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Capital Benefits / Non-Medicare Medical Expenses / Loss of Income

What does this section cover?
This cover reimburses expenses that are not standard Medicare items and incurred within twelve (12) calendar months of you sustaining an injury, and are paid by you for treatment certified necessary by a legally qualified medical physician. This cover includes the cost of medical supplies and ambulance hire.

Important information
The Health Insurance Act (Cth) 1973 does not permit the trustee or insurer to contribute to any charges covered by Medicare (including the Medicare Gap).

This means that any charges for treatment from a doctor, surgeon, anaesthetist or surgeon's assistant are not covered. It also means charges for x-ray, some MRI scans (if Medicare registered) and public hospitals are not covered. In addition, there will be no refund in respect of:

any expenses recoverable by you from any other insurance scheme or plan providing medical or similar coverage, or from any other source except for the excess of the amount recoverable from such other policies/plans.
any expense to which the National Health Act (Cth) 1953 or any of the regulations made there under apply.

What are the benefits payable?
The table of benefits below must be read in conjunction with the policy wording.


Benefit	Description	Cover
Non Medicare medical	Reimbursement of non-Medicare medical expenses incurred within 12 calendar months.	- 80% reimbursement - $3,000 maximum per claim - $50 excess per claim
Domestic home help	Reimbursement of actual costs of domestic home help. Available to non-income earners only.	- 100% reimbursement - $300 maximum per week - 7 day excess period - 52 week maximum benefit period
Student tutorial	Reimbursement of actual costs incurred for home tutorial expenses. Only available to full time students who are non-income earners.	- 100% reimbursement - $300 maximum per week - 7 day excess period - 52 week maximum benefit period
Bed care patient	Weekly payment to an insured person who is confined to a bed after a bodily injury for a period of not less than 7 days.	- 100% reimbursement - $300 maximum per week - 7 day excess period - 52 week maximum benefit period
Out of pocket expenses	Reimbursement of actual costs incurred for out of pocket expenses.	- 100% reimbursement - $200 maximum per week - 7 day excess period - 52 week maximum benefit period
Chauffeur plan		- 100% reimbursement - $200 maximum per week - 7 day excess period - 52 week maximum benefit period
Rehabilitation	Reimbursement of all reasonable costs incurred for the rehabilitation of a bodily injury including but not limited to a gymnasium, pilates studio or physical trainer.	- $5,000 maximum per claim
Home / vehicle modification	Reimbursement of costs incurred for home / vehicle renovations required as a direct result of bodily injury which is claimable under events 2 - 7 of Capital Benefits including but not limited to ramps, guide rails etc.	- $10,000 maximum per claim
Funeral expenses	Reimbursement of costs as a result of event 1 of Capital Benefits.	- $5,000 maximum per claim
Broken bones		- $3,000 maximum per claim

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