(before any rebate, loading or discount)
Covers two adults & dependants (3 or more people, only 2 of whom are adults)
Available in Western Australia
# 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 covers children and other dependants up to and including the age of 20, students up to and including the age of 24, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.
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 $250 per admission. This is limited to a maximum of $500 per year.
Excess payments do not apply to hospital admissions for dependants.
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 - $125.00 |
| Major dental | 12 | $850 per person | Full crown veneered - $800.00 |
| Endodontic | 2 | No annual limit | Filling of one root canal - $125.00 |
| Orthodontic | 12 | $400 per person $2,400 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - $2,400.00 |
| Optical | 2 | $299 per person | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals | 2 | $700 per person (combined limit for non pbs pharmaceuticals & vaccinations - Sub-limits apply) | Per eligible prescription - $70.00 |
| Physiotherapy | 2 | $700 per person (combined limit for physiotherapy, occupational therapy & speech therapy - Sub-limits apply) | Initial visit - $40.00 Subsequent visit - $36.00 |
| Chiropractic | 2 | $480 per person (combined limit for chiropractic, podiatry, psychology, acupuncture, remedial massage, dietetics/dietary advice, exercise physiology & osteopathy - Sub-limits apply) | Initial visit - $26.00 Subsequent visit - $22.00 |
| Podiatry | 2 | Initial visit - $26.00 Subsequent visit - $22.00 | |
| Psychology | 2 | Initial visit - $38.00 Subsequent visit - $38.00 | |
| Acupuncture | 2 | Initial visit - $35.00 Subsequent visit - $35.00 | |
| Remedial massage | 2 | Initial visit - $40.00 Subsequent visit - $40.00 | |
| Hearing aids | 12 | $750 per person | Hearing aid - 75% of charge |
| Blood glucose monitors | 12 | $100 per person | Per monitor - 75% of charge |
| Ante-natal/Post-natal classes | 2 | $150 per person | Initial visit - $15.00 Subsequent visit - $15.00 |
| Dietetics/dietary advice | 0 | Combined limit - see Chiropractic | Initial visit - $26.00 |
| Exercise physiology | 2 | Combined limit - see Chiropractic | Initial visit - $26.00 Subsequent visit - $26.00 |
| Health management / Healthy lifestyle | 2 | $100 per person | Health management - $50.00 |
| Home nursing | 2 | $750 per Calendar Year | Initial visit - $16.00 Subsequent visit - $16.00 |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $28.00 Subsequent visit - $28.00 |
| Orthotics (podiatric orthoses) | 12 | $150 per person | Orthotics supply & fit - 75% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $26.00 Subsequent visit - $22.00 |
| Speech therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $28.00 Subsequent visit - $32.00 |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $70.00 |
| CSIRO Total Wellbeing Diet $299 1 Per Membership Per Year | |||
| Other treatments - check with your insurer |
Aged Pensioner concession 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 or a subscription through the state ambulance service.
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.