(before any rebate, loading or discount)
Covers one adult & dependants, including persons with a disability* (2 or more people, only one of whom is an adult)
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.
This policy covers children and other dependants up to and including the age of 20, students up to and including the age of 30, as well as persons with a disability.
* Participants in the National Disability Insurance Scheme(NDIS) are considered persons with a disability. Insurers may have a broader definition of persons with a disability. Check with the 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 on admission. This is limited to a maximum of $250 per person and $500 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.
No waiting period applies for hospital treatment resulting from an accident.
By using Peoplecare's 'preferred providers' you may have lower out of pocket costs on Dental and Optical treatments and have access to more 'no gap' treatments. A list of 'preferred providers' is available from Peoplecare. See https://peoplecare.com.au/Members/Providers/Other-health-providers.
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
|---|---|---|---|
| General dental | 2 | No annual limit (Sub-limits apply) | Periodic oral examination - $31.00 Scale & clean - $60.00 Fluoride treatment - $26.00 Surgical tooth extraction - $120.00 |
| Major dental | 12 | $2,650 per person (Sub-limits apply) | Full crown veneered - $750.00 |
| Endodontic | 2 | No annual limit | Filling of one root canal - $110.00 |
| Orthodontic | 12 | $2,100 per person $2,100 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - $2,100.00 |
| Optical | 6 | $300 per person | Single vision lenses & frames - $300.00 Multi-focal lenses & frames - $300.00 |
| Non PBS pharmaceuticals | 2 | $500 per person up to $1,000 per policy (combined limit for non pbs pharmaceuticals & vaccinations - Sub-limits apply) | Per eligible prescription - $65.00 |
| Physiotherapy | 2 | $550 per person up to $1,100 per policy (combined limit for physiotherapy, exercise physiology, eye therapy (orthoptics), occupational therapy & other services - Sub-limits apply) | Initial visit - $50.00 Subsequent visit - $30.00 |
| Chiropractic | 2 | $550 per person up to $1,100 per policy (combined limit for chiropractic & osteopathy - Sub-limits apply) | Initial visit - $45.00 Subsequent visit - $25.00 |
| Podiatry | 2 | $435 per person up to $870 per policy (combined limit for podiatry, acupuncture, remedial massage & dietetics/dietary advice - Sub-limits apply) | Initial visit - $35.00 Subsequent visit - $25.00 |
| Psychology | 2 | $500 per person up to $650 per policy (Sub-limits apply) | Initial visit - $120.00 Subsequent visit - $60.00 |
| Acupuncture | 2 | Combined limit - see Podiatry | Initial visit - $35.00 Subsequent visit - $25.00 |
| Remedial massage | 2 | Combined limit - see Podiatry | Initial visit - $35.00 Subsequent visit - $25.00 |
| Hearing aids | 24 | $1,500 per person 1 appliance(s) every 5 years | Hearing aid - 80% of charge |
| Blood glucose monitors | 2 | $200 per person 1 appliance(s) every 3 years (combined limit for blood glucose monitors & other services - Sub-limits apply) | Per monitor - $200.00 |
| Ante-natal/Post-natal classes | 2 | $150 per person | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Dietetics/dietary advice | 2 | Combined limit - see Podiatry | Initial visit - $35.00 Subsequent visit - $25.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $40.00 Subsequent visit - $30.00 |
| Eye therapy (orthoptics) | 2 | Combined limit - see Physiotherapy | Initial visit - $40.00 Subsequent visit - $30.00 |
| Health management / Healthy lifestyle | 6 | $150 per person up to $300 per policy | Health management - 100% of charge |
| Home nursing | 2 | $1,000 per person | Initial visit - $45.00 Subsequent visit - $45.00 |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $60.00 Subsequent visit - $35.00 |
| Orthotics (podiatric orthoses) | 2 | $250 per person up to $500 per policy 1 appliance(s) every 2 years (Sub-limits apply) | Orthotics supply & fit - 80% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $45.00 Subsequent visit - $25.00 |
| Speech therapy | 2 | $800 per person | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $65.00 |
| Other treatments - check with your insurer |
In Northern Territory this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Non-emergency: Unlimited transport with a waiting period of 1 day.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
Unlimited Ambulance covers you Australia wide for land, sea and air transport.
https://www.peoplecare.com.au/health-insurance/hospital-cover/ambulance
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.