(before any rebate, loading or discount)
Covers only one person
Available in South 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).
| Bone, joint and muscle | Eye (not cataracts) | Pain management |
| Brain and nervous system | Gastrointestinal endoscopy | Skin |
| Breast surgery (medically necessary) | Gynaecology | Tonsils, adenoids and grommets |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Hernia and appendix | Hospital psychiatric services |
| Dental surgery | Joint reconstructions | Palliative care |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Rehabilitation |
| Digestive system | Male reproductive system | |
| Ear, nose and throat | Miscarriage and termination of pregnancy |
| Assisted reproductive services | Implantation of hearing devices | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Back, neck and spine | Insulin pumps | Pregnancy and birth |
| Blood | Joint replacements | Sleep studies |
| Cataracts | Lung and chest | Weight loss surgery |
| Dialysis for chronic kidney failure | Pain management with device | |
| Heart and vascular system | Plastic and reconstructive surgery (medically necessary) |
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 $750 per admission. This is limited to a maximum of $750 per person and $750 per policy 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.
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 | $600 per policy | Periodic oral examination - $29.60 Scale & clean - $60.20 Fluoride treatment - $17.90 |
| Optical | 6 | $150 per policy | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Physiotherapy | 2 | $200 per policy (combined limit for physiotherapy, exercise physiology & other services) | Initial visit - $40.00 Subsequent visit - $40.00 |
| Chiropractic | 2 | $200 per policy (combined limit for chiropractic & osteopathy) | Initial visit - $32.00 Subsequent visit - $32.00 |
| Acupuncture | 2 | $200 per policy (combined limit for acupuncture, remedial massage, chinese medicine & other services) | Initial visit - $30.00 Subsequent visit - $30.00 |
| Remedial massage | 2 | Initial visit - $25.00 Subsequent visit - $25.00 | |
| Chinese medicine | 2 | Initial visit - $30.00 Subsequent visit - $30.00 | |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $25.00 Subsequent visit - $25.00 |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $32.00 Subsequent visit - $32.00 |
| Blood glucose monitors | Major dental | Podiatry |
| Endodontic | Non PBS pharmaceuticals | Psychology |
| Hearing aids | Orthodontic | Other treatments - check with your insurer |
Excludes chiropractic x-rays.
In South 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.
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.