Value Health Benefits & Limits
| Your Benefits | Limits |
| Day Care, Hospitalisation, Surgical and Medical Treatment in any Government Public Hospital (requires prior approval) 30 days waiting period for sickness or illness. No waiting period for accident cases. | Annual limit of $7,500 per condition |
| Hospital bed and all related services and charges | As charged but not more than Public Health Schedule. |
| Prosthesis | As charged but limited to $1,000 per condition. |
| Cash allowances | $20 per day provided the hospital stay is more than 48 hours. Limit of $400 per stay |
| Visiting Consultants | As charged but not more than the Australian Commonwealth Medical Benefit Shedule of Fees (CMBS). |
| Local Consultants | As charged but not more than the Public Health Schedule of Fees. |
| Day Care, Hospitalisation, Surgical and Medical Treatment in Suva Private Hospital (where condition cannot be treated in any Government Hospital) |
Annual Limit of $40,000 per condition. |
| Hospital bed and all related services and charges | 100% of charged costs with inner limits. |
| Prosthesis | 100% of charged costs but subject to the limits agreed with the Suva Private Hospital |
| Consultant/Surgeon | As charged but not more than the prescribed amount set according to Theatre Bands. |
| Air Transportation Subsidy | 2 trips per hospital stay limited to $100 per trip. |
| Day Care, Hospitalisation, Surgical and Medical Treatment in Suva Private Hospital (although treatment is available in any Government Hospital) |
Only a cash allowance of $50 per day of hospital stay. |
| Loyality Benefit for Funeral Cover (after one full year of cover) |
$1,500 on the death of the Primary Insured. |
| OPTIONAL BENEFITS | |
| Overseas Evacuation if treatment is not available locally. (30 days waiting period for scikness or illness. No waiting period for accidents and prior approval required) Premium is age banded-refer premium table. | |
| Colonial Preferred Provider | 100% of charged costs with inner limits. Annual limit of $150,000 per condition. |
| Non Preferred Provider and treatment not available locally. | 80% reimbursement of charged costs with inner limits. Annual limit of $40,000 per condition. |
| Optical & Dental (12 months waiting period) Premium $156 per person per annum |
Annual limit of $500 |
| Optical Covers Optometrist consultantions,contact lenses,prescriptions spectacle lenses and spectacle frames.A limit of 1 pair of prescription spectacles in a year. |
80% reimbursement of charged costs but not more than $250 per annum. |
| Dental Covers filings (excluding gold filings),diagnostic services and dental maintenance. |
80% reimbursement of charged costs but not more than $250 per annum. |
| Allied Health Services Benefit (12 months waiting period) Premium $125 per person per annum. Physiotherapist, Acupuncturist, Chiropractor, Dietitian, Occupational Therapist, Orthoptist, Podiatrist, and Speech Therapist. |
Annual limit of $200. Will reimburse up to $24 per treatment. In any 12 months a maximum of 6 treatments will be allowed for any one type of treatment. |
| Attachable Benefits |
|
| Priority Care (1 month waiting period) Premium $140 per person per annum Nominate your provider from our list of preferred providers around Fiji including Suva Private Hospital's 24-hour clinic. A registration fee up to a maximum of $5.00 per visit is payable to your nominated doctor. |
• Unlimited consultation with your nominated General Practitioner during normal working hours. • Issuance of prescriptions for Rx pharmaceuticals; • Provision of dressings,injections,infusions and drips. |
| Health Pac (1 month waiting period) Premium $215 per person per annum This is a combination of the Outpatient Plan (Priority Care) and Specialist and Diagnostic Services. Same conditions as Priority Care apply to the Outpatient Plan in this benefit. Specialist and Diagostic Services can be used on referral from your nominated provider. |
Outpatient Plan (Priority Care). As on the previous row. Specialitists and Diagnostic Services Provides 90% reimbursement for medical charges with inner limits. Annual limits are: - Diagnostics - $500 per annum - Specialist - $2,000 per annum |
| PREMIUM RATES | ||
| Age Band (Age next birthday |
Value Health | Overseas Evacuation |
| 6 months-14 years | 18 | 44 |
| 15-19 | 28 | 60 |
| 20--24 | 38 | 105 |
| 25-29 | 61 | 166 |
| 30-34 | 64 | 173 |
| 35-39 | 68 | 185 |
| 40-44 | 73 | 200 |
| 45-49 | 90 | 245 |
| 50-54 | 110 | 297 |
| 55-59 | 157 | 427 |
| 60-64 | 192 | 524 |
| 65-69 | 287 | 645 |
| 70-75 | 287 | 645 |
IMPORTANT NOTES
Information in this web page is for information only and does not constitute a legally binding document. Full details are outlined in the Policy Document.
- Terms and conditions apply
- Maximum limits stated are annual amounts.
- All dependants must be totally reliant on and relatedto the Primary Insured by being the spouse or partner or biological or adopted single child under the gae of 18 years or uder the age of 25 years if a full time student in an accredited educational institution. Proof of being a dependant may be required.
- All amounts are in Fijian currency unless otherwise stated.
- Overseas Evacuation only done in New Zealand or Australia.
- All treatments must be carried out in Fiji unless otherwise stated.
- All pre-existing conditions
- All congenital conditions
- All conditions related to HIV
- All conditions related to drugs and alcohol abuse
- All conditions related to Sexually Transmitted Diseases
For Family Concession Rates the following conditions apply:
- Family Rate applies to a family consisting of the primary insured, legally married or defacto spouse or single parent with more than 2 children but not more than 6.
- Family with upto 6 dependent children, the premium rate will be calculated as the sum of premiums for the Primary Insured, legally married or defacto spouse and 2 oldest dependants or a single parent and 2 oldest dependants in accordance to their age next birthday. No premiums will be charged for dependents3 to 6.
- Family with more than 6 children, premium will be calculated as per the sum of premiums in 2 above, plus, from the 7th dependant where the premium will be calculated in accordance to their respective age next birthday.
- A policy fee of $30.00 is to be added to the primary insured's premium. Group schemes are exempted from the policy fee.
- Premiums on individual policies are payable on an annual,semi annual or quarterly basis.
Click here to download a Health Insurance Application form or call 132 888 and contact your Life & Health Insurance Agent. Alternatively, you can also click here to contact or visit your nearest Life & Health Insurance Sales Office.
Copyright 2010 Colonial Fiji