Prescriptions and medications. What can I claim? We all know that the cost of prescription medications can add up. That’s why it’s great to know that you may be covered for some of those high-cost prescription medications (medicines, vaccinations and injections) under your Extras cover. Your RT Health Cover Guide is a good place to start when checking in to see what you’re covered for. Your benefit and benefit limit will be listed under ‘Pharmaceuticals’. What can I claim? There are a few things to know about claiming prescriptions and medications (once you’ve served any waiting periods). We’ve listed a few here for you. So you can claim a benefit for your prescribed medication, it must: Be prescribed to you by a registered medical practitioner in Australia Be a S4 or S8 medication (that means it’s a prescription-only medicine) Be purchased in Australia and approved by the Therapeutic Goods Administration (TGA) Not already subsidised under the Pharmaceutical Benefits Scheme (PBS).  The PBS is a government program that subsidises medicines to make them cheaper.  Cost more than the current PBS co-payment amount of $31.60 per item purchased (the amount set by the government for 1 January to 31 December 2024). We’ll pay a benefit on your script costs on non-PBS items (after you’ve paid the PBS patient co-payment amount of $31.60). The amount you get back will depend on your level of cover. What can’t I claim? It’s also important to know there are medications you can’t claim (and the reasons why). RT Health can’t pay benefits on: Over-the-counter medications that you can buy without a prescription Medicines and pharmaceuticals listed on the PBS Prescriptions and medications that cost less than the PBS amount of $31.60 (the amount set by the government for 1 January to 31 December 2024). Items not prescribed, dispensed and/or purchased in Australia. Pharmaceuticals not approved by the TGA for supply or sale in Australia. Tips for quick claiming There are a couple of things that will make paying your claim for pharmaceuticals and prescription medications easier. Send us your Official Pharmacy Receipt with your claim. This is a more detailed receipt provided by your chemist/pharmacist that we need to make sure your claim is payable. Just ask your pharmacist for one when you fill your script. We need this receipt to pay your claim (we’re not able to accept register receipts, packaging or scripts when assessing your claim). Not sure you can claim? We’re here to guide you. If you need some info on how and what you can claim, just give us a call on 1300 886 123 or send a quick email to help@rthealth.com.au Use our app. Making claims on the app is quick and easy. Find out more here. 

Extras cover. Your path to a fitter, more active you. Having great Extras cover can really pay dividends when it comes to being proactive about your health and wellbeing. It’s like having a savings account that you can call on when it comes to self-care. Great eyes. Great teeth. Great ears. Being able to plan for regular check-ups to keep your teeth and eyes in great shape means you’re ahead of the curve when it comes to keeping your health in tip-top shape. Extras cover supports you to stay well be giving you the freedom to book and plan ahead … without having to worry so much about the cost. And once you’ve got a family to take care of, it becomes even more important. At RT Health we pride ourselves on our Extras cover options. There really is something for everyone. Plus, our members can save even more by using our network of preferred providers for your dental and optical needs. We have agreements with dental and optical providers. This makes things easier for you knowing there’ll be a reduced out of pocket (in most cases) when you visit our list of providers. There’s all listed under ‘the ‘Heath Services’ tab on our website. You’ll find them listed under dental providers and optical providers. And remember, you have access to HCF’s network of Eyecare and Dental Centres, if there’s one near you. But if you have a provider you’ve come to know and trust, you’ll still be covered. RT Health will still provide benefits for claimable services from any registered dental or optical providers in Australia. Hearing aids are also an important item for many Aussies. Extras cover provides that helping hand when it comes to claiming the cost of these vital aids. Your Extras cover also helps cover the cost of your audiology consultations.  Get paid for going to the gym Well, not really. But we do give you a helping hand by paying benefits under ‘Health Improvement ‘towards your gym membership (as long as you're covered by your Extras).  If your gym is a registered fitness provider, you’ve filled in the special ‘Gym benefits authorisation and claim’ form (this is separate from the usual claim form) and have had it signed by your doctor or healthcare provider, you’ll get a benefit to pay towards your gym membership. And, you can claim one every year by following the same process. How cool! Specialist therapies when you need them There’s nothing worse than living with pain. Specialist therapy treatments like chiro and physio can go a long way to providing relief. And if you’ve got Extras cover, you know you won’t need to foot the whole bill at your appointments. Specialist therapies also includes access to services like occupational therapy, dietetics, osteopathy, podiatry, speech therapy and eye therapy (orthoptics).  So, depending on your level of cover, you’ll get some financial support in getting treatments when you need them. Need a massage? Alternative therapies are also included in the benefits paid on most Extras covers. That means you’ll get a benefit when you receive a remedial massage treatment (from a registered provider).  Acupuncture (so many people swear by it), Chinese herbalism and myotherapy may also be covered. Mental health support Many people don’t realise that psychology is covered by Extras (depending on the level of cover you choose). There are generous benefits under most RT Health’s Extras covers to provide members with access to great mental health support.   A helping hand with medicines We all know that sometimes prescribed pharmaceuticals can cost a lot. That’s why it’s great to know that you may be covered for some of those high-cost items that have been prescribed for you. We’ll pay a benefit on your script costs on non-PBS items (after you’ve paid the PBS patient co-payment amount of $31.60). The amount you get back will depend on your level of cover. Nonetheless, it’s a great way your Extras cover support you to stay well. (You’ll also need an Official Pharmacy Receipt when you submit your claim, so don’t forget to remind your pharmacist you need one).  You can read more about claiming prescriptions and medications here.  Health Aids and Services There’s much, much more that’s covered by your Extras, so it’s worth doing a deep dive into your Cover Guide to see what you’re covered for.  You’ll need a referral letter from your healthcare provider to claim on benefits listed under Health Aids on your Cover Guide.  We’ve listed a few things here that you might not know you’re covered for by your Extras cover (these may depend on your level of cover). Custom orthotics Blood glucose monitors, blood pressure monitors Compression garments (not sporting wear) BPAP and CPAP machines Wheelchairs, crutches. Questions? Being empowered to use your Extras cover to support your general health and wellbeing is an important aspect of private health cover.  That’s why we’re with you every step of the way. If you have a question, just give us a call. We’d be happy to help.

Avoiding out-of-pocket costs when going to hospital We all hope our hospital stays are few and far between. But at RT Health, we like to make things simple. And, we want you to get great value from your cover. That means avoiding as many out-of-pocket costs and unexpected bills as you can. With just a few simple questions at stages throughout the planning for hospital process, you’ll be able to get the info you need to be prepared for your hospital stay. As an RT Health member with private hospital cover, you can choose to be treated in either a private or public hospital. Your choice will depend on your level of cover and the type of treatment you’re having. Keep in mind that even as a private patient in a public hospital, it’s possible you’ll be placed on a waiting list. TALKING TO YOUR DOCTORS Visit your GP You might know the drill. You need a referral from your GP to see a specialist doctor (like a surgeon, for instance) to kick off the whole planned procedure process. Finding a specialist Finding the right specialist for you is important when it comes to managing your health and avoiding or limiting your out-of-pocket costs. Your treating doctor is really your choice. You have the right to ask your GP for another referral if you’re not happy with the specialist they’ve suggested, or you can also ask for an ‘open referral’. This means you can choose from a list of appropriately qualified specialists and select the one who suits you best. (Remember, any specialist consultations or treatments you receive outside of hospital can’t be claimed under your private hospital insurance. Hospital insurance only applies once you are admitted as an inpatient to hospital.) Our Find a Doctor tool can help you see if your doctor/specialist has previously participated in our Medicover program. DON’T BE AFRAID TO ASK QUESTIONS It’s important to make sure you fully understand your planned procedure. Knowing all the relevant information is part of informed clinical consent. You want to get the best value from your private hospital cover as well, so asking your specialist about any out-of-pocket costs is vital. RT Health’s Medicover program can help curb out-of-pocket costs. It’s a ‘gap cover scheme’ that helps us provide benefits to cover some or all of any gap payments. Doctors can elect to participate on a case-by-case basis, so you’ll need to check in with your treating specialists to see if they’ll participate for your treatment (more on this below). GET INFORMED When you visit your specialist, you’ll learn about the treatment options recommended for you. Now’s the time to gather information, so make sure you receive an itemised quote to help guide your decision making. Your doctor should be able to give you a breakdown of the cost of your treatment. This is known as informed financial consent. You should also ask about any out-of-pocket costs that you may incur from other treating specialists or care providers (like assisting surgeons, anaesthesiologists or pathology testing). Here are some questions to ask your specialist when it comes to your medical costs. What are the MBS item numbers for my treatment and what will be the charge for each of these items? Can I have a written quote or advice on costs of my procedure (and any out-of-pocket costs), including fee estimates for any other treating doctors, so I can review before agreeing to the treatment? Will you treat me under RT Health’s Medicover program? How and when will I be billed for any out-of-pocket costs? Talking to your hospital If you choose to go to a public or private hospital that’s contracted with RT Health, your hospital fees should generally be covered (as long as you’re covered for the treatment you’re having). However, it’s always good to ask some specific questions of the hospital before your admission. Here’s a few handy questions that will help you find out if you’ll be up for additional hospital costs: Will I have to pay a gap for my hospital accommodation? What costs will I have to pay out of my own pocket during my time in hospital? (It’s good to know that things like TV, internet, parking, magazines, newspapers aren’t included). If you have an excess, when does it need to be paid, and how? Give RT Health a call As soon as you know that you’ll be having a hospital stay, give us a call. We’ll be able to confirm with you that your hospital fees will be covered, depending on how you’re being treated (public vs. private). We’ll also be able to help you have peace of mind knowing what bills you may expect to get from your treatment (hopefully very few!). We’ll chat with you about: the treatment/procedure you’re having and making sure you’re covered any restrictions you may have on your cover making sure the hospital you’re booked in with is contracted with RT Health any waiting periods and/or pre-existing conditions (if you’re a newer member or have recently changed your cover) making sure your membership is paid up-to-date and any payments you’ll need to make before your treatment your excess (if you have one).