Gold Hospital

RBHS’s Gold Hospital includes cover for all 38 hospital clinical categories available on private hospital cover in Australia according to the Federal Government’s hospital cover tiers. Gold is the top cover followed by Silver, Bronze and Basic.

The RBHS’s Gold Hospital Cover can give you peace of mind to know that you are covered should you or your family ever need it.

Who can be covered?

The RBHS have policies for:

  • Single
  • Family – This extends to couples and single parents. There is no limit to the number of children under this policy.
  • Extended Family – This extends to single parent extended family. There is no limit to the number of children under this policy.
What is Extended Family Cover?

The RBHS currently covers children on their parents’ membership until they’re 18 years of age, or 25 if they are studying full-time and not married or living with their partner.

If your child reaches 18 and they’re not studying full-time (and not married or living with their partner), the RBHS Extended Family cover option lets you keep them on your membership until they’re 25 for an additional premium.

What is the Employer Supported Premium?

RBA staff may be eligible for the employer supported premium where the RBA will provide contributions to a member’s premium.

Your contract will outline whether you are eligible for the employer supported premium, or you can check with the RBA HR team regarding your eligibility.

 

What's included

Hospital treatment for physical rehabilitation for a patient related to surgery or illness.

For example: inpatient and admitted day patient rehabilitation, stroke recovery, cardiac rehabilitation.

Hospital treatment for the treatment and care of patients with psychiatric, mental, addiction or behavioural disorders.

Psychoses such as schizophrenia, mood disorders such as depression, eating disorders and addiction therapy are covered.

Hospital treatment for care where the intent is primarily providing quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain.

Hospital treatment for the investigation and treatment of the brain, brain-related conditions, spinal cord and peripheral nervous system.

For example: stroke, brain or spinal cord tumours, head injuries, epilepsy and Parkinson’s disease.

Not in this category:

  • Treatment of spinal column (back bone) conditions is listed separately under Back, neck and spine.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for the investigation and treatment of the eye and the contents of the eye socket.

For example: retinal detachment, tear duct conditions, eye infections and medically managed trauma to the eye.

Not in this category:

  • Cataract procedures are listed separately under Cataracts.
  • Eyelid procedures are listed separately under Plastic and reconstructive surgery.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for the investigation and treatment of the ear, nose, throat, middle ear, thyroid, parathyroid, larynx, lymph nodes and related areas of the head and neck.

For example: damaged ear drum, sinus surgery, removal of foreign bodies, stapedectomy and throat cancer.

Not in this category:

  • Tonsils, adenoids and grommets are listed separately under Tonsils, adenoids and grommets.
  • The implantation of a hearing device is listed separately under Implantation of hearing devices.
  • Orthopaedic neck conditions are listed separately under Back, neck and spine.
  • Sleep studies are listed separately under Sleep studies.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment of the tonsils, adenoids and insertion or removal of grommets.

Hospital treatment for the investigation and treatment of diseases, disorders and injuries of the musculoskeletal system.

For example: carpal tunnel, fractures, hand surgery, joint fusion, bone spurs, osteomyelitis and bone cancer.

Not in this category:

  • Chest surgery is listed separately under Lung and chest.
  • Spinal cord conditions are listed separately under Brain and nervous system.
  • Spinal column conditions are listed separately under Back, neck and spine.
  • Joint reconstructions are listed separately under Joint reconstructions.
  • Joint replacements are listed separately under Joint replacements.
  •  Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).
  • Management of back pain is listed separately under Pain management. Pain management that requires a device is listed separately under Pain management with device.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for surgery for joint reconstructions.

For example: torn tendons, rotator cuff tears and damaged ligaments.

Not in this category:

  • Joint replacements are listed separately under Joint replacements.
  • Bone fractures are listed separately under Bone, joint and muscle.
  • Procedures to the spinal column are listed separately under Back, neck and spine.
  • Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).

Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.

For example: kidney stones, adrenal gland tumour and incontinence.

Not in this category:

  • Dialysis is listed separately under Dialysis for chronic kidney failure.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for the investigation and treatment of the male reproductive system including the prostate.

For example: male sterilisation, circumcision and prostate cancer.

Not in this category:

  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for the investigation and treatment of the digestive system, including the oesophagus, stomach, gall bladder, pancreas, spleen, liver and bowel.

For example: oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids.

Not in this category:

  • Endoscopy is listed separately under Gastrointestinal endoscopy. Hernia and appendicectomy procedures are listed separately under Hernia and appendix.
  • Bariatric surgery is listed separately under Weight loss surgery.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for the investigation and treatment of a hernia or appendicitis.

Not in this category:

  • Digestive conditions are listed separately under Digestive system.

Hospital treatment for the diagnosis, investigation and treatment of the internal parts of the gastrointestinal system using an endoscope.

For example: colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP).

Not in this category:

  • Non-endoscopic procedures for the digestive system are listed separately under Digestive system.

Hospital treatment for the investigation and treatment of the female reproductive system.

For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.

Not in this category:

  • Fertility treatments are listed separately under Assisted reproductive services.
  • Pregnancy and birth-related conditions are listed separately under Pregnancy and birth.
  • Miscarriage or termination of pregnancy is listed separately under Miscarriage and termination of pregnancy.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.



Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy.

Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours.

Not in this category:

  • Surgical treatment of cancer is listed separately under each body system.

Hospital treatment for pain management that does not require the insertion or surgical management of a device.

For example: treatment of nerve pain and chest pain due to cancer by injection of a nerve block.

Not in this category:

  • Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under Pain management with device.

Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included.

For example: melanoma, minor wound repair and abscesses.

Not in this category:

  • Removal of excess skin due to weight loss is listed separately under Weight loss surgery.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for the investigation and treatment of breast disorders and associated lymph nodes, and reconstruction and/or reduction following breast surgery or a preventative mastectomy.

For example: breast lesions, breast tumours, asymmetry due to breast cancer surgery, and gynecomastia.

Not in this category:

  • This clinical category does not require benefits to be paid for cosmetic breast surgery that is not medically necessary.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for the investigation and management of diabetes.

For example: stabilisation of hypo- or hyper- glycaemia, contour problems due to insulin injections.

Not in this category:

  • Treatment for diabetes-related conditions is listed separately under each body system affected. For example, treatment for diabetes-related eye conditions is listed separately under Eye.
  • Treatment for ulcers is listed separately under Skin.
  • Provision and replacement of insulin pumps is listed separately under Insulin pumps.

Hospital treatment for the investigation and treatment of the heart, heart-related conditions and vascular system.

For example: heart failure and heart attack, monitoring of heart conditions, varicose veins and removal of plaque from arterial walls.

Not in this category:

  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for the investigation and treatment of the lungs, lung-related conditions, mediastinum and chest.

For example: lung cancer, respiratory disorders such as asthma, pneumonia, and treatment of trauma to the chest.

Not in this category:

  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Hospital treatment for the investigation and treatment of blood and blood-related conditions.
 
For example: blood clotting disorders and bone marrow transplants.
 
Not in this category:
  • Treatment for cancers of the blood is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion.

For example: sciatica, prolapsed or herniated disc, spinal disc replacement, and spine curvature disorders such as scoliosis, kyphosis and lordosis.

Not in this category:

  • Joint replacements are listed separately under Joint replacements.
  • Joint fusions are listed separately under Bone, joint and muscle.
  • Spinal cord conditions are listed separately under Brain and nervous system.
  • Management of back pain is listed separately under Pain management.
  • Pain management that requires a device is listed separately under Pain management with device.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or accident, or congenital.

For example: burns requiring a graft, cleft palate, club foot and angioma.

Not in this category:

  • Plastic surgery that is medically necessary relating to the treatment of a skin-related condition is listed separately under Skin.
  • Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.

Hospital treatment for surgery to the teeth and gums.

For example: surgery to remove wisdom teeth, and dental implant surgery.

Hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon, but limited to cover for: accommodation; and the cost of a prosthesis as listed in the prostheses list set out in the Private Health Insurance (Prostheses) Rules, as in force from time to time.

Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.

Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.

Not in this category:

  • Stapedectomy is listed separately under Ear, nose and throat.

Hospital treatment for surgery to remove a cataract and replace with an artificial lens.

Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of prostheses.

For example: replacement of shoulder, wrist, finger, hip, knee, ankle, or toe joint.

Not in this category:

  • Joint fusions are listed separately under Bone, joint and muscle.
  • Spinal fusions are listed separately under Back, neck and spine.
  • Joint reconstructions are listed separately under Joint reconstructions.
  • Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).

Hospital treatment for dialysis treatment for chronic kidney failure.

For example: peritoneal dialysis and haemodialysis.

Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.

Not in this category:

  • Treatment for the baby is covered under the clinical category relevant to their condition. For example, respiratory conditions are covered under Lung and chest.
  • Female reproductive conditions are listed separately under Gynaecology.
  • Fertility treatments are listed separately under Assisted reproductive services.
  • Miscarriage and termination of pregnancy is listed separately under Miscarriage and termination of pregnancy.

Hospital treatment for fertility treatments or procedures.

For example: retrieval of eggs or sperm, In vitro Fertilisation (IVF), and Gamete Intra-fallopian Transfer (GIFT).

Not in this category:

  • Treatment of the female reproductive system is listed separately under Gynaecology.
  • Pregnancy and birth-related services are listed separately under Pregnancy and birth.

Hospital treatment for surgery that is designed to reduce a person’s weight, remove excess skin due to weight loss and reversal of a bariatric procedure.

For example: gastric banding, gastric bypass, sleeve gastrectomy

Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes.

Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain.

For example: treatment of nerve pain, back pain, and pain caused by coronary heart disease with a device (for example an infusion pump or neurostimulator).

Not in this category:

  • Treatment of pain that does not require a device is listed separately under Pain management.

Hospital treatment for the investigation of sleep patterns and anomalies.

For example: sleep apnoea and snoring.

Features of this cover

Choose your doctor

It's important to feel comfortable with your doctor, and private hospital cover lets you choose who treats you.

Access Australia-wide coverage at more than 560 hospitals with 36,000 medical specialists

RBHS is a member of the third largest buying group, the Australian Health Service Alliance, to give you the freedom to use almost all hospitals and doctors in the country.

Avoid Medicare Levy Surcharge

The Medicare Levy Surcharge is paid by high income earners (that’s singles who earn over $90,000 and families that earn over $180,000 in the 2018/19 financial year) who don’t have private hospital cover.

The surcharge is between 1% and 1.5% (depending on your household income) and is paid on top of the 2% Medicare Levy paid by most Australian taxpayers. For more info on the Medicare Levy Surcharge, visit the ATO.

Benefit from the Australian Government Rebate on Private Health Insurance to reduce your premiums

The rebate helps with the cost of private health insurance (so that more people take out private cover).

It is income tested and is applied to both hospital and extras cover. If you have a Lifetime Health Cover loading, the Rebate is not applied to that portion of your payments.

The Rebate you get is based on the age of the oldest person of your membership, your taxable household income (for Medicare Levy Surcharge purposes), CPI (inflation) and average health fund industry premium increases.

Secure your maximum age-based discount

Join before you turn 26 to secure the maximum discount. The RBHS’s Gold Hospital cover qualifies for an age-based. You can join the RBHS to get your age-based discount of retain your existing age-based discount when you transfer to RBHS within 30 days of leaving your old cover. The maximum discount is 10% off our Gold Hospital cover.

Lock in your Lifetime Health Cover loading age

Lifetime Health Cover is designed to get people to take out private hospital cover earlier in life.

If you have hospital cover by 1 July after your 31st birthday and keep it, you don’t have to worry about it. If you decide to get hospital cover later, you’ll pay 2% more for cover for every year you’re over 30. This is called your Lifetime Health Cover loading.

Lifetime Health Cover loadings stay on your cover for 10 years. Once you’ve had hospital cover for 10 years straight, the loading is removed.

Hospital cover - what's covered

  • Public or private hospital bed - shared or a private room (if available)
  • Same-day surgery
  • Theatre fees
  • Special unit accommodation
  • In-hospital psychiatric treatment
  • In-hospital rehabilitation treatment
  • In-hospital pharmacy
  • Surgical prostheses, up to the benefit listed on teh Government
  • Prostheses List (a prosthesis is an artificial substitute for a body part)
  • Ambulance services Australia wide
  • Hospital substitution options
  • Health programs

Hospital cover - what's not covered

There are a few things that aren't covered by your hospital cover. They include treatments & services that

  • are received within your waiting periods
  • Medicare doesn't cover 
  • are received outside Australia
  • are covered by a compensation or another type of insurance (like third party or sports club insurance)
  • were received more than 2 years ago
  • Outpatient treatment & services

and:

  • Some high cost (non PBS/TGA approved) drugs
  • Pharmacy - most pharmacy items that you're given while you're in hospital are covered by your hospital bill. The hospital may charge you extra for pharmacy items that you take home with you and this isn't covered by your hospital cover.
  • Prostheses that aren't listed on the Government Prostheses List. (A prosthesis is an artificial substitute for a body part.)
  • Ambulance subscriptions or state-based levies
  • Ambulance services paid for by the Government, compensation or another type of insurance
  • Ambulance services that aren't medically necessary
  • Some medical devices and consumables
  • Experimental treatments
  • Incidental fees such as Foxtel & newspapers