Hospital cover highlights

  • Private hospital cover for the most commonly claimed services
  • Restricted benefits for services you're less likely to need
  • $70 daily co-payment option to keep premiums low
  • Emergency ambulance transport
  • What's covered?
  • What's not covered
  • Waiting periods
  • Co-payment
  • KickStart (Basic Plus) hospital cover will cover you for:

    • Private or Public Hospital accommodation & services includes overnight, same day, intensive care* and theatre fees. Cover is provided for a private or shared room in a private or public hospital for the following services:
      1. Accident related treatment after joining^
      2. Tonsils, adenoids and grommets
      3. Joint reconstructions
      4. Hernia and appendix
      5. Dental surgery
      6. Bone, joint and muscle
    • All other services in any hospital are eligible for restricted benefits#. Restricted benefits are payable only at the minimum rate specified by law and may only provide a benefit similar to a public hospital shared room rate. Restricted benefits may not be sufficient to cover admissions in a private hospital. Restricted services are covered for a shared room in a public hospital.

    *Theatre and Labour ward fees are not charged in a public hospital

    • Medical expenses related to providers for services while admitted in hospital e.g. fees from doctors, surgeons anaesthetists, pathology, imaging etc. Covered for all services eligible for benefits from Medicare up to Medicare Benefits Schedule (MBS) Fee. Members have their choice of doctor/surgeon in a public or private hospital. CBHS will cover the difference between the Medicare benefit and the MBS fee for services provided as an admitted patient to a hospital
    • Access Gap Cover is where a provider chooses to participate under an arrangement with the fund. CBHS covers up to 100% of an agreed amount in excess of the MBS fee which reduces or eliminates your out-of-pocket medical expenses. (i.e. surgeons, anaesthetists, pathologists, imaging fees etc)
    • Surgically implanted prostheses to at least the minimum benefit specified in the prosthesis list issued under Private Health Insurance legislation
    • Pharmacy covers most drugs related to the reason for your admission in an agreement private hospital
    • Emergency ambulance transport for an accident or medical emergency by approved ambulance providers
    • Better Living programs to help you manage your health and wellness.
    • Hospital Substitute Treatment means the possibility of receiving rehabilitation treatment or the care of a registered nurse at home.

    ^Accident related treatment means treatment provided in relation to an Accident that occurs after a Member joins the Fund and the Member provides documented evidence of seeking treatment from a Health Care Provider within 7 days of the Accident occurring. If Hospital Treatment is required, the Member must be admitted to a Hospital within 180 days of the Accident occurring. Any additional Hospital Treatment (after the initial 180 days) will be paid as per the level of Benefits payable on the Member’s chosen level of cover (if applicable).

    # All hospital services provided in a public hospital are eligible for Minimum Default Benefits. These benefits are stipulated by the department of Health and listed in the relevant Private Health Insurance (Benefit Requirement) Rules. Some hospitals may charge above the Minimum Default Benefit for shared room accommodation. Please note that fees charged in excess of Minimum Default Benefits are an out-of-pocket expense and are not eligible for reimbursement under CBHS policies.

    *A benefit is not payable in respect of a service that was rendered to a Member if the services can be claimable from any other source.

  • KickStart (Basic Plus) hospital cover will not cover you for

    • If a member is admitted into a private hospital for restricted services, benefits are payable only at the minimum rate specified by law. These benefits may only provide a benefit similar to a public hospital shared room rate. These benefits may not be sufficient to cover admissions in a private hospital
    • Nursing home type patient contribution, respite care or nursing home fees
    • Take home/discharge drugs (non-PBS drugs may be eligible for benefits from your Extras cover)
    • Services claimed over 24 months after the service date
    • Services provided in countries outside of Australia
    • Prostheses used for cosmetic procedures, where no Medicare benefit is payable
    • Ambulance transfers between hospitals (for residents in VIC, SA and NT).


    For treatment listed as an exclusion there is no benefit payable and member will incur significant out of pocket expense for these services. Please review the exclusions on this cover and always check with CBHS to see if you are covered before receiving treatment. The following services are excluded from this cover:

    • Podiatric surgery (provided by a registered podiatric surgeon)
    • Cosmetic services
    • Services for which a Medicare benefit is NOT payable
  • Waiting periods:

    Waiting periods apply to those who are new to private health insurance or those who already have cover with CBHS or another fund, and choose to upgrade to a higher level of cover.

    Parts of waiting periods served within one health fund can be completed in another when a person transfers funds. If you upgrade your level of cover waiting periods may apply to benefits not previously included within your original cover.

    Hospital waiting period Calendar month
    Pre-existing conditions* (except for hospital psychiatric services, rehabilitation and palliative care) 12 months
    Pregnancy and birth 12 months
    Hospital psychiatric services**, rehabilitation and palliative care 2 months
    Accidents***, emergency ambulance transport 1 day
    All other treatments 2 months


    * If a member has a pre-existing condition, a waiting period of 12 months will apply before we will pay hospital or medical benefits towards any treatment for that condition.

    ** Note that upon serving the two month waiting period, members can choose to upgrade their cover (once in a lifetime) and access the higher benefits for hospital psychiatric treatment associated with that cover, without serving an additional waiting period. For more details contact us on 1300 654 123 or by sending an email to

    *** Accident means an unexpected or unforeseen event caused by an external force or object resulting in an injury to the body which requires treatment by a medical practitioner, Hospital or dentist (as the context requires) but excludes pregnancy.

  • Co-payment:

    A daily co-payment of $70 applies to KickStart (Basic Plus). This means that if you go into hospital you will pay $70 for every day that you are there, up to a maximum of 6 days per person or 12 days per family in a calendar year. So, if you are admitted to hospital for two days, you will pay an co-payment of $140.


Extras cover highlights

  • Unlimited preventative dental annual limits

  • Cover for some major dental services

  • Generous limits on services including optical, physio, chiro and other therapies

  • High per service benefits every time you claim

  • Extras
  • What you get
  • Dental Dental *
    1. Unlimited preventative dental care (2 month waiting period)
    2. Limited general dental (2 month waiting period)
    3. Limited major dental (6 month waiting period)
  • Optical Prescribed Optical
    1. Frames, lenses and contact lenses covered up to the maximum claimable benefit per service
  • Therapies Therapies
    1. Physio, Chiro, Osteo, Clinical Psychology and Dietitians covered with up to the maximum claimable benefit per service (2 month waiting period)
    2. Alternative therapies including Oriental Therapies and Massage Therapies are also covered with up to 100% cost per service benefits with an overall limit of $200 (2 month waiting period)
  • General Health General Health
    1. Blood glucose accessories and non-pharmaceutical benefits scheme drugs requiring a prescription by law up to the maximum claimable benefit per service (2 month waiting period and referred to by a CBHS recognised doctor)
  • Wellness Benefits Wellness Benefits ^
    1. A generous 90% cost per service benefit applies to health checks including breast examinations, bone density tests, skin cancer screening+, bowel/prostate cancer screening, eye screenings (2 month waiting period)
    2. We cover health management services that will help you quit smoking, as well as weight and stress management programs (2 month waiting period)
    3. We even cover Gym Memberships as part of a Health Management program where recommended by a GP or recognised provider (2 month waiting period

    4. * Benefits are not payable for Do-It-Yourself (DIY) dentistry including whitening kits, aligners and occlusal splints. Please contact us to confirm whether a benefit is payable.

      + Examples of skin cancer screening include mole mapping or digital mole photography.

      ^ CBHS provides benefits towards scans, screenings and tests, where members take a pro-active way to manage their health, but only where these do not attract a benefit from Medicare. We are only able to pay a benefit for selected scans, screenings and tests when they are NOT covered by Medicare. Your GP or provider will be able to advise you if your scan, screen or test, meets Medicare’s criteria for benefits.

A benefit is not payable in respect of a service that was rendered to a Member if the services can be claimable from any other source.

Each group of services within Extras and Packages cover has an overall limit on the amount you can claim. Most limits are based on per person per calendar year, unless otherwise stated in our Extras table.

Description 100% Of the cost up to the per service benefit Overall Limit Benefit Period Waiting Period
Preventative Dental
Oral examinations (011, 012, 013) $27.50-$40 Unlimited Calendar year 2 Months
X-ray (022) $23
Removal of plaque (111) $30
Removal of calculus (114,115) $42-$55
Fluoride application (121) $20
Mouthguard (151,153) $62-$65
Fissure sealing (161) $30
General Dental
Fillings $49-$115


Calendar year 2 Months
Consultation & Examinations $28.50-$35.50
X-rays $20-$45
Extraction or Surgical Dental $50-$200
Major Dental   6 Months
Periodontics (gum treatment) $24-$190
Endodontic (root canal treatment) $35-$180
Service 100% Of the cost up to the per service benefit Overall Limit Benefit Period Waiting Period
Frames 100%


Calendar Year 6 Months
Contact lenses
Description 100% Of the cost up to the per service benefit Overall Limit Benefit Period Waiting Period
Physiotherapy (Initial/Subsequent) $40/$30 $250 Calendar year 2 Months
Chiropractic (Initial/Subsequent) $40/$40
Osteopathy (Initial/Subsequent) $40/$30
Clinical Psychology $50 $250
Dietitian $15-$75 $100
Oriental therapies $26 $200 Calendar year 2 Months
Acupressure, Acupuncture
Chinese Herbal Medicine Consultation, Chinese Massage,
Traditional Chinese Medicine Consultation
Massage therapies
Deep Tissue Massage
Lymphatic Drainage, Myotherapy, Remedial Massage
Sports Massage, Swedish Massage
Therapeutic Massage
Description 100% Of the cost up to the per service benefit Overall Limit Benefit Period Waiting Period
Blood Glucose Accessories 100% $100 Calendar Year 2 Months
Non-Pharmaceutical Benefits Scheme drugs requiring a prescription by law 100% less the current prescribed PBS co-payment for general patients up to $75 per prescription $200

90% of the cost up to the overall limit below

Service Overall Limit Benefit Period Waiting period 
Health checks  $100  Calendar year   2 months
Breast examinations (i.e. mammograms/x-rays)
Bone density tests
Skin cancer screening
Bowel/prostate cancer screening
Eye Screenings
Health management  $100  Calendar year  2 months
Quit smoking programs2
Weight management programs2
Stress management courses2
Gym membership/Personal training1 $115 ($100 sub limit on personal training) Calendar year  2 months
1 CBHS can only pay a benefit for gym membership/personal trainer where the gym/personal trainer service is provided as part of a health management program, certified by your GP or a recognised provider confirming that the gym/personal trainer program is a health management program. Approval form is available from CBHS. Please note that GP consultations are not covered by CBHS. 2 Must be approved by CBHS

Other Package Covers

  • CBHS Prestige (Gold)


    Prestige (Gold) is a premium level of cover with top of the range hospital cover and very generous limits on Extras. Plus, access to Best Doctors services.

  • CBHS StepUp (Bronze Plus)

    (Bronze Plus)

    A mid-level package cover ideal for those planning a family. Hospital cover includes pregnancy services, while Extras includes more than the basics.

  • CBHS FlexiSaver (Basic Plus)

    (Basic Plus)

    An entry level package for the young healthy singles and couples, designed to give the flexibility to use extras overall limit on service needed the most.

What Our Members Think

I joined as a CBHS member in 1978. Through many health events and challenges CBHS has always been there for me and my family. Their exceptional service over this time has always been appreciated.

- Jenny J

What Our Members Think

I've not long joined CBHS from another fund, but so far I've been impressed by the super helpful and friendly staff, the higher claim limits and rebates at a very competitive premium, and how easy it is to lodge manual claims through the app. Thanks CBHS - you've won me over! 😃

- Jessica B

What Our Members Think

What I love about CBHS is their customer service - friendly staff and always ready to help and email you the information you ask about. Keep up the great work!!!

- Linda S

What Our Members Think

I love CBHS as its so so easy to lodge a claim and whenever i need a question answered friendly consultant is one phone call away. The phone back option instead of waiting is brilliant!

- Rachel N

What Our Members Think

I have been with CBHS since I began at CBA 15 years ago...Now I have three beautiful children, one who has a disability. Our top extras cover has been really essential for his early intervention. I do love the ease of claiming online.

- Annette E

What Our Members Think

I am relatively new to CBHS and am loving it already. I worked for a CBA subsidiary a long time ago but was still eligible to join. So much better that the for-profit funds - our premium is only a little more and we pay a lower co-contribution and get great benefits. I am loving the massage rebate for my partner and gym rebate for me!

- David G

What Our Members Think

I'm extremely happy with CBHS! I have been a customer for about six years. I think the price is reasonable. And i would refer you to my family and friends any day. Thank you CBHS!!!

- Karen W

What Our Members Think

Love CBHS as I never have to doubt that they've got my back when I need it. Been through other insurers who have limited options or limits, yet cost the same or more.

- Mark F