Private Health Insurance (Medical Devices and Human Tissue Products) Rules (No. 2) 2023
11Benefits for listed items provided as part of hospital‑substitute treatment
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11 Benefits for listed items provided as part of hospital‑substitute treatment
(1) This section is made for the purposes of paragraph (a) of the column headed “The amount of the benefit must be …” in item 4 of the table in subsection 72‑1(2) of the Act and sets out the amount that is the minimum benefit for a listed item provided as part of hospital‑substitute treatment. (2) For a listed item provided as part of an episode of hospital‑substitute treatment, the minimum benefit for the listed item is the amount specified in the column headed “Minimum benefit” of the table in Schedule 1 for the listed item.
Note: Private health insurers cannot cover, as part of hospital‑substitute treatment, a service for which medicare benefit is payable unless the service is specified in the Private Health Insurance (Health Insurance Business) Rules (see paragraph 121‑10(3)(a) of the Act).