(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 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).
| Assisted reproductive services | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| 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) |
| Cataracts | Implantation of hearing devices | Pregnancy and birth |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Joint replacements | Sleep studies |
| Dialysis for chronic kidney failure | Kidney and bladder | Tonsils, adenoids and grommets |
| Digestive system | Lung and chest | Weight loss surgery |
| Ear, nose and throat | Male reproductive system |
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.
Excess payments do not apply to hospital admissions for day surgery.
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.
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 | $1,100 per policy (Sub-limits apply) | Periodic oral examination - $39.00 Scale & clean - $72.00 Fluoride treatment - $28.00 Surgical tooth extraction - $120.00 |
| Major dental | 12 | $1,650 per policy (combined limit for major dental, endodontic & orthodontic - Sub-limits apply) | Full crown veneered - $600.00 |
| Endodontic | 12 | Filling of one root canal - $145.00 | |
| Orthodontic | 12 | Braces for upper & lower teeth, including removal plus fitting of retainer - $600.00 | |
| Optical | 6 | $240 per policy | Single vision lenses & frames - $240.00 Multi-focal lenses & frames - $240.00 |
| Non PBS pharmaceuticals | 2 | $700 per policy (Sub-limits apply) | Per eligible prescription - $75.00 |
| Physiotherapy | 2 | $700 per policy (combined limit for physiotherapy & exercise physiology) | Initial visit - $60.00 Subsequent visit - $60.00 |
| Chiropractic | 2 | $500 per policy (combined limit for chiropractic, acupuncture, remedial massage, chinese medicine & osteopathy) | Initial visit - $37.00 Subsequent visit - $37.00 |
| Podiatry | 2 | $1,000 per policy (combined limit for podiatry, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses) & speech therapy - Sub-limits apply) | Initial visit - $40.00 Subsequent visit - $40.00 |
| Psychology | 2 | $250 per policy | Initial visit - $60.00 Subsequent visit - $60.00 |
| Acupuncture | 2 | Combined limit - see Chiropractic | Initial visit - $37.00 Subsequent visit - $37.00 |
| Remedial massage | 2 | Combined limit - see Chiropractic | Initial visit - $37.00 Subsequent visit - $37.00 |
| Hearing aids | 36 | $1,600 per policy 2 appliance(s) every 3 years (Sub-limits apply) | Hearing aid - $800.00 |
| Blood glucose monitors | 12 | $300 per policy 1 appliance(s) every 3 years (Sub-limits apply) | Per monitor - $300.00 |
| Audiology | 2 | $200 per policy | Initial visit - $33.00 Subsequent visit - $33.00 |
| Chinese medicine | 2 | Combined limit - see Chiropractic | Initial visit - $37.00 Subsequent visit - $37.00 |
| Dietetics/dietary advice | 2 | Combined limit - see Podiatry | Initial visit - $33.00 Subsequent visit - $33.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $60.00 Subsequent visit - $60.00 |
| Eye therapy (orthoptics) | 2 | Combined limit - see Podiatry | Initial visit - $30.00 Subsequent visit - $30.00 |
| Health management / Healthy lifestyle | 2 | $300 per policy (Sub-limits apply) | Health management - $120.00 |
| Home nursing | 2 | $500 per policy | Initial visit - $40.00 Subsequent visit - $40.00 |
| Occupational therapy | 2 | Combined limit - see Podiatry | Initial visit - $33.00 Subsequent visit - $33.00 |
| Orthotics (podiatric orthoses) | 2 | Combined limit - see Podiatry | Orthotics supply & fit - $200.00 |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $37.00 Subsequent visit - $37.00 |
| Speech therapy | 2 | Combined limit - see Podiatry | Initial visit - $33.00 Subsequent visit - $33.00 |
| Vaccinations | 2 | $250 per policy (Sub-limits apply) | Per service - $75.00 |
| Group physio/hydrotherapy session $18 per service. Flu vaccination 1 per calendar year $25 per service. Other eligible vaccines $75 per service. For eligible medicinal cannabis prescriptions a 12 month waiting period applies | |||
| Other treatments - check with your insurer |
In South Australia this policy provides:
Emergency: Unlimited with a waiting period of 2 months.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
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.