Learn more about the hospital cover you can get with rt health.
Railway and Transport Health Fund (rt health) is a restricted health insurance provider. This means it’s only open to eligible members rather than the general public. Restricted health funds are often able to deliver lower premiums, or additional benefits, compared to unrestricted health funds, and may be worth considering first if you’re eligible.
What hospital cover options does RT Health offer?
There are five different hospital cover options.
- Public Hospital: Public hospital only, but no exclusions or restrictions. Lets you choose your own doctor in public hospitals, for additional care and a cost-effective way of avoiding Lifetime Health Cover loading.
- First Start Hospital: Designed for younger people without any specific health needs who are looking for cost-effective private hospital cover in case of the unexpected.
- Step Up Hospital: An affordable step up from First Start, adding public hospital cover for things like pregnancy and cardiac procedures.
- Smart Hospital: Relatively comprehensive cover with very few exclusions or restrictions to receive private hospital benefits for all but three treatments.
- Premium Hospital: High-level comprehensive hospital cover for full private hospital treatments without exclusions.
Public Hospital cover will not cover you at any private hospitals but will let you choose you own doctor and help cover public hospital attendance costs for all procedures that are covered by Medicare.
All the other plans will let you attend a private hospital for all treatments covered by Medicare, except for those specified in the following table.
|Treatment||Public||First Start||Step Up||Smart||Premium|
|Joint replacement procedures and revisions||Public hospital only|
|Kidney dialysis||Public hospital only|
|Spinal surgery||Public hospital only|
|Major eye surgery||Public hospital only|
|Cardiac procedures||Public hospital only||Public hospital only|
|Obstetrics and pregnancy related||Public hospital only||Public hospital only|
|Assisted reproductive services||Public hospital only||Public hospital only|
|Psychiatric||Public hospital only||Public hospital only||Public hospital only||Public hospital only|
|Rehabilitation||Public hospital only||Public hospital only||Public hospital only|
|Weight-loss surgery||Public hospital only||Public hospital only||Public hospital only|
Why should I consider RT Health hospital cover?
You can choose your excess with all plans except Public Hospital cover. The excess is paid per adult hospital visit up to once per person per year.
By choosing a higher excess you can get lower premiums. No excess is payable for dependent children’s hospital admissions under a family plan.
|Public||First Start||Step Up||Smart||Premium|
|Excess options||$0 only||$250 or $500||$250 or $500||$250 or $500||$0, $250 or $500|
Public hospital only cover plans are some of the most affordable health insurance policies available, which can make them a good choice if affordability, and avoiding the Lifetime Health Care levy, is your top priority.
Not all health insurance funds will offer these kinds of policies, and restricted health funds are often able to deliver additional member benefits. So if you’re eligible for rt health and looking for cheap hospital cover then this plan may be one of the most suitable options around.
First Start hospital cover represents a significant jump in cover and will let you access private hospital care for many procedures, so it may be worth considering the upgrade if it remains affordable. However, this will not cover you for pregnancy or related services at all.
As such, the Step Up or Smart plans may be worth considering if you’re happy paying more for a blend of private and public hospital cover and want coverage for pregnancy, fertility and obstetrics related procedures. If you’re looking to start a family then one of these two options may be the way to go.
Premium Hospital is an all-around high level of cover without any specific exclusions or restrictions, suitable for people with ongoing or complex health needs. If you want to get covered for all procedures in private hospitals around Australia then this plan can help.
Some people in particular may benefit from certain rt health features, such as:
- Single parent cover: You can get lower prices as a single parent with kids instead of needing to pay the full two-parent price for family cover.
- RT Families Foundation: This charitable organisation offers help to members’ families in need of additional support for things that aren’t covered by Medicare or your private health insurance.
- Travel insurance discounts: rt health members can get 40% off QBE travel insurance.
- Life insurance: You can get Zurich Ezicover life insurance through rt health.
What are the limitations and waiting periods?
There are some conditions and restrictions that apply to all rt health hospital plans.
- Non-agreement hospitals: If you receive treatments in a private hospital that rt health does not have a contract with, known as non-agreement hospitals, you can only claim minimal accommodation benefits and will have significant out-of-pocket expenses. You can check for agreement hospitals in your area and make sure you’ll be covered prior to admission.
- Non-Medicare procedures: You are not covered for non-Medicare procedures, such as purely cosmetic plastic surgery, by these plans.
- Outpatient treatments: You are only covered as a hospital inpatient. This means benefits aren’t payable until you’ve officially been admitted to a hospital. For example, emergency department services won’t be covered because they are received before hospital admission.
- Take-home pharmaceuticals: You can’t claim the cost of pharmaceuticals given to you to take at home. However, sometimes these medications can be covered under health insurance extras plans.
- Additional services and items: You can’t claim the cost of additional items you might use in hospital, like TV hire, newspapers, internet access or certain hospital administration fees.
Waiting periods also apply as follows:
- 12 months: Pregnancy, fertility and obstetrics related, and all pre-existing conditions except psychiatric, palliative care and rehabilitation
- 2 months: Psychiatric, rehabilitation and palliative care, regardless of whether or not it’s a pre-existing condition, and all other services
- 1 day: Accidents
How do I make a claim with RT Health?
Typically, agreement hospitals can bill rt health directly, while any applicable excess and gap expenses can be paid to the hospital or practitioner as applicable.
If you end up paying for covered services out of pocket, it can be claimed back later by sending a completed claims form to rt health.
How can I pay my premiums?
You can pay your premiums by:
- Direct debit from bank account or credit card. They can be paid weekly, fortnightly, monthly, quarterly, half-yearly or yearly.
- Payroll deduction. If your workplace has arrangements with rt health you can have premiums deducted from your salary.
You can also pay monthly, quarterly, half-yearly or yearly after receiving a renewal notice. This can be paid with BPAY, Post Billpay, credit card, cheque or cash in person at an rt health member centre.
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