(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 - check with your insurer for details.
This policy does not provide benefits for travel or accommodation (outside of hospital).
| Blood | Eye (not cataracts) | Pain management |
| Bone, joint and muscle | Gastrointestinal endoscopy | Plastic and reconstructive surgery (medically necessary) |
| Brain and nervous system | Gynaecology | Skin |
| Breast surgery (medically necessary) | Hernia and appendix | Tonsils, adenoids and grommets |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Joint reconstructions | Hospital psychiatric services |
| Dental surgery | Kidney and bladder | Palliative care |
| Diabetes management (excluding insulin pumps) | Lung and chest | Rehabilitation |
| Digestive system | Male reproductive system | |
| Ear, nose and throat | Miscarriage and termination of pregnancy |
| Assisted reproductive services | Implantation of hearing devices | Pregnancy and birth |
| Back, neck and spine | Insulin pumps | Sleep studies |
| Cataracts | Joint replacements | Weight loss surgery |
| Dialysis for chronic kidney failure | Pain management with device | |
| Heart and vascular system | Podiatric surgery (provided by a registered surgical podiatrist – limited benefits) |
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.
Health Partners Support Programs: Hospital, and, Chemo in the Home. Unlimited Emergency Ambulance. Includes Accident Cover – providing you with protection for all clinical categories that are listed as exclusions on your cover. T&Cs apply. Plus access to a range of Member Discounts, visit healthpartners.com.au for more information.
Health Partners operates a preferred provider scheme available only in South Australia. See https://www.healthpartners.com.au/members/providers/.
| 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 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. | |||
|---|---|---|---|
| Treatment | Waiting 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* | 12 | Full crown veneered - 60% of charge | |
| Endodontic* | 12 | Filling of one root canal - 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 |
| Chiropractic | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Podiatry | 2 | $200 per person (combined limit for podiatry, psychology, dietetics/dietary advice, eye therapy (orthoptics), health management / healthy lifestyle, occupational therapy & speech therapy) | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Psychology | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Acupuncture | 2 | $200 per person (combined limit for acupuncture, remedial massage & chinese medicine) | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Remedial massage | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Chinese medicine | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Dietetics/dietary advice | 2 | Combined limit - see Podiatry | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Eye therapy (orthoptics) | 2 | Combined limit - see Podiatry | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Health management / Healthy lifestyle | 2 | Combined limit - see Podiatry | Health management - 60% of charge |
| Occupational therapy | 2 | Combined limit - see Podiatry | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Speech therapy | 2 | Combined limit - see Podiatry | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Vaccinations* | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - n/a |
| In South Australia, get more from your cover with Health Partners providers. Enjoy 60% back on physio visits at participating 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. | |||
| Blood glucose monitors | Optical | Other treatments - check with your insurer |
| Hearing aids | Orthodontic |
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.
In Northern Territory this policy provides:
Emergency: Unlimited with a waiting period of 2 months.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
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.
https://www.healthpartners.com.au/health-insurance/understanding-private-health-insurance/
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.