S 4(1) amended by No 99 of 2018, s 3 and Sch 1 items 1 and 2, by omitting " (1) " before " For the purposes of this Act " and substituting para (b), effective 1 April 2019 and applicable in relation to the 2018-19 income year and later income years. Para (b) formerly read:

(b) any excess payable in respect of benefits under the policy is no more than:

S 4(1) and (2) substituted for s 4(1) to (3) by No 32 of 2007, s 3 and Sch 2 item 4, effective 1 April 2007. S 4(1) formerly read:

4(1)
For the purposes of this Act, a person is covered by an insurance policy that provides private patient hospital cover if the policy is an applicable benefits arrangement, within the meaning of section 5A of the National Health Act 1953 , to which paragraph 5A(1)(a) of that Act applies.

S 4(2) repealed by No 99 of 2018, s 3 and Sch 1 item 3, effective 1 April 2019 and applicable in relation to the 2018-19 income year and later income years. S 4(2) formerly read:

4(2)
Paragraph (1)(b) does not apply in relation to an insurance policy under which a person has been insured continuously since the end of 24 May 2000, as long as the amount of any excess payable under the policy has not increased since that time.

S 4(1) and (2) substituted for s 4(1) to (3) by No 32 of 2007, s 3 and Sch 2 item 4, effective 1 April 2007. S 4(2) formerly read:

4(2)
However, for the purposes of this Act a person is not covered by an insurance policy that provides private patient hospital cover if:

(a) the insurance policy that covers the person is an applicable benefits arrangement that:

(i) is modified in accordance with an election described in paragraph (ba) of Schedule 1 to the National Health Act 1953 ; and

(ii) is associated with a health benefits fund conducted by a registered organization under that Act; and

(b) the difference between the lesser benefits mentioned in that paragraph and the benefits payable in accordance with a corresponding applicable benefits arrangement not modified in accordance with such an election is more than:

(i) $1,000; or

(ii) $500, if there is only one contributor (as defined in that Act) to the health benefits fund for the applicable benefits arrangement mentioned in paragraph (a) of this subsection and benefits are not payable under the arrangement in respect of the contributor's dependants (as defined in that Act), if any.

S 4(1) and (2) substituted for s 4(1) to (3) by No 32 of 2007, s 3 and Sch 2 item 4, effective 1 April 2007. S 4(3) formerly read:

4(3)
Subsection (2) does not prevent a person from being covered by an insurance policy that provides private patient hospital cover if:

(a) the person has been covered by the policy continuously since the end of 24 May 2000; and

(b) the election mentioned in subparagraph (2)(a)(i) was made before the end of 24 May 2000.

S 4(4) repealed by No 99 of 2018, s 3 and Sch 1 item 3, effective 1 April 2019 and applicable in relation to the 2018-19 income year and later income years. S 4(4) formerly read:

4(4)
For the purposes of this Act, a person is also covered by an insurance policy that provides private patient hospital cover if:

(a) the policy is issued by a person to whom subsection 67(3) of the National Health Act 1953 applied immediately before the commencement of the Private Health Insurance Act 2007 ; and

(b) in a case where the person referred to in paragraph (a) had been, immediately before that commencement, a registered organisation within the meaning of the National Health Act 1953 - the policy would have been, immediately before that commencement, an applicable benefits arrangement, within the meaning of section 5A of that Act, to which paragraph 5A(1)(a) of that Act would apply.

S 4(4) amended by No 32 of 2007, s 3 and Sch 2 items 5 and 6, by substituting " applied immediately before the commencement of the Private Health Insurance Act 2007 " for " applies " in para (a) and substituting para (b), effective 1 April 2007. Para (b) formerly read:

(b) if the person referred to in paragraph (a) were a registered organization within the meaning of that Act - the policy would be an applicable benefits arrangement, within the meaning of section 5A of that Act, to which paragraph 5A(1)(a) of that Act would apply.

S 4(5) repealed by No 99 of 2018, s 3 and Sch 1 item 3, effective 1 April 2019 and applicable in relation to the 2018-19 income year and later income years. S 4(5) formerly read:

4(5)
However, for the purposes of this Act a person is not covered by an insurance policy that provides private patient hospital cover if:

(a) the person is covered by an insurance policy described in subsection (4); and

(b) any excess payable in respect of benefits under the policy is more than:

(i) $500 in any 12 month period, in relation to a policy under which only one person is insured; and

(ii) $1,000 in any 12 month period, in relation to any other policy.

S 4(5) amended by No 32 of 2007, s 3 and Sch 2 item 7, by substituting para (b), effective 1 April 2007. Para (b) formerly read:

(b) under subsection (2), the person would not be covered by an insurance policy that provides private patient hospital cover for the purposes of this Act, assuming that:

(i) the policy mentioned in paragraph (a) of this subsection were a policy described in subsection (1); and

(ii) the person issuing the policy were a registered organization conducting a health benefits fund under the National Health Act 1953 ; and

(iii) the policy were associated with the fund.

S 4(6) repealed by No 32 of 2007, s 3 and Sch 2 item 8, effective 1 April 2007. S 4(6) formerly read:

4(6)
Subsections (2) and (5) do not limit the circumstances in which, for the purposes of this Act, a person is not covered by an insurance policy that provides private patient hospital cover.

Example:

For the purposes of this Act, a person is also not covered by an insurance policy that provides private patient hospital cover if the person is not covered by an insurance policy described in subsection (1) or (4).

S 4 substituted by No 76 of 2000.