(before any rebate, loading or discount)
Covers only one person
Available in NSW & ACT
# 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.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.
| Back, neck and spine | Gastrointestinal endoscopy | Pain management |
| Blood | Gynaecology | Pain management with device |
| Bone, joint and muscle | Heart and vascular system | Plastic and reconstructive surgery (medically necessary) |
| Brain and nervous system | Hernia and appendix | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Breast surgery (medically necessary) | Implantation of hearing devices | Rehabilitation |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Skin |
| Dental surgery | Joint reconstructions | Sleep studies |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Tonsils, adenoids and grommets |
| Digestive system | Lung and chest | Hospital psychiatric services |
| Ear, nose and throat | Male reproductive system | Palliative care |
| Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Assisted reproductive services | Dialysis for chronic kidney failure | Pregnancy and birth |
| Cataracts | Joint replacements | Weight loss surgery |
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 of $500 per admission. This is limited to a maximum of $500 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.
NSW/ACT residents -Ambulance coverage is included Australia wide. Residents of all other States please contact the fund for details. NOTE: This Hospital cover provides cover for a Gap Cover Scheme minimising Out-of-Pocket expenses for Doctors services. ****Accident cover is allowed provided you are admitted to hospital (1 day waiting period).
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 | 2 | Gap Free Preventative Dental 100% Benefit Limit 2 Service Person Per Year Items Number 011-015 111-116 | Periodic oral examination - 100% of charge Scale & clean - 100% of charge Fluoride treatment - $25.00 Surgical tooth extraction - $110.00 |
| Major dental | 12 | $1,100 per policy | Full crown veneered - $800.00 |
| Endodontic | 12 | No annual limit | Filling of one root canal - $150.00 |
| Orthodontic | 12 | $600 per policy $2,500 lifetime limit (Sub-limits apply) | Braces for upper & lower teeth, including removal plus fitting of retainer - $2,500.00 |
| Optical | 2 | $290 per policy | Single vision lenses & frames - $210.00 Multi-focal lenses & frames - $290.00 |
| Non PBS pharmaceuticals | 2 | $700 per policy | Per eligible prescription - $70.00 |
| Physiotherapy | 2 | $700 per policy (combined limit for physiotherapy, occupational therapy & speech therapy) | Initial visit - $55.00 Subsequent visit - $45.00 |
| Chiropractic | 2 | $600 per policy (combined limit for chiropractic, podiatry, psychology, acupuncture, remedial massage, dietetics/dietary advice, exercise physiology & osteopathy - Sub-limits apply) | Initial visit - $40.00 Subsequent visit - $35.00 |
| Podiatry | 2 | Initial visit - $45.00 Subsequent visit - $40.00 | |
| Psychology | 2 | Initial visit - $50.00 Subsequent visit - $50.00 | |
| Acupuncture | 2 | Initial visit - $40.00 Subsequent visit - $40.00 | |
| Remedial massage | 2 | Initial visit - $50.00 Subsequent visit - $30.00 | |
| Hearing aids | 36 | $750 per policy (combined limit for hearing aids & other services - Sub-limits apply) | Hearing aid - $625.00 |
| Blood glucose monitors | 12 | $500 per policy 1 appliance(s) every 1 year (combined limit for blood glucose monitors & other services) | Per monitor - 75% of charge |
| Ante-natal/Post-natal classes | 2 | $250 per policy | Initial visit - $25.00 |
| Dietetics/dietary advice | 2 | Combined limit - see Chiropractic | Initial visit - $35.00 |
| Exercise physiology | 2 | Combined limit - see Chiropractic | Initial visit - $26.00 Subsequent visit - $22.00 |
| Health management / Healthy lifestyle | 2 | $65 per policy | Health management - $65.00 |
| Home nursing | 2 | $950 per policy | Initial visit - $35.00 |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $35.00 |
| Orthotics (podiatric orthoses) | 2 | $200 per policy | Orthotics supply & fit - 75% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $35.00 Subsequent visit - $30.00 |
| Speech therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $35.00 Subsequent visit - $40.00 |
| Does not include treatment for: Alexander technique; Aromatherapy; Bowen therapy; Buteyko; Feldenkrais; Western herbalism; homeopathy; iridology; kinesiology; naturopathy; Pilates; reflexology; Rolfing; Shiatsu; Tai chi; Yoga CSIRO Total Wellbeing Diet $60 Per Year Per Membership | |||
| Other treatments - check with your insurer |
Orthodontic is paid at 75% of account in current year to max $600.00 with $250.00 per year accumulated up to a maximum benefit of $2500.00 per person per lifetime.
Health Care Concession Card, Pensioner Concession Card, and Commonwealth Seniors Health Card holders are entitled to free ambulance transport services. If you are not eligible for a concession and want to be covered, you can purchase insurance from a private health fund.
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.