(before any rebate, loading or discount)
Covers only one person
Available in Western Australia
Closed to new members
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading, an age-based discount or an insurer discount. Check with your insurer for details.
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).
| Back, neck and spine | Gastrointestinal endoscopy | Pain management |
| Blood | Gynaecology | Pain management with device |
| Bone, joint and muscle | Heart and vascular system | Palliative care |
| Brain and nervous system | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Hospital psychiatric services | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Implantation of hearing devices | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Sleep studies |
| Digestive system | Lung and chest | Tonsils, adenoids and grommets |
| Ear, nose and throat | Male reproductive system | |
| Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Assisted reproductive services | Insulin pumps | Weight loss surgery |
| Cataracts | Joint replacements | |
| Dialysis for chronic kidney failure | Pregnancy and birth |
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.
Covers fund approved hospital-substitution & chronic disease management services. Rates discounted for premiums paid by direct debit.
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 | $500 per policy (combined limit for general dental, major dental, endodontic, orthodontic & other services - Sub-limits apply) $1,050 lifetime limit for Orthodontic | Periodic oral examination - $39.20 Scale & clean - $84.00 Fluoride treatment - $31.50 |
| Major dental | 12 | Surgical tooth extraction - $83.30 Full crown veneered - $225.00 | |
| Endodontic | 12 | Filling of one root canal - $60.50 | |
| Orthodontic | 12 | Braces for upper & lower teeth, including removal plus fitting of retainer - $300.00 | |
| Optical | 6 | $120 per policy | Single vision lenses & frames - $120.00 Multi-focal lenses & frames - $120.00 |
| Physiotherapy | 2 | $350 per policy (combined limit for physiotherapy, chiropractic, acupuncture, osteopathy & other services - Sub-limits apply) | Initial visit - $17.00 Subsequent visit - $17.00 |
| Chiropractic | 2 | Initial visit - $17.00 Subsequent visit - $17.00 | |
| Acupuncture | 2 | Initial visit - $17.00 Subsequent visit - $17.00 | |
| Osteopathy | 2 | Initial visit - $17.00 Subsequent visit - $17.00 |
| Blood glucose monitors | Podiatry | Other treatments - check with your insurer |
| Hearing aids | Psychology | |
| Non PBS pharmaceuticals | Remedial massage |
An annual sub-limit up to $200 per person per calendar year applies for preventative dental.
In Western Australia this policy provides:
Emergency: Unlimited with no waiting period.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
WA ambulance services depend on whether you live within the Perth metropolitan area or regional WA. Benefits for emergency transportations are available on hospital and selected eligible extras covers. To avoid unexpected out of pockets, we strongly recommend taking out a subscription to be covered Australia wide, regardless of your health insurance. If you have eligible extras cover, provide us with the subscription receipt to receive a benefit up to 100% of the subscription cost.
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.