Trauma Recovery Extender Benefit 2010
We pay for ongoing intensive day-to-day care from the Trauma Recovery Extender Benefit
The Trauma Recovery Extender Benefit is available on Executive, Comprehensive, Priority, Saver and KeyCare Plus Plans. Core Plans do not offer day-to-day cover and so members on Core Plans do not have access to the Trauma Recovery Extender Benefit. Typical day-to-day costs this benefit pays for:
- GP and specialist visits
- Private nursing*
- Allied healthcare services, such as physiotherapy, occupational therapy and speech therapy
- Prescribed medicine, schedule 3 and above*
- Radiology
- Pathology
- External medical items*, like wheelchairs, limb prostheses or hearing instruments
- Consultations with a psychiatrist or psychologist
*On the Executive, Comprehensive and Priority Plans the day-to-day limits that apply to claims paid from your day-to-day benefits also apply to the Trauma Recovery Extender Benefit. On the Saver and KeyCare Plus Plans, different limits apply. View the limits.
How the benefit works
Once you’re on the Trauma Recovery Extender Benefit, certain claims linked to the trauma event won’t be paid from your Medical Savings Account. Instead, we will fund these claims from your Trauma Recovery Extender Benefit. This helps preserve the money in your Medical Savings Account. We pay these claims from this benefit for the rest of the calendar year in which the trauma happened.
The Trauma Recovery Extender Benefit pays for certain day-to-day care after a traumatic incident which results in the following conditions:
Trauma conditions
Crime-related injuries
- Conditions resulting from a near-drowning
- Poisoning
- Severe anaphylactic (allergic) reaction
- External and internal head injuries (We use Beta or FIMS score indications to measure the severity of this physical trauma.)
These conditions must require an ICU stay of 5 days or more
Other Trauma conditions
- Paraplegia (paralysis of the lower half of the body affecting both legs, usually due to disease of, or injury to, the spinal cord)
- Quadriplegia (paralysis of all four limbs, ie arms and legs).
To qualify for these benefits there must be severe lessening of the quality, strength, or effectiveness of the limbs, shown by loss of reflexes, numbness and loss of spine motion.
We use Beta or FIMS score indications to measure the severity of the physical trauma.
- Severe burns (characterized by the destroying of the skin through the depth of the dermis and possibly into underlying tissues, loss of fluid and sometimes shock).To qualify for this benefit, 15% of the surface area must have full thickness body surface area burns,
