Private Health Information Statement - Combined policy

Optimum Basic Hospital & Business 80 Benefits (Single)

Monthly Premium

$262.50 #

(before any rebate, loading or discount)

Covers only one person

Available in All States

# 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.

Overseas resident and employees/members of organisations with arrangements with this health insurer

Hospital cover

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).

This policy includes cover for

Hospital Cover Legend
Back, neck and spineEye (not cataracts)Male reproductive system
BloodGastrointestinal endoscopyMiscarriage and termination of pregnancy
Bone, joint and muscleGynaecologyPain management
Brain and nervous systemHeart and vascular systemPain management with device
Breast surgery (medically necessary)Hernia and appendixPalliative care
CataractsHospital psychiatric servicesPlastic and reconstructive surgery (medically necessary)
Chemotherapy, radiotherapy and immunotherapy for cancerImplantation of hearing devicesPregnancy and birth
Dental surgeryInsulin pumpsRehabilitation
Diabetes management (excluding insulin pumps)Joint reconstructionsSkin
Dialysis for chronic kidney failureJoint replacementsSleep studies
Digestive systemKidney and bladderTonsils, adenoids and grommets
Ear, nose and throatLung and chestWeight loss surgery

This policy does not include cover for

Hospital Cover Legend
Assisted reproductive servicesPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)

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.

The following payments may also apply for hospital admissions

Excess: No excess

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 0 months for all other treatments

Gap Cover

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.

Other features of this hospital cover

Provides cover for included services in public Hospitals with additional Medical benefits for outpatient services and access the Mental Health waiver. Home support services and programs: This program allows you to leave hospital early and continue to receive expert in-home care, so you can recover in the comfort of your own home.

For further information about this policy see

https://www.guhealth.com.au/

General Treatment Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: Pharmaceutical benefits paid for items with an official pharmacy receipt, after you pay a sum equal to the Australian Government’s highest current PBS co-payment. Orthodontics treatment maximum lifetime limit is $2,200 per person. Hearing Aids are limited to one appliance per person every five years.
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental0$1,100 per policy
(combined limit for general dental, major dental, endodontic & orthodontic)
$2,200 lifetime limit for Orthodontic
Periodic oral examination - 80% of charge
Scale & clean - 80% of charge
Fluoride treatment - 80% of charge
Surgical tooth extraction - 80% of charge
Major dental12Full crown veneered - 80% of charge
Endodontic12Filling of one root canal - 80% of charge
Orthodontic*12Braces for upper & lower teeth, including removal plus fitting of retainer - 80% of charge
Optical0$200 per policySingle vision lenses & frames - 80% of charge
Multi-focal lenses & frames - 80% of charge
Non PBS pharmaceuticals*0$700 per policy
(combined limit for non pbs pharmaceuticals, podiatry, psychology, hearing aids, blood glucose monitors, occupational therapy, orthotics (podiatric orthoses) & speech therapy)
Per eligible prescription - 80% of charge
Physiotherapy0$450 per policy
(combined limit for physiotherapy & ante-natal/post-natal classes)
Initial visit - 80% of charge
Subsequent visit - 80% of charge
Chiropractic0$450 per policy
(combined limit for chiropractic & osteopathy)
Initial visit - 80% of charge
Subsequent visit - 80% of charge
Podiatry0Combined limit - see Non PBS pharmaceuticalsInitial visit - 80% of charge
Subsequent visit - 80% of charge
Psychology0Combined limit - see Non PBS pharmaceuticalsInitial visit - 80% of charge
Subsequent visit - 80% of charge
Acupuncture0$200 per policy
(combined limit for acupuncture, remedial massage, chinese medicine, dietetics/dietary advice, exercise physiology & other services)
Initial visit - 80% of charge
Subsequent visit - 80% of charge
Remedial massage0Initial visit - 80% of charge
Subsequent visit - 80% of charge
Hearing aids*12Combined limit - see Non PBS pharmaceuticalsHearing aid - 80% of charge
Blood glucose monitors12Combined limit - see Non PBS pharmaceuticalsPer monitor - 80% of charge
Ante-natal/Post-natal classes0Combined limit - see PhysiotherapyInitial visit - 80% of charge
Subsequent visit - 80% of charge
Chinese medicine0Combined limit - see AcupunctureInitial visit - 80% of charge
Subsequent visit - 80% of charge
Dietetics/dietary advice0Combined limit - see AcupunctureInitial visit - 80% of charge
Subsequent visit - 80% of charge
Exercise physiology0Combined limit - see AcupunctureInitial visit - 80% of charge
Subsequent visit - 80% of charge
Occupational therapy0Combined limit - see Non PBS pharmaceuticalsInitial visit - 80% of charge
Orthotics (podiatric orthoses)12Combined limit - see Non PBS pharmaceuticalsOrthotics supply & fit - 80% of charge
Osteopathy0Combined limit - see ChiropracticInitial visit - 80% of charge
Subsequent visit - 80% of charge
Speech therapy0Combined limit - see Non PBS pharmaceuticalsInitial visit - 80% of charge
Subsequent visit - 80% of charge

This policy does not include General treatment (Extras) cover for

General treatment legend
Other treatments - check with your insurer

Other features of this general treatment cover

GU Health specialises in corporate health cover, providing superior health plans with executive benefits. Enjoy a generous 80% back on all included treatments and services.

For further information about this policy see

https://www.guhealth.com.au/

Ambulance cover

In All States this policy provides:

Emergency: Unlimited with no waiting period.

Non-emergency: Unlimited transport with no waiting period.

Call-out fees: will not be paid.

State schemes provide ambulance services for residents of Tasmania (https://www.health.tas.gov.au/ambulance/fees_and_accounts) and Queensland (https://www.ambulance.qld.gov.au/).

For further information about this policy see

https://www.guhealth.com.au/forms-and-publications/fact-sheets

Disclaimer

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.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

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.

Not Covered

These categories are not covered by this policy.