(before any rebate, loading or discount)
Covers one adult & dependants (2 or more people, only one of whom is an adult)
Available in South Australia
# 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 21, 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.
Membership of this insurer is restricted to Cover for the ADF community - serving, ex-serving ADF, employees of contractors to ADF and families.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover - check with your insurer for details.
This policy does not provide benefits for travel or accommodation (outside of hospital).
| 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) | Implantation of hearing devices | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Sleep studies |
| Digestive system | Lung and chest | Tonsils, adenoids and grommets |
| Ear, nose and throat | Male reproductive system | Hospital psychiatric services |
| Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Assisted reproductive services | Dialysis for chronic kidney failure | Pregnancy and birth |
| Cataracts | Joint replacements | Weight loss surgery |
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 $500 per admission. This is limited to a maximum of $500 per person and $500 per policy per year.
Excess payments do not apply to hospital admissions for dependants.
Co-payments: No co-payments
Waiting periods:
Covered as a private patient in a private hospital for any included services on your policy. Navy Health’s cover includes hospital accommodation fees, intensive care fees, theatre fees, and up to 100% of the Medicare Benefits Scheduled fee (MBS) for day admissions or overnight stays. For services that are listed as restricted, you are covered as a private patient in a public hospital. Any admission to a private hospital for a restricted service may result in significant out of pocket costs. For services that are listed as excluded, no benefits are payable.
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.
Core Silver+ Hospital is a hospital policy that offers you a great balance of coverage and price and is perfect for individuals or families with varying health needs. You are also covered for unlimited ambulance cover Australia-wide, which means you are not required to take out ambulance cover elsewhere.
https://navyhealth.com.au/core-silver-hospital-and-premium-extras-cover
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 person (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 person 1 service(s) every 3 years | Braces for upper & lower teeth, including removal plus fitting of retainer - 80% of charge |
| Optical | 6 | $350 per person | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals | 2 | $600 per person (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $120.00 |
| Physiotherapy | 2 | $850 per person | Initial visit - $67.00 Subsequent visit - $52.00 |
| Chiropractic | 2 | $750 per person up to $1,500 per policy (combined limit for chiropractic, osteopathy & other services) | Initial visit - $60.00 Subsequent visit - $41.00 |
| Podiatry | 2 | $500 per person | Initial visit - $57.00 Subsequent visit - $44.00 |
| Psychology | 2 | $600 per person | Initial visit - $110.00 Subsequent visit - $80.00 |
| Acupuncture | 2 | $550 per person up to $1,100 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 person 1 appliance(s) every 3 years | Hearing aid - 100% of charge |
| Blood glucose monitors | 6 | $700 per person | Per monitor - 85% of charge |
| Audiology | 2 | $500 per person | 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 person | 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 person | Initial visit - $70.00 Subsequent visit - $55.00 |
| Home nursing | 2 | $1,000 per person | Initial visit - $60.00 Subsequent visit - $60.00 |
| Occupational therapy | 2 | $500 per person | Initial visit - $60.00 Subsequent visit - $40.00 |
| Orthotics (podiatric orthoses) | 2 | $300 per person | 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 person | 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.
https://navyhealth.com.au/core-silver-hospital-and-premium-extras-cover
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.
https://navyhealth.com.au/core-silver-hospital-and-premium-extras-cover
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.