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Private Health Insurance (Complying Product) Rules 2015
In force
Administered by
Department of Health and Aged Care
This item is authorised by the following title:
Private Health Insurance Act 2007
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F2024C01114 (C54)
01 November 2024
-
28 February 2025
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Part 1 Preliminary
1. Name of Rules
3A. Authority
4. Definitions
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Part 2 General
5. Insured groups
5A Psychiatric treatment—limitations
6. Maximum percentage of discount
7. Benefits authorised to be provided under a policy
8. Complying products―coverage requirements
8A Benefit requirement―nursing home type patients
9AA Terminating products—portability requirements
9A Specialist psychiatric treatment—portability requirements
9B Specialist psychiatric treatment—choice to have upgrade treated in accordance with rule 9A
10. Transfer certificates
11. Performance indicators
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Part 2A Age based discounts
11A. Definitions
11B. Requirements for age based discount policy to be complying health insurance policy
11C. Calculation of age based discount
11D. Circumstances in which a person is entitled to age based discount
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Part 2B Requirements relating to product tiers for, and names of, insurance policies
11E. Product tiers for insurance policies that cover hospital treatment
11F. Coverage of treatments for insurance policies that cover hospital treatment
11G. Provision of restricted and unrestricted cover
11H. Naming of insurance policies that cover hospital treatment
11J. Naming of insurance policies that cover general treatment only
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Part 3 Private health information statements and other information that must be given
12. Private health information statements
13. Method of making private health information statements available
14. Information relating to changes to premiums to be provided to Private Health Insurance Ombudsman
15. Information provided to insured persons
16. Information provided to persons about product subgroups
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Part 4 Pilot Projects
17. Kinds of pilot projects
18. Requirements of pilot projects
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Part 5 Transitional provisions
19. Transitional provisions relating to the Private Health Insurance (Complying Product) Amendment (Psychiatric Care) Rules 2018
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Schedule 1―Information and form of words for private health information statement—all policies
1. Interpretation
2. Information and form of words for private health information statement—all policies
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Schedule 2—Additional information, and form of words, for private health information statement—hospital treatment
1. Interpretation
2. Additional information and form of words—hospital treatment
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Schedule 3—Additional information, and form of words, for private health information statement—general treatment
1. Interpretation
2. Additional information and form of words—general treatment
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Schedule 4—Product tiers and clinical categories
1. Product tiers and clinical categories
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Schedule 5—Clinical categories
1 Interpretation
2 Clinical categories
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Schedule 6—Common treatments list
1 Common treatments list
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Schedule 7—Support treatments list
1 Support treatments list
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Endnotes
Endnote 1—About the endnotes
Endnote 2—Abbreviation key
Endnote 3—Legislation history
Endnote 4—Amendment history