Premier Plus Benefits & Limits

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It must be noted that prior approval from BSP Health is required to use most of the benefits available under this plan. 
YOUR BENEFITS YOUR LIMITS
Day Care, Hospitalisation and Surgical Expenses (One-off waiting period of 90 days will apply from the commencement of cover. No waiting period shall apply for conditions arising from an accident. BSP Health will either pay the Local Public Hospital or Approved Private Medical Facility directly or reimburse the cost of treatment.)
Approved Private Medical Facility Annual Limit of $120,000 per condition.
Day Care and related services
100% of charged costs and subject to the schedule of fees provided by the Approved Private Medical Facility.
Hospitalisation, Surgery and related services
100% of charged costs and subject to the schedule of fees provided by the Approved Private Medical Facility.
Prosthesis
Annual limit of $1,000 per condition.
Prosthesis Follow-up Care
Annual limit of $1,000 per condition.
Pre and Post Operative Consultation with Local and Visiting Consultants  For Local Consultants, charged costs will apply as per the Approved Private Medical Facility Schedule of Fees. For Visiting Consultants, charged costs will apply as per the Australian Government Medicare Benefits Schedule.
Transport Subsidy  Up to $150 per trip and limited to 2 trips per confinement. 
Ambulance Services  Reimbursement of charged costs for Hospitalisation or Medical Emergencies.
Any Local Public Hospital
Annual Limit of $10,000 per condition.
Day Care and related services
Charged costs will apply as per the Public Health Schedule of Fees.
Hospitalisation, Surgery and related services Single room accommodation upon availability. Charged costs will apply as per the Public Health Schedule of Fees.
Prosthesis
Annual limit of $1,000 per condition.
Prosthesis Follow-up Care
Annual limit of $1,000 per condition.
Pre and Post Operative Consultation with Local and Visiting Consultants For Local Consultants, charged costs will apply as per the Approved Private Medical Facility Schedule of Fees. For Visiting Consultants, charged costs will apply as per the Australian Government Medicare Benefits Schedule.
Cash Allowance  $50 per day up to $1,000 per confinement provided hospital stay is more than 48 hours and is claimable after discharge. 
Ambulance Services
Reimbursement of 100% of charged costs.
Specialised Treatment by Our Preferred Provider  - covers treatment, travel, meals and accommodation of insured and, if medically necessary, accommodation, meals and travel for an accompanying person and medical attendant.
Approved Local Specialised Treatment that is available and provided by our provider in Fiji. A combined limit of $300,000 per condition.  This limit will change if you seek treatment from your Preferred Provider.
Specialised Treatment not available in Fiji and provided by our provider in New Zealand, Australia or India.
Specialised Treatment  by Your Preferred Provider
i) Specialised Treatment available in Fiji but you prefer treatment by your own provider in New Zealand, Australia or India.  Reimbursement of 60% of charged costs limited to $100,000 per condition. Only treatment costs are covered.
ii) Specialised Treatment not available in Fiji but prefer treatment by your own provider in New Zealand, Australia or India. Reimbursement of 80% of charged costs limited to $150,000 per condition. Covers treatment, travel, meals and accommodation of insured and if medically necessary, accommodation, meals and travel for an accompanying person and medical attendant.
Loyalty Benefits
Funeral Assistance Cover $2,500 per death for the Primary Insured and Insured Spouse limited to $5,000 per policy after one year of continuous cover.
Free Medical Check up
For the Primary Insured and Insured Spouse after every two full years of continuous cover and third year's first installment premiums have been paid.
 Maternity Benefit (One-off waiting period of 12 months from commencement of cover).
Applicable for any registered Public or Private Hospital in Fiji, Australia, New Zealand or India. Reimbursement of 80% of charged costs with an annual limit of $3,500 per policy.
Annual Premium Rates
Age Band
Single ($) Family ($)
From - 13 years 142.07

14-18   170.48

19-23   853.90
1,949.20
24-28 1,182.50 2,605.50
29-33 1,220.37 2,682.23
34-38 1,284.29 2,810.09
39-43 1,362.43 2,966.36
44-48 1,493.19 3,227.79
49-53 1,828.24 3,909.66
54-58 2,522.53 5,298.35
59-63 3,460.01 7,185.07
64 5,338.71 11,018.23

For Family Concession Rates the following conditions apply:

  1. Family rate includes the Primary Insured and his/her legally married or de facto spouse or a single parent or legal guardian with up to 6 dependents.
  2. The single rate will apply if the family rate is more expensive.
  3. Premium rate for age band From birth-13 and 14-18 is only available to the family plan.
  4. The 19-23 age band premium rates will apply to a family where the Primary Insured is under the age of 19.
  5. For a family with more than six children, the six youngest children will use the family rate according to the Primary Insured's age band. The older children will use the single premium rate for age bands From birth-13 and 14-18.

OPTIONAL BENEFITS

To enhance your health insurance benefits, Premier Plus also offers five optional benefits. You can choose one or more of the options, whatever suits your needs and your budget. These options cannot be sold independent of Value Care. The product package under a family plan must be the same or less than the package of the Primary Insured, therefore no family member can have more benefits than the Primary Insured.


IMPORTANT NOTES

The Information in this web page is for information only, effective from 21 January 2013 and does not constitute a legally binding document. Full details are outlined in the Policy Document.

  • Terms and conditions apply to all benefits.
  • Maximum limits are annual amounts unless stated otherwise.
  • Treatments that are not available at an Approved Private Medical Facility will be referred to the Local Public Hospital.
  • All dependents must be totally reliant on and related to the Primary Insured by being the biological or adopted single child up to the age of 17 years or up to the age of 23 years if a full time student in an accredited recognised educational institution. Proof of dependency will be required.
  • All amounts are in Fijian dollars unless stated otherwise.
  • A waiting period refers to the period of time the health plan does not cover an insured for a specific benefit or condition.

 

GENERAL EXCLUSIONS

  • All existing medical conditions.
  • All congenital conditions.
  • All conditions related to drugs and alcohol abuse.
  • All conditions related to Sexually Transmitted Infection (STI), Human Immunodeficiency Virus (HIV) infection and Acquired Immune Deficiency Syndrome (AIDS).
  • Air Ambulance Services

 

HOW TO APPLY

We welcome the opportunity to discuss your specific needs and to plan and protect you and your family from future medical expenses. To arrange a no-obligation appointment or to discuss your needs, simply call 132 700 or your Sales Advisor. You can also visit any of our Customer Services Centres or send an online enquiry.

Click here to download a Medical Insurance Application form or click here to download a Medical Claim form.