Private Health Information Statement - Combined policy

Healthmate Starter Silver Plus

Monthly Premium

$207.36 #

(before any rebate, loading or discount)

Covers only one person

Available in Northern Territory

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 or an insurer discount. Check with your insurer for details.

Hospital cover

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.

This policy includes cover for

Hospital Cover Legend
Assisted reproductive servicesEye (not cataracts)Pain management
Back, neck and spineGastrointestinal endoscopyPain management with device
BloodGynaecologyPalliative care
Bone, joint and muscleHeart and vascular systemPlastic and reconstructive surgery (medically necessary)
Brain and nervous systemHernia and appendixPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
Breast surgery (medically necessary)Implantation of hearing devicesPregnancy and birth
CataractsInsulin pumpsRehabilitation
Chemotherapy, radiotherapy and immunotherapy for cancerJoint reconstructionsSkin
Dental surgeryJoint replacementsSleep studies
Diabetes management (excluding insulin pumps)Kidney and bladderTonsils, adenoids and grommets
Dialysis for chronic kidney failureLung and chestHospital psychiatric services
Digestive systemMale reproductive system
Ear, nose and throatMiscarriage and termination of pregnancy

This policy does not include cover for

Hospital Cover Legend
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.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess on admission. This is limited to a maximum of $250 per person and $250 per policy per year.

Excess payments do not apply to hospital admissions for accidents.

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)
  • 2 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

Comprehensive hospital cover packaged with extras. No excess for accident related treatment and dependants under 25. Includes travel and accommodation benefits for hospital admission and cover for unlimited emergency ambulance trips. See fund rules for more information. Access to over 100 exclusive offers through HCF Thank You program. For more information visit: www.hcf.com.au/thankyou.

General Treatment Cover

Our nationwide network of No-Gap participating providers gives you access to comprehensive extras cover at an affordable price. Find out more See https://www.hcf.com.au/locations/find-a-participating-provider.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: Includes 100% back on 2 dental check-ups, and 100% back on an initial physio, chiro, osteo and podiatry consult, at participating providers and subject to annual limits.
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental*2$400 per policy
(Sub-limits apply)
Periodic oral examination - $30.00
Scale & clean - $57.00
Fluoride treatment - $27.00
Major dental12No annual limitSurgical tooth extraction - $156.00
Optical2$180 per policySingle vision lenses & frames - 100% of charge
Multi-focal lenses & frames - 100% of charge
Physiotherapy*2$500 per policy
(combined limit for physiotherapy, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy & speech therapy - Sub-limits apply)
Initial visit - $35.00
Subsequent visit - $25.00
Chiropractic*2$330 per policy
(combined limit for chiropractic & osteopathy - Sub-limits apply)
Initial visit - $35.00
Subsequent visit - $22.00
Podiatry*2$150 per policy
(Sub-limits apply)
Initial visit - $25.00
Subsequent visit - $20.00
Acupuncture2$250 per policy
(combined limit for acupuncture, remedial massage & chinese medicine - Sub-limits apply)
Initial visit - $35.00
Subsequent visit - $20.00
Remedial massage2Initial visit - $35.00
Subsequent visit - $20.00
Chinese medicine2Initial visit - $35.00
Subsequent visit - $20.00
Dietetics/dietary advice2Combined limit - see PhysiotherapyInitial visit - $35.00
Subsequent visit - $25.00
Eye therapy (orthoptics)2Combined limit - see PhysiotherapyInitial visit - $35.00
Subsequent visit - $20.00
Health management / Healthy lifestyle2$100 per policyHealth management - $100.00
Occupational therapy2Combined limit - see PhysiotherapyInitial visit - $40.00
Subsequent visit - $28.00
Osteopathy*2Combined limit - see ChiropracticInitial visit - $35.00
Subsequent visit - $28.00
Speech therapy2Combined limit - see PhysiotherapyInitial visit - $40.00
Subsequent visit - $29.00
Vaccinations2$100 per policyPer service - $50.00
$400 combined limit per person per year ($800 per policy) for General dental includes Extractions, Basic Restoration and other restoration services and some general and some miscellaneous services. Vaccinations covers travel vaccines on HCFs approved pharmacy list only. Lower benefits apply for some services after the 15th visit. HCF-approved Online Cognitive Behavioural Therapy courses with a separate annual limit per person/ per policy.

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

General treatment legend
Blood glucose monitorsNon PBS pharmaceuticalsOther treatments - check with your insurer
EndodonticOrthodontic
Hearing aidsPsychology

Other features of this general treatment cover

Health Dollars Loyalty Rewards accrue for 4 years up to a max of $100 per person /$200 per family policy, per year. These can be used to reduce hospital excess or top up current extras benefits

Ambulance cover

In Northern Territory this policy provides:

Emergency: Unlimited with a waiting period of 1 day.

Call-out fees:  will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover

If you are a resident of NT and you don't have an ambulance subscription with your state ambulance service and aren't offered cover under another arrangement, you have unlimited emergency ambulance services provided by state Ambulance Service Providers.

For further information about this policy see

https://www.hcf.com.au/faqs/faqs-cover#what-is-ambulance-cover

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.