(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in Tasmania
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading or an insurer discount. Check with your insurer for details.
Membership of this insurer is restricted to Seventh-day Adventist Church employees, Local Church Officers and their families.
This policy exempts you from the Medicare Levy Surcharge.
This policy does not provide accident cover or benefits for travel and accommodation (outside of hospital).
| Bone, joint and muscle | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Brain and nervous system | Gastrointestinal endoscopy | Pain management |
| Breast surgery (medically necessary) | Gynaecology | Skin |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Hernia and appendix | Tonsils, adenoids and grommets |
| Diabetes management (excluding insulin pumps) | Joint reconstructions | Hospital psychiatric services |
| Digestive system | Kidney and bladder | Palliative care |
| Ear, nose and throat | Male reproductive system | Rehabilitation |
| Assisted reproductive services | Heart and vascular system | Plastic and reconstructive surgery (medically necessary) |
| Back, neck and spine | Implantation of hearing devices | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Blood | Insulin pumps | Pregnancy and birth |
| Cataracts | Joint replacements | Sleep studies |
| Dental surgery | Lung and chest | Weight loss surgery |
| Dialysis for chronic kidney failure | Pain management with device |
The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.
Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.
Excess: You will have to pay an excess on admission. This is limited to a maximum of $750 per person and $1500 per policy per year.
Co-payments: No co-payments
Waiting periods:
This provider offers 'known gap' or 'no gap' cover for medical bills for this product.
The Medical Costs Finder lets you find out more about the cost of specialist medical services.
$750 excess per person per annum for adult non-dependents. For NSW & ACT residents only, Hospital cover includes ambulance cover for emergency (unlimited with no waiting period) and call-out fees (paid for each attendance, including emergency treatment without transport to hospital) in that state or territory only. No ambulance cover for excluded services.
https://acahealth.com.au/quote-details/?hospital=essentials&extras=complete
This health insurer does not operate a preferred provider scheme.
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
|---|---|---|---|
| General dental | 9 | $1,700 per person (combined limit for general dental, major dental, endodontic & other services - Sub-limits apply) | Periodic oral examination - $100.00 Scale & clean - $100.00 Fluoride treatment - $100.00 |
| Major dental | 9 | Surgical tooth extraction - $270.00 Full crown veneered - $1,000.00 | |
| Endodontic | 9 | Filling of one root canal - $1,200.00 | |
| Orthodontic | 9 | $1,700 per person $3,600 lifetime limit (Sub-limits apply) | Braces for upper & lower teeth, including removal plus fitting of retainer - $3,600.00 |
| Optical | 4 | $450 per person (Sub-limits apply) | Single vision lenses & frames - $400.00 Multi-focal lenses & frames - $400.00 |
| Non PBS pharmaceuticals | 2 | $800 per person (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $100.00 |
| Physiotherapy | 2 | $950 per person (combined limit for physiotherapy, chiropractic, exercise physiology, eye therapy (orthoptics), occupational therapy, osteopathy, speech therapy & other services) | Initial visit - $75.00 Subsequent visit - $55.00 |
| Chiropractic | 2 | Initial visit - $56.00 Subsequent visit - $40.00 | |
| Podiatry | 2 | $400 per person | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Psychology | 2 | $500 per person (combined limit for psychology & other services) | Initial visit - $110.00 Subsequent visit - $80.00 |
| Acupuncture | 2 | $500 per person (combined limit for acupuncture, remedial massage, chinese medicine & other services) | Initial visit - $45.00 Subsequent visit - $45.00 |
| Remedial massage | 2 | Initial visit - $45.00 Subsequent visit - $45.00 | |
| Hearing aids | 12 | $1,500 per person 1 appliance(s) every 3 years (combined limit for hearing aids & other services) | Hearing aid - $1,500.00 |
| Blood glucose monitors | 12 | $150 per person 1 appliance(s) every 1 year (combined limit for blood glucose monitors & other services) | Per monitor - $150.00 |
| Audiology | 2 | No annual limit | Initial visit - 50% of charge Subsequent visit - 50% of charge |
| Ante-natal/Post-natal classes | 2 | $500 per policy | Initial visit - 80% of charge |
| Chinese medicine | 2 | Combined limit - see Acupuncture | Initial visit - $45.00 Subsequent visit - $45.00 |
| Dietetics/dietary advice | 2 | $300 per person | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $22.50 Subsequent visit - $22.50 |
| Eye therapy (orthoptics) | 2 | Combined limit - see Physiotherapy | Initial visit - 80% of charge |
| Home nursing | 2 | $1,200 per person up to $100 per service (Sub-limits apply) | Initial visit - $1,200.00 |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $80.00 Subsequent visit - $65.00 |
| Orthotics (podiatric orthoses) | 12 | $400 per person | Orthotics supply & fit - $400.00 |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - $45.00 Subsequent visit - $32.00 |
| Speech therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $50.00 Subsequent visit - $40.00 |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $100.00 |
| Natural Therapies: Naturopathy, Western Herbal Medicine, Shiatsu | |||
| Other treatments - check with your insurer |
Product also covers Osteopathy, Speech Therapy, Occupational Therapy, Homeopathy, Antenatal Classes, Cardiac Rehabilitation, Confinement by Midwife, Diabetes Education, Dietetics, Home Nursing, Orthopaedic Shoes, Vitamins, Naturopathy, Western Herbal Medicine, Shiatsu, and more.
https://acahealth.com.au/quote-details/?hospital=essentials&extras=complete
Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.
https://acahealth.com.au/quote-details/?hospital=essentials&extras=complete
The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.
These categories are not covered by this policy.