Clubs

Medicare is a Commonwealth Government programme that provides eligible Australian residents with free or low-cost medical and hospital care.

Medicare provides access to:

• Free treatment as public (Medicare) patient in public hospital
• Free or subsidised treatment by practitioners such as Doctors or specialists.

The medical benefits schedule (MBS) lists all treatments and Associated MBR relating to Medicare.

You can access the MBS at any time by Medicare’s website. Items commonly used by sports participants that are Medicare listed can include General Practitioners, surgeons and an anaesthetists.

The MBS lists a rebate amount for each Medicare Item.

Example: A short consultation with a Doctor = Medicare rebate of $15.36

However, doctors or specialists may charge more than the listed MBS amount.

The difference between was is charged and the MBS rebate is call the “Medicare Gap”

1. The Doctor charges $45
2. Medicare provides a rebate of $15.35
3. Medicare Gap = $29.65 (our of pocket expense).

The Health Insurance Act 1973 (Cth) strictly prohibits any general insurer from insuring any item that is listed on the Medicare Benefits Schedule.

This also means that regardless of your out of pocket expenses, it is against the law for the insurer to cover the Medicare Gap.

So what does that mean?

If your medical or other treatment has a Medicare Item number, such as the doctor fee above, it is claimable on Medicare by is uninsurable and you may not claim for reimbursement.

In the example you cannot claim the $29.65.

If your medical or other treatment does not have a Medicare Item Number, you may claim for reimbursement through Marsh . For specific insurance and Risk Protection information please visit the making a claim section of this website.

Your affiliation with your state or territory tennis association provides you and your members with automatic cover for Personal Accident, Management Liability, Public Liability and Professional Indemnity.

No, you will be issued with a claim number shortly after the claim has been lodged. This claim number can then be used on any further documentation that needs to be submitted to Sportscover in order to support your claim.

No, insurers are unable to pay claims already covered under Medicare, including the Medicare gap in accordance with the Health Insurance Act (Cth) 1973.

A $50 excess is applicable for each and every non-Medicare medical treatment or emergency transport claim in accordance with the policy terms and conditions.

There is a fourteen day waiting period on all loss of income claims in accordance with the policy terms and conditions.

The policy provides cover for emergency ambulance transport only, up to $1,000 for any one event with a $50 excess.

Subject to the policy limits and sub-limits you can make more than one claim during the policy period. It is important however, that you obtain a clearance from your treating physician prior to returning to playing tennis.

No, your club premises and its contents are not covered under the Tennis Australia policy for any material damage or theft. If you would like a quotation for this type of insurance, please complete the Asset Protect application form.

Yes, if you are a Business Package coach member and therefore have automatic equipment cover, we highly recommend you keep an up to date inventory of all your equipment. This could include invoices, photos etc.

• Doctor’s Fees
• Surgeon’s Fees
• Anaesthetist Fees
• X-rays
• Public hospital costs
• MRI Scans

You can’t claim if you …

• Play against medical advice
• Have a pre-existing injury
• Are under the influence of alcohol or drugs
• Are involved in a criminal act
• Have a pre-existing illness or disease (i.e. cancer, heart condition)

Yes, Club fundraising activities are automatically covered under the National Insurance Program. These automatic coverage inclusions would cover things such as Bunnings BBQ’s, Christmas parties or Come and Try days.

If however, your proposed activity involves any of the following please contact Marsh to ensure that cover can be confirmed with the insurer prior to the activity: 4WD rallies, jumping castles, water activities, aircraft, fireworks, livestock, rides of any kind, large crowds or events involving security personnel.

Yes, prospective/trial members are covered under the Insurance Program for up to four weeks from initial approach. After the four week period they will need to become a member in order to be covered by the Program.

The Club must keep all potential claim/injury information on file for at least 7 years after the member has turned 18 years old.

Management Liability insurance is ONLY available to incorporated entities! If your club is not incorporated, individual committee members run the risk of exposing their home, car and financial assets.