|1. How does the Australian health care system work?||Australia has a national health care system that provides access to health care for Australian citizens, New Zealand citizens or holders of permanent resident visas. The major part of the national health care system is called ‘Medicare’. Medicare provides high-quality health care which is both affordable and accessible to all Australians, often provided free of charge at the point of service.
Medicare covers areas of medical, hospital and pharmaceutical costs, but does not cover private hospital costs, dental, optical and similar services. Medicare does not provide cover for emergency ambulance assistance or for transport to hospitals.
It is very important that you have a good understanding of the Australian health care system so that you will be able to access the best and most effective treatment for you.
|2. What is OVHC?||Overseas Visitors Health Cover (OVHC) is health insurance for international visitors which provides cover for the costs of:
• In-hospital medical treatment
• Prescription medicines
• Surgically implanted prostheses
• Emergency ambulance transport
• Medical repatriation (only if authorised by AGA)
• Out of hospital medical treatment (Visitors Plus only)
|3. Why is OVHC importance?||Hospital and Medical treatment can be expensive
Australia has a public health insurance system, known as Medicare, and a public hospital system, however, overseas visitors are generally not eligible for Medicare coverage or free treatment in public hospitals*. This means that overseas visitors who need hospital or medical treatment while they are in Australia will have to pay for these services, and the costs can potentially be significant – in most cases hospital treatment will cost more than $1,500 per day.
If your visa is subject to Visa Condition 8501, you must maintain adequate arrangements for health insurance while you are in Australia. Your visa conditions can be checked on the website of the Australian Government Department of Immigration and Border Protection (DIBP). Allianz Global Assistance’s OVHC cover meets all DIBP requirements and will satisfy Visa Condition 8501.
|4. How long do I need OVHC for?||If visa condition 8501 applies to you, the Australian Government requires that you have continuous OVHC for the entire length of your stay in Australia.|
|5. How can I pay for OVHC?||To become an OVHC member, visit the membership application page and follow the prompts to apply for OVHC membership.
You can choose to pay by regular fortnightly, monthly, quarterly, six-monthly or annual installments via automatic payment (direct debit) from your chosen credit card or bank account.
You will continue to be a member and have continuous cover while you continue to pay your premiums.
|6. Who is covered under an OVHC policy?||Your Certificate of Insurance will show which policy you have selected. Your policy may be either:
|7. How long do I have to be covered?||For relevant visa types, the Australian Government requires that you have adequate arrangements for health insurance for the entire length of your stay in Australia. You can purchase OVHC up to 12 months at a time.|
|8. What isn’t covered?||Services which are not covered under your policy:
Benefits are not payable:
For the purposes of these exclusions, the start date for calculating the relevant period of 12 months or 2 months, and whether or not the condition is a pre-existing condition, will be determined in accordance with the ‘waiting periods’ section of the OVHC policy document.
|9. Is there a waiting period?||There is a waiting period for pre-existing conditions.
You cannot claim for costs arising during the applicable waiting period if such costs arise from a pre-existing condition or a pregnancy-related condition.
The waiting period is calculated as 12 months (or, for psychiatric, rehabilitative or palliative care, 2 months) commencing from:
whichever the later date is.
If you are switching to Allianz Global Assistance from a similar policy held with another insurer, and there has not been a gap in your coverage of more than 30 days, we will count the time you were covered under your previous policy towards any waiting period which applies to your coverage with us – see the section ‘Other Important Matters’ on page 12 of the OVHC policy document.
If you have previously held OVHC or OSHC with us and:
New waiting periods will commence upon commencement of any new policy you take out with us after that time.
|10. What is a pre-existing medical condition?||A pre-existing condition is an ailment, illness or conditions the signs or symptoms of which (in the opinion of a medical practitioner appointed by us) existed at any time in the period of 6 months ending on the relevant start date (determined in accordance with the above rules).
In forming this opinion, the medical practitioner must have regard to any information in relation to the ailment, illness or condition provided to that medical practitioner by the medical practitioner who treated the ailment, illness or condition.
This includes an ailment, illness or condition that was present but had not been diagnosed by a medical practitioner at the time of your arrival in Australia or the date your eligible visa was granted, whichever is the later date.
|11. When does my cover start and end?||Your cover starts the day you arrive in Australia or the day your visa is granted (whichever is later) and ends on the expiry date of your visa, as long as you continue to pay your regular OVHC premium installments.|
|12. What is a direct-billing medical provider?||Allianz Global Assistance OVHC has made special arrangements for our members with many medical providers to direct bill us for the covered amount of your bill. This means that you simply provide your valid OVHC membership card – so make sure you carry your valid card with you at all times.
Some medical providers may charge a ‘gap’ fee at the time of service, but the rest of the bill will be taken care of by Allianz Global Assistance OVHC. This means you do not need to make a claim. You can easily find your closest direct-billing medical provider here on the website using our Find a Doctor page.
Please note: there are no benefits payable for services provided by a direct-billing medical provider for OVHC Budget Visitors – Hospital Only policies. These benefits are only payable on OVHC Visitors Plus policies.
|13. What should I do if I need medical treatment?||General practitioners (benefits apply to Visitors Plus policies only)
If you are not in a medical emergency situation, the first point of contact is a general practitioner (GP), medical practitioner or local health/medical centre. You can access many services at your local health centre. Some of the services available are:
In most cases, it is necessary for you to make an appointment to see your doctor.
Accident and emergency treatment
Many hospitals have a 24-hour Accident and Emergency department. Accident and Emergency departments should only be accessed in the case of emergency situations. When you visit an accident and emergency department, a nurse will assess you and if your illness or injury is not deemed as an emergency, you may need to wait a long time to see a doctor.
If you have been admitted for emergency treatment, contact Allianz Global Assistance immediately on 1800 814 781. If you have been referred to hospital for a non-emergency admission, contact the claims department on 1300 727 193 prior to admission. You will need to provide Allianz Global Assistance with the details of your treatment and hospital stay. We will then be able to confirm your cover and assist you with making arrangements for payment to the hospital.
Generally, OVHC covers the total cost of your stay and treatment as an in-patient in a shared ward of a public hospital. As a public patient, your doctors will be nominated by the hospital. After your hospital discharge, your care will be carried out in either the outpatient clinic, by one of the hospital’s specialists in his/her private rooms or you will be referred to your local general practitioner.
You can choose to be treated in a private hospital. Through our relationship with Peoplecare Health Limited, we have agreements in place with most private hospitals in Australia. These hospitals (known as Agreement Hospitals) ensure that an agreed schedule of fees (including in-patient accommodation, theatre, and special unit accommodation fees as appropriate) is charged by the hospital and paid by Allianz Global Assistance on a member’s behalf. You may incur out-of-pocket costs for private hospital expenses.
There are some private hospitals that are not Agreement Hospitals. In these cases, we may not cover the full cost of your hospitalisation. However, if you call us before you go into hospital we’ll be able to provide you with an estimate of your out-of-pocket expenses. Members who choose a non-agreement hospital may incur out-of-pocket expenses for hospital-related services.
|14. I’m leaving Australia and my OVHC hasn’t expired. Can I get a refund?||You can apply in writing for a pro-rata refund of premium for the unexpired portion of your policy if: