(before any rebate or insurer discount)
Covers only one person
Available in South Australia
# 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.
Membership of this insurer is restricted to Cover for the ADF community - serving, ex-serving ADF, employees of contractors to ADF and families.
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 | No annual limit (no limit on preventative dental) | Periodic oral examination - $47.50 Scale & clean - $84.50 Fluoride treatment - $26.30 |
| Major dental | 12 | $2,000 per policy (combined limit for major dental, endodontic & other services - Sub-limits apply) | Surgical tooth extraction - $168.80 Full crown veneered - $773.80 |
| Endodontic | 12 | Filling of one root canal - $161.30 | |
| Orthodontic | 12 | $2,500 per policy 1 service(s) every 3 years | Braces for upper & lower teeth, including removal plus fitting of retainer - 80% of charge |
| Optical | 6 | $350 per policy | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals | 2 | $600 per policy (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $120.00 |
| Physiotherapy | 2 | $850 per policy | Initial visit - $67.00 Subsequent visit - $52.00 |
| Chiropractic | 2 | $750 per policy (combined limit for chiropractic, osteopathy & other services) | Initial visit - $60.00 Subsequent visit - $41.00 |
| Podiatry | 2 | $500 per policy | Initial visit - $57.00 Subsequent visit - $44.00 |
| Psychology | 2 | $600 per policy | Initial visit - $110.00 Subsequent visit - $80.00 |
| Acupuncture | 2 | $550 per policy (combined limit for acupuncture, remedial massage, chinese medicine & exercise physiology) | Initial visit - $38.00 Subsequent visit - $38.00 |
| Remedial massage | 2 | Initial visit - $38.00 Subsequent visit - $38.00 | |
| Hearing aids | 12 | $1,300 per policy 1 appliance(s) every 3 years | Hearing aid - 100% of charge |
| Blood glucose monitors | 6 | $700 per policy | Per monitor - 85% of charge |
| Audiology | 2 | $500 per policy | Initial visit - $70.00 Subsequent visit - $55.00 |
| Chinese medicine | 2 | Combined limit - see Acupuncture | Initial visit - $38.00 Subsequent visit - $38.00 |
| Dietetics/dietary advice | 2 | $500 per policy | Initial visit - $80.00 Subsequent visit - $55.00 |
| Exercise physiology | 2 | Combined limit - see Acupuncture | Initial visit - $38.00 Subsequent visit - $38.00 |
| Eye therapy (orthoptics) | 2 | $500 per policy | Initial visit - $70.00 Subsequent visit - $55.00 |
| Home nursing | 2 | $1,000 per policy | Initial visit - $60.00 Subsequent visit - $60.00 |
| Occupational therapy | 2 | $500 per policy | Initial visit - $60.00 Subsequent visit - $40.00 |
| Orthotics (podiatric orthoses) | 2 | $300 per policy | Orthotics supply & fit - 85% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $60.00 Subsequent visit - $41.00 |
| Speech therapy | 2 | $500 per policy | Initial visit - $110.00 Subsequent visit - $55.00 |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $120.00 |
| Other treatments covered include: Laser Eye Surgery ($1,500 per person per benefit year), Medically Prescribed Appliances (includes Blood Glucose Monitors) ($700 per person per benefit year), CPAP Devices ($1,000 per benefit year) and School Accidents ($800 per person per benefit year). Members can access special offers from any of Navy Health’s preferred optical providers: OPSM, Laubman & Pank, Specsavers, Teachers Eye Care, Eyebenefit and Q Optical Network (QON). General treatment benefit year runs from 1 July to 30 June. | |||
| Other treatments - check with your insurer |
Telehealth services available for Physiotherapy, Psychology, Dietetics and Speech Therapy.
In South Australia this policy provides:
Emergency: Unlimited with a waiting period of 2 months.
Non-emergency: Unlimited transport with a waiting period of 2 months, or 2 months for pre-existing conditions.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
We cover 100% of the cost of ambulance services within Australia, provided it is provided by a state based run Ambulance service, by either air/sea or land. We do not provide benefits for privately run patient transport services.
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.