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.
Ambulance
Members on selected 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 Private Hospital (Bronze)
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.
Cataracts
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
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.
DoH
Department of Health. 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 Access Gap Cover through our partnership with The Australian Health Service Alliance (AHSA).
Providing you choose a doctor that participates in the program you can reduce or even eliminate any gap for medical fees when treated as an inpatient in hospital.
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.
Heart and vascular system
Surgeries related to the treatment of the heart and blood vessels. Includes cardiac surgery and coronary care.
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.
Hospital costs
The costs of services provided by the hospital. These can include things such as the hospital accommodation and meals, operating theatre fees and dressings and bandages.
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.
Medical costs
The cost of receiving your treatment. Medicare and Frank pay benefits towards your medical costs. Medical providers can set their own fees, which determines your out-of-pocket costs for medical treatment.
Medical gap
Medical Gap is the difference between what your doctor charges and what’s covered by Medicare and your hospital cover.
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.
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.
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.
Ombudsman
Free independent advice is available from the Private Health Insurance Ombudsman.
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.
Participating Private Hospital
Hospitals that have an agreement with Frank for what they will charge our members. If you're admitted to a Participating Private Hospital (for a procedure that is included on your Frank cover), you'll pay any applicable excess and we'll pay for your hospital bill. You may still have out-of-pockets for things such as medication when you are discharged, wi-fi, or any incidentals during your stay.
PHIS
Private Health Information Statements (PHIS) 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 PHIS; hospital, general treatment (extras) and combined (bundles).
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
Unlike public hospitals, which are funded by the state and federal governments, private hospitals are funded by a combination of private and government sources including private health insurance, Medicare, the Pharmaceutical Benefits Scheme, third party insurers, and patients. See Participating Private Hospital.
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.
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.
