Change of Druids Cover – When changing to higher levels of hospital cover, qualifying periods and the Pre Existing Ailments Rule applies. In the interim your previous level of cover will apply until you have met all requirements.
Claims Year – The Druids’ Claim Year for all benefit limits is I January to 31 December and the 100% Rule applies to all claims.
Membership – Contributions in Arrears
If you allow your contributions to fall 2 months in arrears your membership may be cancelled and you will have no entitlement to benefits or reinstatement of that membership.
Compensation from other sources – Benefits are not payable for conditions that may give rise to claims for compensation from other sources (eg TAC Workcare, Sports Insurance or litigation cases). The Society reserves the right to recover benefits paid in such cases. Such cases should be discussed with Druids staff so that members are not left out of pocket.
Pre-Existing Ailment Rule – 12 Months waiting period. Benefits are not payable for pre-existing ailments for the first 12 months of membership.

A Pre-Existing Ailment means an ailment or illness, the signs or symptoms of which, in the opinion of a medical practitioner appointed by the Society, existed at any time during the six months preceding the day on which the contributor began contributions to the Society. This is irrespective of whether the member or dependant was aware of the condition. This includes all elective and cosmetic surgery.

In any case where a Pre-Existing ailment may have been present the Society will forward a Medical Treatment History Form to the member for completion by both the medical practitioner and specialist consulted by the member or his/her dependants.
IMPORTANT: PLEASE NOTE, Druids Friendly Society strongly suggests that all members and prospective members discuss any concerns they have with our staff. A confidential review of possible conditions will he undertaken and if necessary referred to our medical referee. In this way the eligibility of benefits can he confirmed before costly treatments are undertaken.
Qualifying Periods – The following qualifying periods apply from the first day of membership.
• One day for accidents.
• Two months for general illness, ancillary, hospital and general dental treatment.
• Six months for spectacles, including tinted optical lenses and contact lenses.
• Twelve months for pre-existing ailments; obstetrics and confinement related conditions, and major dental services such as bridgework, crowns and dentures. Please check with Druids staff if you have doubts about any
dental services.
Transfers from another fund – When transferring from another registered health fund no qualifying periods for benefits will apply provided the following conditions are satisfied:
Transfers between funds must be continuous with no lapse in cover from your previous fund.

The balance of all outstanding qualifying periods must be served before benefits will be payable. If the coverage applied for with Druids is not an equivalent or lower level to the previous cover, further qualifying periods will apply to benefits not previously covered.

All restrictions of benefits applied by your previous health fund will apply for the balance of the restriction or 12 months, whichever is the lesser of the two. Details of membership and claims history will be required from your previous Fund. This can he achieved by completing the form provided and forwarding it to us with your application.

Informed Financial Consent.
Hospitals have an obligation to their patients to provide proper financial information to protect your rights. When hospital treatment is necessary, the hospital admissions department will confirm with the Society your level of cover, eligibility for benefits and any applicable waiting periods. They will be able to inform you of any out of pocket expenses (if any) you are liable for at the time of making your booking.
Hospital Limits – Hospital benefits are covered for 365 days per year providing your doctor issues an acute care certificate under section 3B of the National Health Act to the Society after each 35 continuous days in hospital. Breaks in hospitalisation of less than 7 days will be counted as part of the 35 days period. If an acute care certificate is not issued, benefits are reduced to Nursing Home Type benefits. Psychiatric and Rehabilitation benefits are
restricted to 65 days hospitalisation in any one claim year and are then reduced to hospital default benefits.
Overseas Cover – Where a member who is a resident of Australia incurs hospital expenses whilst temporarily absent from Australia, hospital benefits are payable at the Medical rate of the hospital table to which that member contributes. In no case will the benefits paid exceed the actual charge raised. Druids Friendly Society recommends that Travel Insurance is purchased before travelling overseas.
Suspension of Cover – Members travelling overseas or experiencing financial hardship can suspend their cover for a minimum period of one month to a maximum period of 2 years. Proof of travel or financial hardship is required. No benefits will be paid for claims incurred during the suspension period.
Claims – Claims for services where the provider’s account has not been settled will be paid by a cheque drawn in favour of the provider.
Payment of Contributions
Contributions can be made by Direct Debit, Credit Card, Cash, cheque or money order directly to the Druids Friendly Society.
We can arrange for a monthly direct debit from a bank account or credit union on either the 1st or the 15th day of each month. Payroll deductions can be arranged if your employer agrees. The Society discounts rates by 4% for half yearly and for annual payments. Discounts have already been deducted from the rates shown.
Ombudsman – Druids Friendly Society prides itself on its service to members; we will do everything reasonable to keep you happy with our service. Should you have a complaint please contact the Society and request assistance in managing your complaint. The Society will acknowledge your complaint in writing and endeavour to resolve the matter usually within 21 days.
If the matter remains unresolved you may refer the complaint to the Private Health Insurance Ombudsman.
General
Druids Friendly Society is a trading name for United Ancient Order of Druids Friendly Society Limited ABN 98 087 649 134. The Society is a Registered Health Benefits Organisation under the National Health Act and has been a registered Friendly Society since 1862.
Corporations Law – Liability of Member
Every Member shall undertake to contribute to the assets of the Society in the event of the Society being wound up during the time he or she is a Member and within one year afterwards. The contribution shall be for payment of any possible debts and liabilities of the Society contracted before the time at which he or she ceased to be a Member and of the costs, charges and expenses of such winding up as may he required, but in no case to exceed $2.00.