(before any rebate, loading or discount)
Covers only one person
Available in All States
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 or an insurer discount. Check with your insurer for details.
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).
| Assisted reproductive services | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| 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) | Hospital psychiatric services | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Cataracts | Implantation of hearing devices | Pregnancy and birth |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Joint replacements | Sleep studies |
| Dialysis for chronic kidney failure | Kidney and bladder | Tonsils, adenoids and grommets |
| Digestive system | Lung and chest | Weight loss surgery |
| Ear, nose and throat | Male reproductive system |
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: No excess
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.
Ambulance Cover Nationwide. No waiting period applies for hospital treatment resulting from an accident.
By using onemedifund's 'preferred providers' you may have lower out of pocket costs on Dental and Optical treatments and have access to more 'no gap' treatments. A list of 'preferred providers' is available from the fund.
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
|---|---|---|---|
| General dental | 2 | $550 per policy (combined limit for general dental & endodontic) | Periodic oral examination - 75% of charge Scale & clean - 75% of charge Fluoride treatment - 75% of charge Surgical tooth extraction - 75% of charge |
| Endodontic | 2 | Filling of one root canal - 75% of charge | |
| Optical | 6 | $180 per policy | Single vision lenses & frames - $180.00 Multi-focal lenses & frames - $180.00 |
| Non PBS pharmaceuticals | 2 | $500 per policy (combined limit for non pbs pharmaceuticals & vaccinations - Sub-limits apply) | Per eligible prescription - $50.00 |
| Physiotherapy | 2 | $350 per policy (combined limit for physiotherapy & exercise physiology) | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Chiropractic | 2 | $350 per policy (combined limit for chiropractic, podiatry, acupuncture, remedial massage, osteopathy & other services) | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Podiatry | 2 | Initial visit - 75% of charge Subsequent visit - 75% of charge | |
| Acupuncture | 2 | Initial visit - 75% of charge Subsequent visit - 75% of charge | |
| Remedial massage | 2 | 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 |
| Health management / Healthy lifestyle | 6 | $100 per policy | Health management - 75% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $65.00 |
| Blood glucose monitors | Major dental | Psychology |
| Hearing aids | Orthodontic | Other treatments - check with your insurer |
Benefits for General Dental, Pharmacy, Physiotherapy, Natural Therapies, Remedial Massage, Chiropractic, Acupuncture, Osteopathy and Podiatry paid at 75% of the cost up to the annual limit. Ambulance Cover Nationwide.
In All States this policy provides:
Emergency: Unlimited with no waiting period.
Non-emergency: Unlimited transport with no waiting period.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
State schemes provide ambulance services for residents of Tasmania (https://www.health.tas.gov.au/ambulance/fees_and_accounts) and Queensland (https://www.ambulance.qld.gov.au/).
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.