(before any rebate or insurer discount)
Covers one adult & dependants (2 or more people, only one of whom is an adult)
Available in All States
# 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 24, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.
This health insurer does not operate a preferred provider scheme.
| Note, for items marked with an asterisk *: $450 benefit limit per person in the first year of dental membership. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $1,500 per person (combined limit for general dental, major dental, endodontic, orthodontic & other services - Sub-limits apply) $2,400 lifetime limit for Orthodontic | Periodic oral examination - $59.85 Scale & clean - $122.70 Fluoride treatment - $51.20 Surgical tooth extraction - $247.45 |
| Major dental* | 2 | Full crown veneered - $800.00 | |
| Endodontic* | 2 | Filling of one root canal - $242.30 | |
| Orthodontic* | 24 | Braces for upper & lower teeth, including removal plus fitting of retainer - $800.00 | |
| Optical | 6 | $280 per person | Single vision lenses & frames - $280.00 Multi-focal lenses & frames - $280.00 |
| Non PBS pharmaceuticals | 2 | $300 per person up to $600 per policy (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $45.00 |
| Physiotherapy | 2 | $650 per person up to $1,300 per policy (combined limit for physiotherapy, exercise physiology & occupational therapy) | Initial visit - $50.00 Subsequent visit - $45.00 |
| Chiropractic | 2 | $600 per person up to $1,200 per policy (combined limit for chiropractic & osteopathy) | Initial visit - $40.00 Subsequent visit - $34.00 |
| Podiatry | 2 | $650 per person up to $1,300 per policy | Initial visit - $48.00 Subsequent visit - $44.00 |
| Psychology | 2 | $650 per person up to $1,300 per policy (combined limit for psychology & other services) | Initial visit - $70.00 Subsequent visit - $60.00 |
| Acupuncture | 2 | $600 per person up to $1,200 per policy (combined limit for acupuncture, remedial massage & other services) | Initial visit - $36.00 Subsequent visit - $34.00 |
| Remedial massage | 2 | Initial visit - $36.00 Subsequent visit - $34.00 | |
| Hearing aids | 36 | $1,200 per person up to $2,400 per policy 1 appliance(s) every 5 years (combined limit for hearing aids, blood glucose monitors & other services - Sub-limits apply) | Hearing aid - $1,100.00 |
| Blood glucose monitors | 36 | Per monitor - $260.00 | |
| Dietetics/dietary advice | 2 | $650 per person up to $1,300 per policy | Initial visit - $44.00 Subsequent visit - $40.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $50.00 Subsequent visit - $45.00 |
| Eye therapy (orthoptics) | 2 | $650 per person up to $1,300 per policy | Initial visit - $42.00 Subsequent visit - $38.00 |
| Health management / Healthy lifestyle | 6 | $150 per person up to $300 per policy | Health management - 70% of charge |
| Home nursing | 2 | $600 per person up to $1,200 per policy | Initial visit - $12.00 Subsequent visit - $12.00 |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $50.00 Subsequent visit - $45.00 |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $50.00 Subsequent visit - $45.00 |
| Speech therapy | 2 | $650 per person up to $1,300 per policy | Initial visit - $60.00 Subsequent visit - $55.00 |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $45.00 |
| Ambulance Subscription refund - $52.50 for single/$105 for families. Health Aids & Appliances (combined limit & maximum benefits apply) – Blood Glucose Monitor - $260, Blood Pressure Monitor - $200, TENS Machine - $200, Nebuliser - $200, Constant Air Pressure monitor (CPAP) - $520, Hearing Aids - $1,100, Braces/Splints - up to $600, CAM Boot - up to $600, Artificial Limbs & Prosthesis - up to $600, Crutches/Walking Frame - up to $50, Wigs - up to $300, Compression Garments - up to $300. Waiting periods vary from one year to three years depending on appliance. Includes dentures - full set claimable every 3 years. | |||
| Other treatments - check with your insurer |
Foot orthotics benefits payable after 12 months waiting period - limit combined with podiatry. Five Star Health Management benefits - a full list of services covered can be found on our website. Mental Health - benefit of $32 towards a consultation with a Counsellor or Mental Health Social Worker (service providers must be accredited by ARHG for benefit to payable) - limit combined with Psychology. Members paying by direct debit will receive a 2.5% discount (cheque or savings account only). Contact the Fund for further details.
Ambulance cover is provided by the State government in Tasmania (https://www.health.tas.gov.au/ambulance/fees_and_accounts) and Queensland (https://www.ambulance.qld.gov.au/). In other states concession card holders may have free cover and there are subscription services in several states (https://privatehealth.gov.au/health_insurance/what_is_covered/ambulance.htm).
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.