Private Health Information Statement - General treatment policy

Basic Extras

Monthly Premium

$50.68 #

(before any rebate or insurer discount)

Covers two adults & dependants (3 or more people, only 2 of whom are adults)

Available in Northern Territory

# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include 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 31, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.

General Treatment Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

General treatment legend
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental2$500 per person up to $2,000 per policyPeriodic oral examination - $30.50
Scale & clean - $57.60
Fluoride treatment - $23.20
Major dental12Accident only cover, $250 per accident, maximum $500 per person, membership limit is $2000. Combined with General Dental. Full crown veneered - n/a
Optical6$150 per personSingle vision lenses & frames - $150.00
Multi-focal lenses & frames - $150.00
Non PBS pharmaceuticals2$250 per person up to $500 per policy
(combined limit for non pbs pharmaceuticals, physiotherapy, chiropractic, podiatry, remedial massage, osteopathy, vaccinations & other services)
Per eligible prescription - $25.00
Physiotherapy2Initial visit - $30.00
Subsequent visit - $30.00
Chiropractic2Initial visit - $26.00
Subsequent visit - $26.00
Podiatry2Initial visit - $25.00
Subsequent visit - $25.00
Remedial massage2Initial visit - $25.00
Subsequent visit - $25.00
Osteopathy2Initial visit - $25.00
Subsequent visit - $25.00
Vaccinations2Per service - $25.00
A benefit is also payable for a 50% rebate on full ambulance subscriptions when paid voluntarily but not as a state tax or levy. Vaccinations are for travel vaccines and must be approved by Latrobe.

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

General treatment legend
AcupunctureHearing aidsOther treatments - check with your insurer
Blood glucose monitorsOrthodontic
EndodonticPsychology

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.

For further information about this policy see

https://www.latrobehealth.com.au/health-cover/emergency-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.