(before any rebate, loading or discount)
Covers one adult & dependants (2 or more people, only one of whom is an adult)
Available in Northern Territory
# 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 31, 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 provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.
| Back, neck and spine | Ear, nose and throat | Miscarriage and termination of pregnancy |
| Blood | Eye (not cataracts) | Pain management |
| Bone, joint and muscle | Gastrointestinal endoscopy | Palliative care |
| Brain and nervous system | Gynaecology | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Hernia and appendix | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Joint reconstructions | Rehabilitation |
| Dental surgery | Kidney and bladder | Skin |
| Diabetes management (excluding insulin pumps) | Lung and chest | Tonsils, adenoids and grommets |
| Digestive system | Male reproductive system | Hospital psychiatric services |
| Assisted reproductive services | Implantation of hearing devices | Pregnancy and birth |
| Cataracts | Insulin pumps | Sleep studies |
| Dialysis for chronic kidney failure | Joint replacements | Weight loss surgery |
| Heart and vascular system | Pain management with device |
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.
If you are young and healthy and are not planning a family, this cover may be for you. Benefits for some hospital services are restricted or excluded to keep the premium more affordable. No excess applies for Dependent Children up to and including 21 years
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/.
| Note, for items marked with an asterisk *: There is an overall combined benefit limit for ALL benefits payable under this product (including dental, optical, therapies, pharmaceuticals, and Healthy Living benefits) up to $2,200 per person and $4,400 per policy per Membership Year. Sub-limits apply. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $400 per person up to $800 per policy | Periodic oral examination - $44.00 Scale & clean - $71.00 Fluoride treatment - $19.00 |
| Major dental* | 12 | $600 per person up to $1,200 per policy (combined limit for major dental & endodontic) | Surgical tooth extraction - $126.00 Full crown veneered - $560.00 |
| Endodontic* | 12 | Filling of one root canal - $119.00 | |
| Optical* | 2 | $245 per person up to $490 per policy | Single vision lenses & frames - $245.00 Multi-focal lenses & frames - $245.00 |
| Non PBS pharmaceuticals* | 2 | $400 per person up to $800 per policy (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $55.00 |
| Physiotherapy* | 2 | $500 per person up to $1,000 per policy (Sub-limits apply) | Initial visit - $44.00 Subsequent visit - $37.00 |
| Chiropractic* | 2 | $500 per person up to $1,000 per policy (combined limit for chiropractic & remedial massage) | Initial visit - $44.00 Subsequent visit - $28.00 |
| Podiatry* | 2 | $400 per person up to $800 per policy (combined limit for podiatry & orthotics (podiatric orthoses) - Sub-limits apply) | Initial visit - $32.00 Subsequent visit - $32.00 |
| Remedial massage* | 2 | Combined limit - see Chiropractic | Initial visit - $33.00 Subsequent visit - $33.00 |
| Health management / Healthy lifestyle* | 2 | $125 per person up to $250 per policy | Health management - $125.00 |
| Orthotics (podiatric orthoses) | 2 | Combined limit - see Podiatry | Orthotics supply & fit - 100% of charge |
| Vaccinations* | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $55.00 |
| Acupuncture | Hearing aids | Psychology |
| Blood glucose monitors | Orthodontic | 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.
In Northern Territory this policy provides:
Emergency: with a waiting period of 1 day, limited to 1 services per year.
Call-out fees: will not be paid.
This product provides Australia wide cover for one emergency ambulance transport service or on-the-spot emergency treatment per person per Membership Year . Other conditions apply – for more information please visit https://www.queenslandcountry.health/cover-options/ambulance-cover/.
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.