(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in South 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 - check with your insurer for details.
This policy does not provide benefits for travel or accommodation (outside of hospital).
| Blood | Ear, nose and throat | Miscarriage and termination of pregnancy |
| Bone, joint and muscle | Eye (not cataracts) | Pain management |
| Brain and nervous system | Gastrointestinal endoscopy | Palliative care |
| Breast surgery (medically necessary) | Gynaecology | Skin |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Hernia and appendix | Sleep studies |
| Dental surgery | Joint reconstructions | Tonsils, adenoids and grommets |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Hospital psychiatric services |
| Digestive system | Male reproductive system | Rehabilitation |
| Assisted reproductive services | Implantation of hearing devices | Plastic and reconstructive surgery (medically necessary) |
| Back, neck and spine | Insulin pumps | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Cataracts | Joint replacements | Pregnancy and birth |
| Dialysis for chronic kidney failure | Lung and chest | Weight loss surgery |
| Heart and vascular system | Pain management with device |
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 on admission. This is limited to a maximum of $750 per person and $1500 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.
Plastic surgery which is medically necessary and related to the treatment of a skin-related condition is covered under the “Skin” clinical category. The excess does not apply to any dependants under the age of 18.
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 | $350 per person up to $700 per policy | Periodic oral examination - $33.00 Scale & clean - $55.00 Fluoride treatment - $20.00 Surgical tooth extraction - $90.00 |
| Optical | 6 | $150 per person up to $300 per policy | Single vision lenses & frames - $150.00 Multi-focal lenses & frames - $150.00 |
| Physiotherapy | 2 | $175 per person up to $350 per policy (combined limit for physiotherapy & exercise physiology) | Initial visit - $28.00 Subsequent visit - $28.00 |
| Chiropractic | 2 | $175 per person up to $350 per policy (combined limit for chiropractic & osteopathy) | Initial visit - $28.00 Subsequent visit - $28.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $28.00 Subsequent visit - $28.00 |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $28.00 Subsequent visit - $28.00 |
| Vaccinations | 2 | $100 per person up to $200 per policy (Sub-limits apply) | Per service - $25.00 |
| Group physio/hydrotherapy session $18 per service. Flu vaccination 1 per calendar year $25 per service. Other vaccines $25 per service. | |||
| Acupuncture | Major dental | Psychology |
| Blood glucose monitors | Non PBS pharmaceuticals | Remedial massage |
| Endodontic | Orthodontic | Other treatments - check with your insurer |
| Hearing aids | Podiatry |
South Australia has a subscription service to cover ambulance within the state, with an additional fee to cover interstate travel (http://www.saambulance.com.au/ProductsServices/AmbulanceCover.aspx).
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.