8ABenefit requirement―nursing‑home type patients

8A Benefit requirement―nursing‑home type patients

(1) For paragraph 72‑1 (1) (b) of the Act, the requirement in subrule (2) is a benefit requirement for a policy that covers hospital treatment.

(2) The requirement is that the amount of benefit payable under the policy in respect of hospital treatment at a hospital for a nursing‑home type patient must not exceed an amount equal to the fees or charges incurred in respect of that hospital treatment less the amount of the patient contribution in relation to the patient for each day on which the patient is a nursing‑home type patient at the hospital.

(3) In this rule:

nursing‑home type patient has the same meaning as in the Private Health Insurance (Benefit Requirements) Rules, made under section 333‑20 of the Act, as in force from time to time.

patient contribution, for each day on which the patient is a nursing‑home type patient at the hospital, means:

(a) in relation to a nursing‑home type patient at a public hospital, the following amount for the State or Territory in which the hospital is located:

(i) Australian Capital Territory ‑ $78.95;
(ii) New South Wales ‑ $80.95;
(iii) Northern Territory ‑ $80.95;
(iv) Queensland ‑ $80.95;
(v) South Australia ‑ $80.95;
(vi) Tasmania ‑ $80.94;
(vii) Victoria ‑ $80.95; and
(viii) Western Australia ‑ $80.95.

(b) in relation to a nursing‑home type patient at a private hospital, $80.95.