根据澳大利亚健康保险规定,OVHC如何治疗癌症
癌症治疗分为 住院治疗 和 医疗服务 在每个 OVHC 提供商的资金规则中:
- AIA OVHC -医院和医疗服务涵盖化疗、肿瘤外科、放射治疗和住院护理。
- 保柏 OVHC (工作和就诊保险)= 住院接受必要的医疗治疗,包括癌症。
- 笔尖 OVHC-如果产品涵盖该治疗类别,则包括癌症相关的住院医疗服务和住院治疗。
因此,OVHC可以覆盖癌症,但只能在正确的产品等级之下。
OVHC涵盖哪些癌症治疗?
癌症护理包括广泛的服务。保险公司将其归类为不同的福利类别——以下是根据您的基金规则进行明确的比较:
表:OVHC下的癌症治疗覆盖范围
| Treatment Type |
Covered by OVHC? |
Notes |
| Chemotherapy (inpatient) |
✔ Yes |
Covered when part of hospital treatment |
| Radiation Therapy |
✔ Yes |
Must be medically necessary |
| Cancer Surgery |
✔ Yes |
Surgeons, anaesthetists, theatre fees included |
| Oncology Specialist Fees (Inpatient) |
✔ Yes |
Paid according to MBS limits |
| Diagnostic Imaging (MRI/CT/PET) |
✔ / ✖ |
Outpatient scans may not be covered |
| High-Cost Medicines |
✔ Partial |
Only if listed under PBS/MBS |
| Outpatient Chemotherapy |
✔ / ✖ |
Basic tiers may exclude |
先前存在的癌症:重要的12个月规则
所有 OVHC 保险公司都遵循 同样的规则 为了 先前存在的疾病:
- 如果您的癌症或癌症相关症状在您的 OVHC 保单开始之前就已经存在,则必须提供 12 个月的等待期 在申请治疗之前。
谁来决定你的癌症是否已经存在?
- 保险公司指定的医生会审查您的病历并确定病历中是否存在症状 保单生效前 6 个月。
- 如果医生得出结论,该病并非事先存在,则您的治疗可能会更早地获得保障。
如果癌症在你的OVHC政策开始后发展起来
如果诊断出癌症 在您的保单开始之后,在您完成标准等待期(一般医院服务通常为 2 个月)之后:
✔ 癌症治疗可以承保
前提是您的具体医院类别包含在内 OVHC 计划。
基本与全面的OVHC:它如何影响癌症保险
一些OVHC计划,尤其是较低级别的计划,可能不包括所有医院类别。这里有一个明确的解释:
表:癌症基本与综合OVHC
| Plan Type |
Typical Coverage |
Cancer Treatment Outcome |
Outpatient Cancer Benefits |
Prescribed Medicines (Cancer) |
| Basic / Budget OVHC |
Only selected hospital categories |
Cancer surgery or chemo may be excluded or restricted |
Usually not covered (most outpatient specialist visits, tests, scans excluded) |
Very limited or no cover;patient pays majority of oncology medicines |
| Mid-range OVHC |
Broader hospital cover |
Most cancer treatments covered as inpatient |
Partial cover for outpatient specialist consultations, tests or scans (depends on insurer) |
Some prescribed medicines may be covered under PBS-equivalent amounts; out-of-pocket common |
| Top / Executive OVHC |
Comprehensive hospital + extra services |
Highest approval chances for cancer care |
Highest level of outpatient support — oncology consults, diagnostic tests, follow-ups often included |
Better medicine support — higher rebates, some high-cost cancer medicines may receive partial cover |
当 OVHC 可能无法涵盖癌症治疗时
1。在最初的 12 个月内已存在的癌症
所有保险公司都严格遵守此规则。
2。治疗类别不包括在您的产品等级中
如果涵盖癌症的医院类别被排除在外或受到限制,则您将不在承保范围内。
3.治疗仅作为门诊提供
医院政策涵盖住院治疗。门诊化疗或扫描可能需要自付费用。
4。在非协议私立医院接受治疗
除OVHC福利外,您可能会面临更高的费用。