, Allianz has agreements in place with a wide network of private practitioners throughout Australia, with whom they've negotiated lower rates for their members. You can easily locate these providers on the Allianz website or through the app, and if you visit one of these, you can save on your out-of-pocket expenses.

Your Allianz policy also has no excess, which is an additional out-of-pocket expense many other policies make you pay per hospital visit.

Out-of-hospital

Your Allianz policy will cover 100% of the MBS fee for doctor's visits. Some doctors charge more than this, and you'll be responsible for the difference (called the gap). If you don't want this extra charge, you'll need to look for a "bulk billing" practitioner. These doctors charge only the MBS fee, leaving you owing nothing.

Your policy also covers 85% of the MBS fee for specialist visits. If you visit a specialist, you'll be responsible for the additional 15% plus any gap.

Eligibility, general exclusions, waiting periods and excesses

Now let’s take a look at Allianz OSHC in more detail:

• Eligibility. To be eligible for cover under Allianz OSHC, you must be an international student on a student visa (or applying for one) or an eligible spouse, de facto, child or stepchild of an international student.
• General exclusions. Benefits are not payable for IVF and assisted reproductive services, treatment outside Australia, treatment arranged prior to arrival in Australia, transport into or out of Australia, treatment covered by other entitlements and elective cosmetic surgery.
• Waiting periods. Waiting periods must be served for pre-existing medical conditions (12 months), pregnancy-related conditions (12 months) and pre-existing psychiatric conditions (2 months) unless deemed an emergency, in which case waiting periods may be waived.
• Excesses. No excesses are payable under Allianz OSHC.

Are there any other member benefits?

There are a number of other benefits of joining Allianz, including:

• Experienced support team offering 24/7 support. Allianz Global Assistance has more than 30 years of experiencing helping travellers overcome road bumps. If you ever need assistance, they're available 24/7 via the Global Assistance helpline.
• Family cover. You can take out a singles, couples or family version of the Allianz OVSC policy. All dependants are covered free under a family policy and all policies even cover pregnancy.
• Access to agreement hospitals and doctors. Allianz has agreements in place with a wide network of hospitals and doctors that have agreed to reduce the out-of-pocket expenses Allianz members have to pay for private care.

How does Allianz' partner network work?

Allianz refers to its network of partner providers as direct-billing medical providers. There are two main benefits to visiting one of these providers:

• They bill Allianz directly. This means you don't have to worry about filling out paperwork for a claim. It's done automatically.
• You can often save money. Many of these providers have agreed to reduce or eliminate their gap payment for Allianz members. This will leave you with fewer out-of-pocket costs for hospital treatment. Just be aware that not all partners will completely eliminate this gap so you may still have some out-of-pocket costs.

To find a doctor, simply visit the Allianz website or app and enter your location. You can filter by languages spoken, by medical specialty and by gender of the practitioner. When visiting one of these providers all you have to do if provide swipe your membership card and they will bill Allianz directly for Allianz' share of the bill. You will have to pay the rest.

You are not required to use a practitioner in Allianz' network. Just be aware that you may have higher out-of-pocket costs and you will have to make your claim manually.

Making a claim for Allianz OSHC

Allianz Global Assistance provides three easy ways to make a claim on your OSHC policy:

FAQs

Q. Who doesn't need OSHC?

• A. Belgian, Norwegian and some Swedish students don’t need to purchase OSHC as they are covered for medically necessary treatment under their country’s Reciprocal Health Care Agreement (RHCA) with Australia.

Q. When does a waiting period commence for a pre-existing condition?

• A. Waiting periods begin from the day you arrive in Australia on a student visa.

Q: How much does Allianz OSHC cost?

• A. The cost will depend on the duration of cover required and the level of cover you opt for (ie, whether you purchase extras cover as well).

Q. What happens if I need treatment while I’m in Australia?

• A. If it’s not life threatening, simply make an appointment with a GP. If you need emergency treatment you should call an ambulance or go to the emergency department of the nearest hospital. You should also call your OSHC insurer to make sure your policy will cover you for that admission.

Q. Can I take out OSHC with an overseas insurer?

• A. No, it must be with an Australian registered private health insurer. This is because the Australian Government regulates Australian insurers and would not be able to protect your interests in the same way with an overseas insurer.

Q. I am leaving Australia and my OSHC has not yet expired. Can I get a refund?

• A. Yes, you can apply in writing for a refund of the unexpired portion of your premium if you are ceasing your studies and leaving Australia prematurely for reasons beyond your control.