(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in Western Australia
# 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.
Membership of this insurer is restricted to current or former union members and their families.
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).
| Blood | Gastrointestinal endoscopy | Palliative care |
| Bone, joint and muscle | Gynaecology | Plastic and reconstructive surgery (medically necessary) |
| Brain and nervous system | Hernia and appendix | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Breast surgery (medically necessary) | Implantation of hearing devices | Skin |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Joint reconstructions | Sleep studies |
| Dental surgery | Kidney and bladder | Tonsils, adenoids and grommets |
| Diabetes management (excluding insulin pumps) | Lung and chest | Hospital psychiatric services |
| Digestive system | Male reproductive system | Rehabilitation |
| Ear, nose and throat | Miscarriage and termination of pregnancy | |
| Eye (not cataracts) | Pain management |
| Assisted reproductive services | Heart and vascular system | Pregnancy and birth |
| Back, neck and spine | Insulin pumps | Weight loss surgery |
| Cataracts | Joint replacements | |
| Dialysis for chronic kidney failure | 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 on admission. This is limited to a maximum of $250 per person 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.
Value-added services: home care after hospital, chronic disease management programs, hospital substitute programs (conditions apply). An excess is applied once per adult per calendar year. The hospital excess is waived for dependants. Reducing your excess is considered to be upgrading your membership. We will charge your previous excess within the first two months of the upgrade, including for adults who are upgrading their level of cover by joining/re-joining as a dependant on a family membership.
No-gap or agreed discounts at preferred optical, dental, and podiatry providers. See https://tuh.com.au/information/using-your-extras/find-provider.
| Note, for items marked with an asterisk *: *General dental overall limit includes general and preventative dental and major dental Endodontia services ($300 sub-limit). *Optical set benefits apply for frames/lenses/repairs, 100% up to annual limit for contacts. *Physiotherapy overall $450 limit includes $200/person $400/membership sub-limit Remedial Massage, Myotherapy, Acupuncture and Chinese Medicine. *Health Management overall limit includes $85 sub-limit Health Screenings, $80 sub-limit Health Management Programs, and $120 sub-limit Healthy Lifestyle Programs. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $600 per person (combined limit for general dental, endodontic & other services) | Periodic oral examination - $31.50 Scale & clean - $60.90 Fluoride treatment - $22.05 Surgical tooth extraction - $100.00 |
| Endodontic | 12 | Filling of one root canal - $135.00 | |
| Optical* | 6 | $200 per person | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Physiotherapy* | 2 | $450 per person (combined limit for physiotherapy, chiropractic, psychology, acupuncture, remedial massage, chinese medicine, exercise physiology, osteopathy & other services - Sub-limits apply) | Initial visit - $42.00 Subsequent visit - $37.00 |
| Chiropractic | 2 | Initial visit - $30.00 Subsequent visit - $27.00 | |
| Psychology | 2 | Initial visit - $75.00 Subsequent visit - $60.00 | |
| Acupuncture* | 2 | Initial visit - $32.00 Subsequent visit - $27.00 | |
| Remedial massage* | 2 | Initial visit - $35.00 Subsequent visit - $35.00 | |
| Chinese medicine | 2 | Initial visit - $32.00 Subsequent visit - $27.00 | |
| Exercise physiology | 2 | Initial visit - $23.00 Subsequent visit - $23.00 | |
| Health management / Healthy lifestyle* | 2 | $150 per person up to $300 per policy (combined limit for health management / healthy lifestyle & other services - Sub-limits apply) | Health management - 80% of charge |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - $33.00 Subsequent visit - $28.00 |
| Also covers: Physiotherapy overall limit includes, Group Physiotherapy $17 per consult, Chiropractic x-ray (one per year) $45, Counselling $35/$28 per consult and Group Psychology $30 per consult, Osteopathic x-ray (one per year) $45. Myotherapy $35 per consult. Health Screenings 80% of cost up to $85 sub-limit. Active Health Bonus $20/person $40/membership (conditions apply). Remote travel and accommodation is provided as a fixed benefit of 15 cents per kilometre for trips exceeding 100 kilometres one way (or 200 kilometres return) calculated directly from the home address (conditions apply). | |||
| Blood glucose monitors | Non PBS pharmaceuticals | Other treatments - check with your insurer |
| Hearing aids | Orthodontic | |
| Major dental | Podiatry |
Online and mobile access, claims via smart phone app.
In Western Australia this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Non-emergency: Unlimited transport with a waiting period of 1 day, or 1 day for pre-existing conditions.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
Members who have COMBINED HOSPITAL AND EXTRAS COVER are entitled to emergency ambulance services benefits. No annual limit will apply to emergency road ambulance services. State-owned air ambulance transportation services are covered up to $6,000 per person per annum. From 1 Jan 2022 members who have eligible stand-alone extras cover may claim the cost of a third-party regional ambulance subscription fee from the Health Program benefit category (sub-limits 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.