Acupuncture

Alternative therapy – Acupuncture is a form of evidence-based Chinese medicine that involves the stimulation of the body’s energy pathways to encourage normal flow of energy (or Qi) through the body. Acupuncture is used in the treatment of long and short-term conditions.

Acute

Refers to illnesses that are rapid in their onset, short in duration and require urgent care. Duration and care will depend on the illness, for example a broken leg and a sore throat may both be classified as ‘acute’.

Acute care certificate

Required for acute hospital stays that is over 35 continuous days. Long-term acute accommodation is mostly for patients requiring nursing-home type care. The certificates are submitted by the hospital to the health fund as these services are paid at a different rate to other acute care patients.

Agreement hospital

Hospitals that have an agreement with Frank to charge the same amount that we pay. This means that if you’re admitted to a Participating Private Hospital (and your Frank cover doesn’t exclude the procedure), you pay any excess and / or co-payments, and we cover the rest of the hospital bill..

Ambulance

Members with either Frank hospital or a combined hospital and extras policy are covered for clinically necessary, emergency ambulance services Australia wide. To ensure you’re covered for all ambulance trips you require across Australia, review state ambulance subscriptions.

Ancillary policy

Also known as Extras cover, this  can be separate to a hospital cover or combined. Extras covers pay a benefit towards agreed services that are generally not covered by Medicare.

Ancillary services

Also known as extras services, includes cover for treatments like dental, optical, physio, chiro and other therapies. These services are not generally covered by Medicare.

Annual limit

The total amount in a year you can claim on an extras service. Frank’s annual limits reset at the beginning of each calendar year.

Antenatal

Services relating to pre or pregnancy care before a birth.

Appliance

Medical appliances are devices used on the body that have a physical or medical effect, or are used for monitoring. Appliances can range from simple bandages to blood pressure monitors.

APRA

The Australian Prudential Regulation Authority (APRA) oversees private health insurance, banks, credit unions, building societies, general insurance and reinsurance companies, life insurance, friendly societies and most members of the superannuation industry.

Artificial aids

Items to help someone manage an illness or condition such as splints, casts, supportive wear, monitoring devices or protective items.

Assisted reproductive services

Pregnancy related service, assisted reproductive services provided by a participating private hospital relating to egg retrieval and implantation.

Benefit

The amount the fund covers for a service. For Frank extras services, you will receive an agreed percentage benefit back on services from a registered provider.

Blood glucose monitors

A blood glucose monitor is a device for monitoring your blood glucose level in order to reduce the chances of developing complications from diabetes.

Branch

A health insurance branch is a physical store or location for visiting your insurer. To keep prices down, Frank does not have branches. You can claim online, access our member area to self-help or chat or call us during business hours.

Basic general treatment policy

This is also known as ‘basic extras cover’ or a ‘basic ancillary product’. Frank’s basic general treatment policies are: Some extras 50% back and Some extras 80% back.

Basic private hospital policy

This is an entry-level hospital cover that offers private care in a private hospital. It likely has some restrictions to keep costs down. Check our Frank’s Basic Private Hospital cover or Basic hospital with some extras.

Calendar year

A period of 12 months, 1 Jan – 31 December. Frank operates on a calendar year and our benefits reset 1 January each year.

Cardiac and cardiac-related services

Surgeries related to the treatment of the heart and blood vessels. Includes cardiac surgery and coronary care.

Cataract and eye lens procedures

Eye surgeries including cataract surgery, eye lens procedures and corneal transplants. Check with Frank if you require these services.

Certified age at entry

Your CAE is based on the age you were on 1 July prior to you first taking out hospital cover. This is used to calculate your Lifetime Health Cover (LHC) loading.

Change of cover

When you transfer to Frank from another fund, we will contact your old fund on your behalf. We’ll request the cancellation of your previous cover and ask them to send us a transfer certificate. A transfer certificate ensures you don’t have to reserve waiting periods and ensures continuity of cover for your certified age at entry and LHC.

Chiropractic

Chiropractic care uses manual treatments (including spinal manipulations – termed ‘adjustments’) to treat disorders of the musculoskeletal system.

Closed policy

A type of policy no longer available to new members. If you are on a closed policy, there may be new offerings better suited to you.

Community Rating

Community Rating means that Frank believes everyone is entitled to access to the same health insurance policies, for the same price, regardless of health status, history or previous claims.

Comprehensive general treatment policy

General treatment is another name for ‘extras’ or ‘ancillary’, the non-hospital component of health insurance. A comprehensive extras policy includes a wide range of services

Contributor

A financial member of a health fund

Co-payment

A co-payment is a fee that you will need to pay if you’re admitted into a private room in a public or private hospital under selected hospital covers. A co-payment helps to reduce the premium of the cover. If you’re admitted into a shared room in a public or private hospital, you won’t need to pay a co-payment. Most Frank hospital covers do not have a co-payment.

Corporate policy

Frank offers some corporate groups special offers. To find out if your business is part of a corporate deal, or if you are interested in your business participating, please contact Frank.

Cosmetic surgery

Limited benefits may apply on hospital covers for cosmetic surgery, depending on the medical justification for the surgery. We recommend you contact us prior to any planned surgery to confirm your cover and benefits.

Dental

General and preventative dental includes dental treatments like check-ups, cleaning and fluoride treatments, x-rays, fillings and basic extractions.

Major Dental includes treatment for things like more complicated fillings, extractions, crowns, bridgework, dental implants, root canal treatment, indirect restorations and occlusal therapy.

Dependant

A person who is included under an eligible membership as a child or student dependent.

DoHA

Department of Health and Aging. See The Department of Health.

Endodontic services

Endodontic treatments (such as a root canal) are for teeth that are diseased or have nerve damage. These services may be covered under Major Dental treatments.

Excess

An excess is the amount you pay when you are admitted into hospital. Excess fees allow us to keep membership costs low.

Exclusions

Exclusions are services or benefits not included in your cover. Some things are excluded because we are not legally allowed to cover them and some are excluded on certain covers to keep prices down. A product fact sheet will explain what is excluded from a cover.

Extras

Also known as ancillary or general treatment services, includes cover for treatments like dental, optical, physio, chiro and other therapies. These services are not generally covered by Medicare.

Frank

Frank Health Insurance aims to make private health insurance easier. We’re online and we focus on health insurance and nothing else.

Fund

Frank Health Insurance are part of GMHBA Ltd, a not for profit health fund who has been around since 1934.

Fund type

There are for profit, not for profit, member owned and mutual health insurers in Australia. Frank is a not for profit fund and we are part of GMHBA Ltd.

Gap

A Medical Gap is the difference between what your doctor charges and what’s covered by Medicare and your hospital insurance cover.

Gap cover arrangements

All of Frank's hospital covers come with Gap Cover. If your doctor charges more than the MBS, Frank will cover you for up to 20% above the MBS (so you get up to 120% of the MBS).

General hospital costs

Benefits as a private patient in a private or public hospital for all procedures or services.

General treatment policy

Also known as extras services, includes cover for treatments like dental, optical, physio, chiro and other therapies. These services are not generally covered by Medicare.

General dental

General and preventative dental includes dental treatments like check-ups, cleaning and fluoride treatments, x-rays, fillings and basic extractions.

Health fund

Frank Health Insurance is part of the GMHBA Ltd health fund.

HICAPS

HICAPS is an on the spot claims processing system for health funds, Medicare and Worksafe claims.  If your provider does not have HICAPS, you can make your claim in the member area.

Hip replacements

A joint replacement surgery removes an impaired joint such as a hip and replaces them with an artificial joint (known as a prostheses).

Home nursing

Home nursing may be part of a hospital substitution program such as Hospital in the Home and Rehab in the home.

Joint replacements

A joint replacement surgery removes an impaired joint and replaces them with an artificial joint (known as a prostheses).

Knee replacements

A joint replacement surgery removes an impaired joint such as a knee and replaces them with an artificial joint (known as a prostheses).

Labour ward fees

Services and treatment relating to child birth and delivery suite costs. See products with Pregnancy cover and check for participating private hospitals.

Major dental

Major Dental includes treatment for things like more complicated fillings, extractions, crowns, bridgework, dental implants, root canal treatment, indirect restorations and occlusal therapy.

MBS payable item

A procedure covered by Frank Health Insurance. Also see Medicare Benefits Schedule.

Medicare Benefits Schedule (MBS)

Items with a MBS number are used to identify procedures. Request an MBS item from your doctor during consultation and Frank can check your level of cover and provide an estimate of any benefits payable to you.

Medical gap

Medical Gap is the difference between what your doctor charges and what’s covered by Medicare and your hospital cover.

Medicare Levy Surcharge (MLS)

The MLS is a tax set by the Australian Government. It applies to individuals and families on higher incomes who don’t have eligible private hospital cover. It goes directly to funding the national public Medicare system.

Medicare Levy Surcharge exemption

If your annual taxable income falls within the MLS range you can avoid the tax altogether by taking out hospital cover. Read more here.

Members own

Members Own Health Funds is a group of 16 like-minded not-for-profit and mutual health funds run to benefit members. Frank Health Insurance is a Members Own health fund.

Norfolk Island residents

From 1 July 2016, Norfolk Island residents are eligible for Medicare and Australian Private Health Insurance. The Australian LHC rules now apply. Residents were given a 12 month grace period from LHC between 1 July 2016 to 1 July 2017.

Obstetrics

Minor Gynaecological services can include laparoscopy, hysteroscopy, dilatation & curettage (D&C) and some minor cervical procedures.

Ombudsman

Free independent advice is available from the Private Health Insurance Ombudsman. You can call the Ombudsman for free on 1300 362 072 or GPO Box 442, Canberra, ACT 2601.

Optical

Includes prescription glasses, prescription sunglasses and prescription contact lenses

Orthodontics

Orthodontic treatment includes braces or a plate. The benefits for orthodontics sit within dental annual benefits that include general, preventative and major dental. Read more about claiming orthodontics here.

Overnight excess

An excess is the amount you pay when you are admitted into hospital. Excess fees allow us to keep membership costs low.

Palliative care

Palliative care is designed to relieve pain and suffering of patients with life threatening illnesses.

Physiotherapy

Physiotherapy is concerned with the assessment, diagnosis, and treatment of disease and disability through physical means.

Podiatric surgery

Podiatry treats disorders of feet and lower limbs. If you have Podiatric Surgery in a hospital performed by an orthopaedic surgeon, then this would be part of a hospital cover.

Podiatry

Podiatry treats disorders of feet and lower limbs including orthotics which are custom foot supports designed to support the feet and correct any lower limb problems.

Portability

The Private Health Insurance Act 2007 includes 'portability' rules to protect consumers who want to change to another hospital policy with the same insurer or with another insurer. This means that you will not have to wait the normal waiting periods again before benefits can be paid to you.

Pre-existing condition

Pre-existing conditions are classed as any ailment, illness or condition with any signs or symptoms in the 6 months before signing up for hospital cover or upgrading existing cover.

Pregnancy and birth related services

Hospital products with Pregnancy cover services and treatment relating to childbirth or complications during pregnancy.

Premium

This is the amount you pay to be a member of Frank Health Insurance. You can pay your premiums weekly, fortnightly, monthly or yearly.

Private hospital

Participating private hospitals are hospitals that have an agreement with Frank to charge an agreed amount to patients. This means that if you’re admitted to a Participating Private Hospital (and your Frank cover doesn’t exclude the procedure), you pay any excess and / or co-payments, and we cover the rest of the hospital bill.

Psychiatric services

Psychiatric services cover the in hospital treatment of a mental illness or addiction.

Psychology

Psychologists work with patients to gain an understanding of their mind and how it impacts their behaviour. Generally this is done through group or one-on-one discussions.

Remedial massage

Remedial Massage is a combination of massage techniques used to treat injuries of the muscles, tendons, ligaments or connective tissues.

SIS

Standard Information Statements (SIS) are available on all private health insurance policies available in Australia. They can be used to compare health insurance products between funds. There are three types of SIS; hospital, general treatment (extras) and combined (bundles).

State

There are instances where your state of residence may affect your cover and requirements, if you move states, ensure you update your details in the member area. We also recommend checking your ambulance cover for that state.

State of the Health Funds Report

A Commonwealth Ombudsman report that provides comparative information on health funds.

Waiting period

A waiting period is simply the period of time you have to wait between joining and being able to claim. They apply to both hospital and extras cover.

Suspension of private health cover

If you’re heading overseas for more than two months, you may be eligible to suspend your Frank cover for a maximum of three years without affecting your CAE and LHC.