RT Health Fund Review

When it comes to your health, you want to know that you and your loved ones will be able to get the care you need whenever you need it. While the Medicare system goes some of the way to ensuring that you get the medical treatment you need, for the ultimate peace of mind you need to take out private health insurance.

If you’re looking for private health cover for yourself or for the entire family, RT Health Fund is a not-for-profit fund owned by its members. Established more than 126 years ago, RT Health Fund offers five levels of hospital cover and three levels of extras cover to suit your cover needs and budget.

Choosing the right cover

RT Health Fund provides five hospital cover options that offer an increasing range of benefits and an increasing premium cost for the higher level of cover: Basic Public Hospital, Bronze Plus First Start Hospital, Bronze Plus Step Up Hospital, Silver Plus Smart Hospital No Pregnancy and Gold Premium Hospital. These can be purchased as standalone cover or you can choose to mix and match them with one of the three extras cover options: Value Extras, Smart Extras and Premium Extras.

Do I need health insurance?

If you’re weighing up whether or not you need health insurance cover, all you need to do is take the Australian Government’s Lifetime Health Cover Scheme into account. Under the scheme, you’ll be charged a premium loading for every year after you turn 31 that you do not have some form of private health cover in place. In other words, the sooner you take out cover the cheaper it will be.

With this in mind, you’ll have to decide on the right cover option for you – and the right cover can differ greatly from one person to the next. For example, someone in their mid 50s with a history of health problems is going to need very different cover to a young, fit and healthy applicant. Consider what you need cover for and how much you want to spend before you choose a fund.

RT Health Insurance Levels of Cover

RT Health Fund offers the following hospital cover options:

Gold Premium Hospital

• No exclusions or restrictions; this policy covers up to 100% of the cost of treatment in the private or public hospital of your choice, and covers you for all 38 clinical categories.

Silver Plus Smart Hospital No Pregnancy

• Comprehensive cover that suits most people's needs. It doesn't cover you for procedures such as joint replacement, pregnancy, or kidney dialysis so it's more affordable than Gold Premium.

Bronze Plus Step Up Hospital

• Suited to the young and healthy, exclusions include joint replacement procedures and their revisions, kidney dialysis, spinal surgery and major eye surgery.

Bronze Plus First Start Hospital

• For those without any specific health issues or concerns. Available with a $350 or $700 excess, First Start covers you for some treatments of a public hospital or partnered private hospital and lets you choose your doctor.

Basic Public Hospital

• As the name suggests, this option only covers you for treatment in a public hospital, not a private hospital. However, you can receive treatment from the doctor of your choice and receive up to 100% of hospital costs. Ambulance attendance and transportation is also covered.

Extras available from RT Health

There are three levels of extras cover, that can be purchased alongside hospital or as standalone products.

Premium Extras

• This is RT Health Fund’s top-level extras cover option and it provides cover for general and major dental, orthodontics, optical, physiotherapy, chiropractic, occupational therapy, orthoptics, dietetics, audiology, podiatry, speech therapy, psychology, pharmaceuticals, vaccines, alternative therapies, home nursing, hearing aids, health aids and more.

Smart Extras

• This mid-level policy option covers the same general treatments as a Premium Extras policy but does not provide as generous benefit limits. It also excludes orthodontics cover, creating a combination between a broad range of cover and affordability.

Value Extras

• This entry-level extras cover option excludes a number of treatment types and features lower benefit limits. However, it still provides cover for general dental, optical, physio, chiropractic, occupational therapy, orthoptics, dietetics, alternative therapies, vaccines, pharmaceuticals, health aids and hearing aids.

Are there any additional benefits?

• No excess for dependent children. RT Health Fund hospital cover members will never have to pay an excess for their dependent children.
• Affordable cover. Sole parent cover is available to make health insurance more affordable for single parent families.
• Cover your kids up to the age of 25. If any of your kids are unmarried and full-time students, they can stay covered under your RT family policy until they reach 25 years of age.
• Optical and dental discounts. Fund members can access a range of discounted products and services at the fund’s new optical practices in Surry Hills and Newcastle. A range of dental and eyewear discounts are also available.
• Free health management programs. RT Health Fund members can take advantage of two free health management programs. Hospital at Home offers hospital-equivalent care to you at home, while health4life helps you make healthy lifestyle changes to prevent chronic disease.

What isn't covered?

Your RT Health Fund claim will not be paid if:

Does RT Health Insurance have an excess?

Depending on the level of hospital cover you take out, you may be required to pay an excess when you are admitted to hospital. The excess is the amount you pay to contribute to your hospital costs and allows you to enjoy lower premiums. Under Gold Hospital, you can choose to pay an optional excess or no excess at all. Both Silver Hospital and Bronze Hospital policies come with an excess that you'll need to pay when you're admitted to hospital, and the amount you have to pay will be detailed in your policy schedule.

I need to make a claim ... what do I do?

If you receive treatment in a private hospital, in most cases the hospital’s bills will be sent directly to your health fund. However, you may receive bills from the different doctors who treat you, and you’ll need to take them to a Medicare office and fill out a two-way claim form. Medicare will then forward your claim on to RT Health Fund to cover the 25% gap that Medicare does not pay.

When you need to make an extras claim, many providers will offer on-the-spot electronic claiming that simply requires you to swipe your membership card. Where this option is not available you will have to download a claim form from the RT Health website, fill it out and submit it to the health fund.

You can also submit a claim via the RT health insurance app. You can download the app from the Apple Store or Google Play Store.

FAQs RT Health

• How do I know which hospitals I will be fully covered in?

  RT Health Fund has agreements in place with the vast majority of private hospitals and day surgeries in Australia. You can view a list of agreement hospitals on the RT website.

• I want to transfer from another health fund to RT – will I need to serve waiting periods again?

  No, Australian law makes it possible for you to switch health funds without having to re-serve any waiting periods. As long as you join RT less than two months after leaving your previous fund, any waiting periods you’ve already served will be recognised.

• Does RT offer gap cover?

  Yes, all of the hospital cover options from RT Health Fund come with Access Gap Cover, which allows you to reduce your out-of-pocket hospital expenses or even avoid them altogether.

• My partner works for an energy generation company – am I eligible to join?

  Yes, family members of people who work in the energy and transport industries are eligible to join RT Health Fund.

Compare health insurance policies today

If you’re eligible to become a member of RT Health Fund, consider the benefits and features it offers when choosing private health cover. Comparing the products offered by a range of funds is the best* way to ensure that you get the cover you need for you and your family.