(before any rebate, loading or discount)
Covers one adult & dependants, including non-student dependants (2 or more people, only one of whom is an adult)
Available in Queensland
# 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, students up to and including the age of 31 and non-students up to and including the age of 31, as well as persons with a disability who qualify as a child, student or non-student in these age ranges.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.
| Bone, joint and muscle | Kidney and bladder | Hospital psychiatric services |
| Dental surgery | Lung and chest | Palliative care |
| Diabetes management (excluding insulin pumps) | Miscarriage and termination of pregnancy | Rehabilitation |
| Hernia and appendix | Skin | |
| Joint reconstructions | Tonsils, adenoids and grommets |
| Assisted reproductive services | Ear, nose and throat | Pain management |
| Back, neck and spine | Eye (not cataracts) | Pain management with device |
| Blood | Gastrointestinal endoscopy | Plastic and reconstructive surgery (medically necessary) |
| Brain and nervous system | Gynaecology | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Breast surgery (medically necessary) | Heart and vascular system | Pregnancy and birth |
| Cataracts | Implantation of hearing devices | Sleep studies |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Weight loss surgery |
| Dialysis for chronic kidney failure | Joint replacements | |
| Digestive system | 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: You will have to pay an excess of $750 per admission. This is limited to a maximum of $750 per person and $1500 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.
No excess applies for Dependent Children up to and including 21 years
https://www.queenslandcountry.health/siteassets/product-factsheet-download/budget_essential.pdf
By using this health insurer's "preferred providers" you will have lower out-of-pocket costs on selected allied health services and have access to more "no gap" services. See https://www.queenslandcountry.health/provider-search/premier-provider-network/.
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
|---|---|---|---|
| General dental | 2 | $900 per person (combined limit for general dental, major dental, endodontic & other services - Sub-limits apply) | Periodic oral examination - $39.00 Scale & clean - $63.00 Fluoride treatment - $16.00 |
| Major dental | 12 | Surgical tooth extraction - $126.00 Full crown veneered - $560.00 | |
| Endodontic | 12 | Filling of one root canal - $119.00 | |
| Orthodontic | 12 | $1,500 lifetime limit (Sub-limits apply) | Braces for upper & lower teeth, including removal plus fitting of retainer - $500.00 |
| Optical | 2 | $215 per person | Single vision lenses & frames - $215.00 Multi-focal lenses & frames - $215.00 |
| Non PBS pharmaceuticals | 2 | $300 per person (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $45.00 |
| Physiotherapy | 2 | $900 per person (combined limit for physiotherapy, chiropractic, podiatry, psychology, acupuncture, remedial massage, audiology, chinese medicine, dietetics/dietary advice, exercise physiology, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), osteopathy & speech therapy - Sub-limits apply) | Initial visit - $39.00 Subsequent visit - $33.00 |
| Chiropractic | 2 | Initial visit - $39.00 Subsequent visit - $25.00 | |
| Podiatry | 2 | Initial visit - $28.00 Subsequent visit - $28.00 | |
| Psychology | 2 | Initial visit - $56.00 Subsequent visit - $56.00 | |
| Acupuncture | 2 | Initial visit - $25.00 Subsequent visit - $25.00 | |
| Remedial massage | 2 | Initial visit - $30.00 Subsequent visit - $30.00 | |
| Audiology | 2 | Initial visit - $35.00 Subsequent visit - $35.00 | |
| Ante-natal/Post-natal classes | 12 | $42 per person | Initial visit - $42.00 Subsequent visit - $42.00 |
| Chinese medicine | 2 | Combined limit - see Physiotherapy | Initial visit - $25.00 Subsequent visit - $25.00 |
| Dietetics/dietary advice | 2 | Combined limit - see Physiotherapy | Initial visit - $53.00 Subsequent visit - $28.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $35.00 Subsequent visit - $25.00 |
| Eye therapy (orthoptics) | 2 | Combined limit - see Physiotherapy | Initial visit - $42.00 Subsequent visit - $42.00 |
| Health management / Healthy lifestyle | 2 | $125 per person | Health management - $125.00 |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $56.00 Subsequent visit - $28.00 |
| Orthotics (podiatric orthoses) | 2 | Combined limit - see Physiotherapy | Orthotics supply & fit - 100% of charge |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - $39.00 Subsequent visit - $28.00 |
| Speech therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $56.00 Subsequent visit - $28.00 |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $45.00 |
| Rewarding Limits - Once you have held your extras cover with us for one year, we will automatically increase your annual limits for dental (excluding orthodontics) and therapies by $50 per year, up to a maximum of $250. After five years of membership, your limits will increase to $1,150 per person per Membership Year. We honour this loyalty limit for as long as you continuously hold this product. Rewarding limits do not apply to sub-limits. | |||
| Blood glucose monitors | Hearing aids | Other treatments - check with your insurer |
Health management (Healthy Living benefit) provides benefits towards the costs of metabolic dieticians or nutritionists consultations to assist with weight management, diabetes education consultations, quit smoking programs, skin checks for skin cancers (except where there is a Medicare benefit), bowel screening and bone density tests, a second yearly prostate specific antigen test not covered by Medicare, supermarket tours conducted by a dietitian or other allied health professional qualified to provide nutrition advice, and gym memberships/personal training sessions provided under an approved health management or chronic disease management program. Please contact the insurer for full details.
https://www.queenslandcountry.health/siteassets/product-factsheet-download/budget_essential.pdf
Ambulance cover is provided by the State government for Queensland residents (https://www.ambulance.qld.gov.au/). This includes cover whilst interstate.
https://www.queenslandcountry.health/cover-options/ambulance-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.