Private Health Information Statement - Combined policy

Basic Hospital Plus $500 Excess with Flex Extras: Eyes / Body

Monthly Premium

$389.83 #

(before any rebate, loading or discount)

Covers two adults & dependants (3 or more people, only 2 of whom are adults)

Available in Tasmania

# 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.

Hospital cover

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).

This policy includes cover for

Hospital Cover Legend
Dental surgeryJoint reconstructionsHospital psychiatric services
Gastrointestinal endoscopyMale reproductive systemPalliative care
GynaecologyMiscarriage and termination of pregnancyRehabilitation
Hernia and appendixTonsils, adenoids and grommets

This policy does not include cover for

Hospital Cover Legend
Assisted reproductive servicesDialysis for chronic kidney failureLung and chest
Back, neck and spineDigestive systemPain management
BloodEar, nose and throatPain management with device
Bone, joint and muscleEye (not cataracts)Plastic and reconstructive surgery (medically necessary)
Brain and nervous systemHeart and vascular systemPodiatric surgery (provided by a registered surgical podiatrist – limited benefits)
Breast surgery (medically necessary)Implantation of hearing devicesPregnancy and birth
CataractsInsulin pumpsSkin
Chemotherapy, radiotherapy and immunotherapy for cancerJoint replacementsSleep studies
Diabetes management (excluding insulin pumps)Kidney and bladderWeight 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.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess of $500 per admission. This is limited to a maximum of $500 per person and $1000 per policy per year.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 2 months for all other treatments

Gap Cover

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.

Other features of this hospital cover

Accident Cover provides you with protection for all excluded clinical categories on your policy. Meaning, you will receive the highest level of cover if you require treatment as a result of an accident (as defined by Health Partners). T&Cs apply. Members can also access a range of discounts, refer to the ‘Member Discount’ page at healthpartners.com.au.

General Treatment Cover

Health Partners operates a preferred provider scheme available only in South Australia. See https://www.healthpartners.com.au/members/providers/.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: Health Partners providers are in SA only (Dental, Optical, Physio and Pharmacy). Get more back with Health Partners providers, including a bonus $100 on your Optical limit and 100% back on your first physio visit each year. Plus, access your pharmacy limit and receive 20% discount on most everyday non-prescription items at participating pharmacies. T&Cs apply. Waiting periods, exclusions, limits and conditions may apply.
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental*2$500 per person
(combined limit for general dental, major dental & endodontic)
Periodic oral examination - 60% of charge
Scale & clean - 60% of charge
Fluoride treatment - 60% of charge
Surgical tooth extraction - 60% of charge
Major dental*12Full crown veneered - 60% of charge
Endodontic*12Filling of one root canal - 60% of charge
Optical*2$200 per personSingle vision lenses & frames - 60% of charge
Multi-focal lenses & frames - 60% of charge
Non PBS pharmaceuticals*2$200 per person
(combined limit for non pbs pharmaceuticals & vaccinations)
Per eligible prescription - n/a
Physiotherapy*2$400 per person
(combined limit for physiotherapy, chiropractic, exercise physiology & osteopathy)
Initial visit - 60% of charge
Subsequent visit - 60% of charge
Chiropractic2Initial visit - 60% of charge
Subsequent visit - 60% of charge
Exercise physiology2Initial visit - 60% of charge
Subsequent visit - 60% of charge
Osteopathy2Initial visit - 60% of charge
Subsequent visit - 60% of charge
Vaccinations*2Combined limit - see Non PBS pharmaceuticalsPer service - n/a
In South Australia, get more from your cover with Health Partners providers, like 100% back on your first physio visit each year, and a bonus $100 on your Optical Limit. Also get 60% back on dental, optical and physio services up to your limits, at Health Partners and other recognised providers. Plus, save 20% on most full-price non-prescription items at over 50 pharmacies across SA, which include participating Priceline and TerryWhite Chemmart stores. T&Cs apply.

This policy does not include General treatment (Extras) cover for

General treatment legend
AcupunctureOrthodonticRemedial massage
Blood glucose monitorsPodiatryOther treatments - check with your insurer
Hearing aidsPsychology

Other features of this general treatment cover

Flex Extras gives you the flexibility to choose the cover that suits your needs. If your needs change or you’re not using a selected option, you can remove or change it at any time to find the right mix for you. T&Cs apply. Waiting periods, exclusions, limits and conditions may apply.

Ambulance cover

Ambulance cover is provided by the State government for residents of Tasmania. This may include cover whilst interstate, except for South Australia and Queensland where no cover applies. In other states please check with Ambulance Tasmania - https://www.health.tas.gov.au/ambulance/fees_and_accounts.

Other features of this ambulance cover

Australia wide unlimited emergency ambulance as defined by Health Partners, is for an unplanned event where there is a serious threat to your health, as a result of an accident, serious medical event or trauma, and immediate medical treatment is needed. Transport costs are covered from the place where you are initially treated, to the nearest hospital that can provide necessary emergency medical treatment. This includes treatment where no transport is provided. It also includes transport between hospitals only where required emergency care could not be provided at the transferring hospital. See Health Partners Member Guide for Terms & Conditions.

For further information about this policy see

https://www.healthpartners.com.au/health-insurance/understanding-private-health-insurance/

Disclaimer

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.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

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.

Not Covered

These categories are not covered by this policy.