(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in Northern Territory
# 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.
Corporate Cover only
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 surgical podiatrist – limited benefits) |
| Breast surgery (medically necessary) | Implantation of hearing devices | Pregnancy and birth |
| 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 | Rehabilitation |
| Assisted reproductive services | Dialysis for chronic kidney failure | Weight loss surgery |
| Cataracts | Joint replacements |
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.
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 | 011-015 & 111-116 2 Services Per Person, All other General Dental $500 Per Person $1400 Per Policy | Periodic oral examination - 100% of charge Scale & clean - 100% of charge Fluoride treatment - 100% of charge Surgical tooth extraction - 60% of charge |
| Major dental | 12 | $500 per person up to $1,200 per policy (combined limit for major dental & endodontic) | Full crown veneered - 60% of charge |
| Endodontic | 2 | Filling of one root canal - 60% of charge | |
| Optical | 2 | $240 per person up to $720 per policy | Single vision lenses & frames - 60% of charge Multi-focal lenses & frames - 60% of charge |
| Non PBS pharmaceuticals | 2 | $200 per person (combined limit for non pbs pharmaceuticals, psychology & vaccinations) | Per eligible prescription - 60% of charge |
| Physiotherapy | 2 | $250 per person (combined limit for physiotherapy, occupational therapy & speech therapy) | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Chiropractic | 2 | $250 per person (combined limit for chiropractic, podiatry, acupuncture, remedial massage, dietetics/dietary advice, exercise physiology & osteopathy) | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Podiatry | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Psychology | 2 | Combined limit - see Non PBS pharmaceuticals | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Acupuncture | 2 | Combined limit - see Chiropractic | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Remedial massage | 2 | Combined limit - see Chiropractic | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Blood glucose monitors | 12 | $75 per person | Per monitor - 60% of charge |
| Ante-natal/Post-natal classes | 2 | $50 per person | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Dietetics/dietary advice | 2 | Combined limit - see Chiropractic | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Exercise physiology | 2 | Combined limit - see Chiropractic | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Orthotics (podiatric orthoses) | 12 | $100 per person | Orthotics supply & fit - 60% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Speech therapy | 2 | Combined limit - see Physiotherapy | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - 60% of charge |
| Hearing aids | Orthodontic | Other treatments - check with your insurer |
Pensioner Concession Card and Commonwealth Seniors Health Card holders are entitled to free ambulance transport services. St John's ambulance offers a subscription service for ambulance cover in the Northern Territory (https://www.stjohnnt.org.au/ambulance/ambulance-cover.php). Cover is included whilst interstate for less than 21 days.
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.