(before any rebate, loading or discount)
Covers only one person
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 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 | Eye (not cataracts) | Pain management |
| Blood | Gastrointestinal endoscopy | Pain management with device |
| Bone, joint and muscle | Gynaecology | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Brain and nervous system | Hernia and appendix | Skin |
| Breast surgery (medically necessary) | Implantation of hearing devices | Sleep studies |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Tonsils, adenoids and grommets |
| Dental surgery | Joint reconstructions | Hospital psychiatric services |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Palliative care |
| Digestive system | Male reproductive system | Rehabilitation |
| Ear, nose and throat | Miscarriage and termination of pregnancy |
| Assisted reproductive services | Heart and vascular system | Plastic and reconstructive surgery (medically necessary) |
| Cataracts | Joint replacements | Pregnancy and birth |
| Dialysis for chronic kidney failure | Lung and chest | 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: No excess
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 of coverage. NOTE: This hospital cover provides 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 | $400 per policy 2 service(s) every 1 year | Periodic oral examination - $22.00 Scale & clean - $36.00 Fluoride treatment - $25.00 Surgical tooth extraction - $55.00 |
| Optical | 2 | 1 appliance(s) every 1 year | Single vision lenses & frames - $145.00 Multi-focal lenses & frames - $185.00 |
| Non PBS pharmaceuticals | 2 | $450 per policy | Per eligible prescription - $50.00 |
| Physiotherapy | 2 | $600 per policy (combined limit for physiotherapy, chiropractic, podiatry, psychology, acupuncture, remedial massage, dietetics/dietary advice, occupational therapy & speech therapy) | Initial visit - $36.00 Subsequent visit - $30.00 |
| Chiropractic | 2 | Initial visit - $26.00 Subsequent visit - $22.00 | |
| Podiatry | 2 | Initial visit - $25.00 Subsequent visit - $22.00 | |
| Psychology | 2 | Initial visit - $25.00 Subsequent visit - $25.00 | |
| Acupuncture | 2 | Initial visit - $25.00 Subsequent visit - $22.00 | |
| Remedial massage | 2 | Initial visit - $30.00 Subsequent visit - $20.00 | |
| Dietetics/dietary advice | 2 | Initial visit - $25.00 | |
| Occupational therapy | 2 | Initial visit - $28.00 | |
| Speech therapy | 2 | Initial visit - $36.00 | |
| 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 | |||
| Blood glucose monitors | Hearing aids | Orthodontic |
| Endodontic | Major dental | Other treatments - check with your insurer |
Other Dental benefits included Restorations i.e. Fillings, Metallic, 3 or more adhesive, and Posterior tooth 3 or more surfaces
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.