(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in Queensland
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, an age-based discount or an insurer discount. Check with your insurer for details.
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 | Eye (not cataracts) | Male reproductive system |
| Blood | Gastrointestinal endoscopy | Miscarriage and termination of pregnancy |
| Bone, joint and muscle | Gynaecology | Pain management |
| Brain and nervous system | Heart and vascular system | Pain management with device |
| Breast surgery (medically necessary) | Hernia and appendix | Palliative care |
| Cataracts | Hospital psychiatric services | Plastic and reconstructive surgery (medically necessary) |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Implantation of hearing devices | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Dental surgery | Insulin pumps | Rehabilitation |
| Diabetes management (excluding insulin pumps) | Joint reconstructions | Skin |
| Dialysis for chronic kidney failure | Joint replacements | Sleep studies |
| Digestive system | Kidney and bladder | Tonsils, adenoids and grommets |
| Ear, nose and throat | Lung and chest | Weight loss surgery |
| Assisted reproductive services | Pregnancy and birth |
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 $1000 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.
By using our FirstChoice providers, you may have lower out-of-pocket costs on many allied health services. A list of "preferred providers" is available from the health insurer. See https://www.nib.com.au/find-a-provider.
| Note, for items marked with an asterisk *: Benefit paid after current PBS patient contribution deducted | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental | 2 | $700 per person | Periodic oral examination - 75% of charge Scale & clean - 75% of charge Fluoride treatment - 75% of charge |
| Major dental | 12 | $1,200 per person (combined limit for major dental & endodontic) | Surgical tooth extraction - 75% of charge Full crown veneered - 75% of charge |
| Endodontic | 12 | Filling of one root canal - 75% of charge | |
| Optical | 6 | $350 per person | Single vision lenses & frames - 75% of charge Multi-focal lenses & frames - 75% of charge |
| Non PBS pharmaceuticals* | 2 | $600 per person | Per eligible prescription - 75% of charge |
| Physiotherapy | 2 | $500 per person (combined limit for physiotherapy, chiropractic, exercise physiology & osteopathy) | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Chiropractic | 2 | Initial visit - 75% of charge Subsequent visit - 75% of charge | |
| Podiatry | 2 | $400 per person (combined limit for podiatry, dietetics/dietary advice, eye therapy (orthoptics), home nursing, occupational therapy & speech therapy) | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Acupuncture | 2 | $250 per person (combined limit for acupuncture, remedial massage, chinese medicine & other services - Sub-limits apply) | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Remedial massage | 2 | Initial visit - 75% of charge Subsequent visit - 75% of charge | |
| Hearing aids | 36 | $1,000 per person (combined limit for hearing aids, blood glucose monitors, orthotics (podiatric orthoses) & other services) | Hearing aid - 75% of charge |
| Blood glucose monitors | 12 | Per monitor - 75% of charge | |
| Chinese medicine | 2 | Combined limit - see Acupuncture | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Dietetics/dietary advice | 2 | Combined limit - see Podiatry | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Eye therapy (orthoptics) | 2 | Combined limit - see Podiatry | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Health management / Healthy lifestyle | 6 | $150 per person | Health management - 75% of charge |
| Home nursing | 2 | Combined limit - see Podiatry | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Occupational therapy | 2 | Combined limit - see Podiatry | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Orthotics (podiatric orthoses) | 2 | Combined limit - see Hearing aids | Orthotics supply & fit - 75% of charge |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Speech therapy | 2 | Combined limit - see Podiatry | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Other Therapies ($400) includes dietary advice, eye therapy, home nursing, occupational therapy, podiatry and speech pathology. Hearing aids / Artificial aids / Orthotics ($1,000) includes e.g. spacer, peak flow meter, nebuliser, blood glucose monitor, Irlen lens (service limits apply). Myotherapy: combined limit of $250 with acupuncture, remedial massage and Chinese herbalism. Healthier Lifestyle includes nib approved weight management, quit smoking and health management programs (gym, personal trainer) and more (service limits apply). Non-PBS pharmaceuticals have a sub limit of $150 for Weight Management Medication. | |||
| Orthodontic | Psychology | Other treatments - check with your insurer |
For customers looking for a high level of cover, tailored for them when they reached a certain time in their life. Of course, you can see your choice of provider, but by choosing a FirstChoice provider, you may have less to pay towards the cost of your treatment. We’ve created the FirstChoice network to help you access quality healthcare and a better deal for you and your family. We’ve locked in lower costs with our FirstChoice providers, so you can enjoy competitive treatment fees when you visit the dentist or a discount the next time you claim for glasses.
Ambulance cover is provided by the State government for Queensland residents (https://www.ambulance.qld.gov.au/). This includes cover whilst interstate.
Emergency ambulance costs are covered by the state government for residents of Queensland.
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.