Value Care SP 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 Limits
Day Care, Hospitalisation and Surgical Expenses in a Local Public Hospital (One-off 30 days waiting period for sickness or illness. No waiting period for accident cases. BSP Health will either pay the Local Public Hospital directly or reimburse the cost of treatment.). Annual limit of $7,500 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 Public Health Schedule of Fees. For Visiting Consultants, charged costs will apply as per the Australian Government Medicare Benefits Schedule.
Cash Allowance $20 per day up to $400 per confinement provided hospital stay is more than 48 hours and is claimable after discharge.
Ambulance Services Reimbursement of charged costs for Hospitalisation or Medical Emergencies.
Day Care, Hospitalisation and Surgical Expenses (One-off waiting period of 30 days will apply from the commencement of cover. No waiting period will apply for conditions arising from an accident).
Annual Limit of $40,000 per condition.
Day Care and related services
Charged costs will apply as per the Approved Private Medical Facility Schedule of Fees.
Hospitalisation, Surgery and related services
Charged costs will apply as per the Approved Private Medical Facility 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.
Transport Subsidy Up to $100 per trip and limited to 2 trips per confinement.
Ambulance Services Reimbursement of charged costs for Hospitalisation or Medical Emergencies.
If treatment is available in any Local Public Hospital Only a cash allowance of $50 per day up to an annual limit of $5,000 per condition will be paid.
Loyalty Benefit for Funeral Assistance Cover
$1,500 per death of the Primary Insured and Insured Spouse limited to $3,000 per policy after one year of continuous cover.
 PREMIUM RATES  
Age Band

 Value Care  Medivac Care
Single ($)
 Family ($)
Single ($)
 Family ($)
From birth - 13 years 28.49   52.09  
14-18 44.30   71.03  
19-23 60.13 180.36 124.31 372.93
24-28 96.59 289.60
196.52 589.57
29-33 101.25 303.76
204.82 614.44
34-38 107.58 322.74
219.02 657.06
39-43 115.57 346.56
236.78 710.33
44-48 142.39 427.17
290.05 870.15
49-53 182.53
547.57
368.77 1,106.29
54-58 260.60 781.59
530.18 1,590.53
59-63 333.40 1,400.39
680.87  2,859.66
64 640.85 2,691.21
1,077.56 4,525.73

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, Value Care SP also offers six 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.

  • Medivac Care - Specialised treatment by Visiting Consultants in Fiji and if treatment is not available locally, then evacuation to our Preferred Provider in India with emergency evacuation to New Zealand or Australia.
  • Outpatient Care - Outpatient consultation at nominated doctors and pharmacies.
  • Outpatient Care Plus - Outpatient consultation plus Specialist and Diagnostics services.
  • Premier Outpatient - Outpatient consultation plus Specialist and Diagnostics services with BSP Health Approved Provider.
  • Dental and Optical Care
  • Allied Health Care
 

IMPORTANT NOTES

The Information in this web page is for information only, effective from November 2015 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.
  • Limit per policy refers to the maximum amount claimable per family or individual cover.
  • Limits are on a per insured basis 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, adopted or under legal guardianship up to the age of 17 years or up to the age of 23 years if a full time student in an accredited 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. BSP Health Care (Fiji) Limited will not pay any claims for conditions sustained during the relevant waiting period.
  • This cover is only offered to all Fiji residents including overseas expatriates holding a work visa valid for a minimum of 3 years.
  • It is important to disclose details of any Existing Medical Conditions or symptom occurring before the commencement of your policy.

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.