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Basic Accident Boost Hospital
*Savings may vary between dentists. It is recommended that members obtain a quote prior to treatment.
Restricted
Hospital treatment for physical rehabilitation for a patient related to surgery or illness.
Hospital treatment for the treatment and care of patients with psychiatric, mental, addiction or behavioural disorders.
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.
Exclusions
Hospital treatment for the investigation and treatment of the brain, brain-related conditions, spinal cord and peripheral nervous system.
Hospital treatment for the investigation and treatment of the eyes and content of the eye sockets.
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.
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.
Hospital treatment for surgery for joint reconstructions.
Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder.
Hospital treatment for the investigation and treatment of the male reproductive system including the prostate.
Hospital treatment for the investigation and treatment of the digestive system, including the oesophagus, stomach, gall bladder, pancreas, spleen, liver and bowel.
Hospital treatment for the investigation and treatment of a hernia or appendicitis.
Hospital treatment for the diagnosis, investigation and treatment of the internal parts of the gastrointestinal system using an endoscope.
Hospital treatment for the investigation and treatment of the female reproductive system.
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.
Hospital treatment for pain management that does not require the insertion or surgical management of a device.
Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails.
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.
Hospital treatment for the investigation and management of diabetes.
Hospital treatment for the investigation and treatment of the heart, heart-related conditions and vascular system.
Hospital treatment for the investigation and treatment of the lungs, lung-related conditions, mediastinum and chest.
Hospital treatment for the investigation and treatment of blood and blood-related conditions.
Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion.
Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity.
Hospital treatment for surgery to the teeth and gums.
Hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon. Benefits are limited to only cover hospital accommodation and the cost of a prosthesis per the prosthesis list, as laid out in the Private Health Insurance (Prosthesis) Rules. Medical services such as the anaesthetist or the surgeon’s account in respect to podiatric surgery are not covered under hospital products.
Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device.
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.
Hospital treatment for dialysis treatment for chronic kidney failure.
Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.
Hospital treatment for fertility treatments or procedures.
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.
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.
Hospital treatment for the investigation of sleep patterns and anomalies.
Hospital FAQs
A waiting period is the time between joining when you first take out health insurance or upgrade your cover and when you’re covered for a treatment or service.
Hospital waiting periods apply to:
- New members who have never held private health insurance before. While serving waiting periods, you won't be covered for treatments or services and will not be entitled to claim a benefit from Frank.
- Members who transfer from another health fund and have had a gap in and/or upgraded their cover (see Switching to Frank below for more information).
- Members who upgrade to a higher level of cover or reduce their excess payable. If treatment or service was included on the previous cover at a lower level, and waiting periods have previously been served, members are entitled to the lower benefits on their previous cover while serving the new waiting period for higher benefits or reduced excess.
- Additional members added onto a policy (unless they've already served their relevant waiting periods). Exceptions apply for newborns, adopted and permanent foster children (where the family membership has existed for at least two months).
Switching to Frank
If you have already served your waiting periods on an equivalent or higher level of cover with another fund and joined Frank within 30 days of leaving that fund, you won't have to re-serve your waiting periods. Otherwise, waiting periods will apply from the date you take out your new cover with Frank. If you’ve upgraded your cover, your waiting periods for higher cover will start on the date you upgraded, but you can still claim the equivalent benefit to your previous level of cover during that period.
Waiting Period: 0 days
Accidents – bodily injuries resulting from accidents which occur after the date of joining or upgrading to a higher cover. Ambulance benefits.
Waiting Period: 2 months
Rehabilitation, palliative care, psychiatric and non-pre-existing conditions.
Waiting Periods: 12 months
Pregnancy and birth-related services and pre-existing conditions.
A 'medical gap' or out-of-pocket cost can be incurred when the fee charged by a specialist exceeds the combined benefit provided by Medicare and Frank for an inpatient procedure.
Medicare will pay the first 75% of the Medicare Benefits Schedule fee (MBS) and Frank will contribute at least 25% of the remaining amount.
The MBS fee is only a recommendation and private surgeons in Australia can charge what they deem appropriate for their services. If the fee they charge is greater than the set MBS fee, you will be required to pay the difference; this is called a ‘medical gap’ or an out-of-pocket cost.
To reduce medical out-of-pocket costs associated with hospital admissions, Frank pays inpatient medical benefits in line with the Australian Health Service Alliance’s Access Gap Cover scheme. The Access Gap Cover scheme is an opt-in billing scheme that provides higher benefits than the Government’s Medicare Benefits Schedule (MBS) fee – or “scheduled fee” – and limits the out-of-pocket costs for the billing of your treatment.
Specialists must be registered for Access Gap Cover and choose to opt in to the scheme for the billing of your treatment.
There are two scenarios for how you may be billed by your specialist when they use the Access Gap Cover scheme:
- No Gap – this is where there will be no gap from the specialist to pay following the procedure.
- Known Gap – this is where you will be charged a maximum gap of $500 per specialist, per admission to hospital, or a maximum of $800 for obstetric services.
- excluded on your level of cover
- received while you are within waiting periods
- treatment that occurred outside of your policy being active
- treatment with unregistered providers
- claims for people not listed on the policy
- treatment outside of Australia
- procedures for which Medicare does not pay a benefit
- claimable for compensation, damages, or benefits from another source (e.g. TAC or WorkCover)
- emergency department service fees while not admitted to hospital (e.g. observation, x-rays, drugs and lab tests)
- non-admitted hospital visits, and
- any outpatient medical cost.
If you elect to be treated as a private patient in a registered public hospital or a non-participating private hospital, Frank will pay only the minimum shared room benefits (~except for NSW public hospitals), and this could result in significant out-of-pocket costs for you. Make sure you get written financial consent for any hospital admissions and get in contact with Frank first to check your coverage.
~For NSW public hospitals, Frank will pay for a private room where a member has:
- Signed the Inpatient Election form to be treated as a private patient; and
- Ticked ‘yes’ to a single room if one is available on the Inpatient Election form.
As a private patient in a public hospital, you may have a choice of doctor however you cannot avoid public hospital waiting lists. The length of a public hospital queue is determined by the hospital and is not influenced by Frank.
Disclaimer
Rates are effective 1 April 2025. | All contribution quotes by this calculator are subject to variation and should therefore be considered indicative contribution rates. | All prices include the Australian Government Rebate on private health insurance as per selected income level and do not include any applicable Lifetime Health Cover loading. | All payments are only available via direct debit from a bank/ credit union account. | Frank does not issue payment notices or invoices.
