(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
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 covers children and other dependants up to and including the age of 20, students up to and including the age of 30, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.
This policy exempts you from the Medicare Levy Surcharge.
This policy does not provide accident cover or benefits for travel and accommodation (outside of hospital).
| Blood | Gynaecology | Tonsils, adenoids and grommets |
| Bone, joint and muscle | Hernia and appendix | Assisted reproductive services |
| Brain and nervous system | Implantation of hearing devices | Cataracts |
| Breast surgery (medically necessary) | Joint reconstructions | Heart and vascular system |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Kidney and bladder | Hospital psychiatric services |
| Dental surgery | Lung and chest | Joint replacements |
| Diabetes management (excluding insulin pumps) | Male reproductive system | Plastic and reconstructive surgery (medically necessary) |
| Dialysis for chronic kidney failure | Miscarriage and termination of pregnancy | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Digestive system | Pain management | Pregnancy and birth |
| Ear, nose and throat | Palliative care | Rehabilitation |
| Eye (not cataracts) | Skin | |
| Gastrointestinal endoscopy | Sleep studies |
| Back, neck and spine | Pain management with device |
| Insulin pumps | 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 $200 per admission. This is limited to a maximum of $200 per person and $400 per policy 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 | General Dental: Unlimited; Restorative Services: $450; Non-specialty Oral Surgery: $350(Policy); Specialty Oral Surgery: $500, $1600 per Lifetime; (Service Limits Apply) | Periodic oral examination - $21.00 Scale & clean - $35.00 Fluoride treatment - $19.00 Surgical tooth extraction - $65.00 |
| Optical | 6 | $250 per person | Single vision lenses & frames - $140.00 Multi-focal lenses & frames - $190.00 |
| Non PBS pharmaceuticals* | 2 | $450 per person | Per eligible prescription - $45.00 |
| Physiotherapy | 2 | $400 per person (combined limit for physiotherapy, chiropractic, exercise physiology & osteopathy - Sub-limits apply) | Initial visit - $28.00 Subsequent visit - $26.00 |
| Chiropractic | 2 | Initial visit - $25.00 Subsequent visit - $22.00 | |
| Psychology | 2 | $300 per person | Initial visit - $45.00 Subsequent visit - $40.00 |
| Remedial massage | 2 | $170 per person (combined limit for remedial massage & dietetics/dietary advice) | Initial visit - $19.00 Subsequent visit - $18.00 |
| Dietetics/dietary advice | 2 | Initial visit - $19.00 Subsequent visit - $18.00 | |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $28.00 Subsequent visit - $26.00 |
| Health management / Healthy lifestyle | 6 | $100 per Single Policy $200 per Family Policy | Health management - 100% of charge |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - $25.00 Subsequent visit - $23.00 |
| The General Dental annual limit includes multiple sub-limits, and for some sub-limits lifetime limits apply. Waiting periods for Dental treatment range between 2 and 12 months. Healthier Lifestyle includes nib approved weight management programs, quit smoking and nicotine replacement. Sublimits apply to physiotherapy, exercise physiology, chiropractic and osteopathy. Please refer to factsheet for further details. Psychology has a sublimit of $150 for Digital Cognitive Behavioural Therapy (CBT). | |||
| Acupuncture | Hearing aids | Podiatry |
| Blood glucose monitors | Major dental | Other treatments - check with your insurer |
| Endodontic | Orthodontic |
A lower level of hospital cover for some services, plus a range of Extras. 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.
In South Australia 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.
All our health covers include unlimited emergency ambulance (1 day waiting period on all emergency ambulance). Emergency ambulance is when you need immediate transport by a State or Territory ambulance to get to a hospital or other facility for urgent medical treatment. No annual limits for emergency ambulance apply.
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.