(before any rebate, loading or discount)
Covers one adult & dependants (2 or more people, only one of whom is an adult)
Available in South 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.
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).
| Dental surgery | Tonsils, adenoids and grommets | Rehabilitation |
| Hernia and appendix | Hospital psychiatric services | |
| Joint reconstructions | Palliative care |
| Assisted reproductive services | Ear, nose and throat | Miscarriage and termination of pregnancy |
| Back, neck and spine | Eye (not cataracts) | Pain management |
| Blood | Gastrointestinal endoscopy | Pain management with device |
| Bone, joint and muscle | Gynaecology | Plastic and reconstructive surgery (medically necessary) |
| Brain and nervous system | Heart and vascular system | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Breast surgery (medically necessary) | Implantation of hearing devices | Pregnancy and birth |
| Cataracts | Insulin pumps | Skin |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Joint replacements | Sleep studies |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Weight loss surgery |
| Dialysis for chronic kidney failure | Lung and chest | |
| 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.
Accident Cover provides you with protection for all clinical categories, even hospital procedures and services that are listed as exclusions 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. Health Partners Support Programs: Hospital to Home, which includes Hospital Guide, Hospital in the Home and Rehab in the Home. Members can also access a range of discounts, refer to the ‘Member Discount’ page at healthpartners.com.au.
At our providers get 100% back on a dental check-up, including x-rays & 100% back on your optical limit. At our participating providers get 100% back on a physio visit. T&Cs apply. See https://www.healthpartners.com.au/members/providers/.
| Note, for items marked with an asterisk *: Health Partners and participating providers are in SA only. If you attend a Health Partners Dental or participating dental provider, higher benefits and 100% back on a dental check-up, including x-rays, will apply. General, Major and Endodontic dental benefits are based on the Health Partners schedule of fees. If your provider charges a higher fee, a larger gap payment will apply. 100% back up to your optical limits applies anywhere (sub-limit applies at recognised providers), but at Health Partners Optical you also receive 40% thereafter once limit reached. At Health Partners participating physiotherapists higher benefits apply. T&Cs apply. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $1,000 per person (combined limit for general dental, major dental & endodontic) | Periodic oral examination - 55% of charge Scale & clean - 55% of charge Fluoride treatment - 55% of charge Surgical tooth extraction - 55% of charge |
| Major dental* | 12 | Full crown veneered - 55% of charge | |
| Endodontic* | 12 | Filling of one root canal - 55% of charge | |
| Optical* | 2 | $200 per person (Sub-limits apply) | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals* | 2 | $200 per person (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - n/a |
| Physiotherapy* | 2 | $450 per person (combined limit for physiotherapy, chiropractic, exercise physiology & osteopathy - Sub-limits apply) | Initial visit - $35.00 Subsequent visit - $30.00 |
| Chiropractic | 2 | Initial visit - $35.00 Subsequent visit - $30.00 | |
| Podiatry | 2 | $350 per person (combined limit for podiatry, psychology, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy & speech therapy) | Initial visit - $30.00 Subsequent visit - $25.00 |
| Psychology | 2 | Initial visit - $60.00 Subsequent visit - $60.00 | |
| Acupuncture | 2 | $100 per person (combined limit for acupuncture, remedial massage & other services) | Initial visit - $25.00 Subsequent visit - $25.00 |
| Remedial massage | 2 | Initial visit - $25.00 Subsequent visit - $25.00 | |
| Dietetics/dietary advice | 2 | Combined limit - see Podiatry | Initial visit - $30.00 Subsequent visit - $25.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $35.00 Subsequent visit - $30.00 |
| Eye therapy (orthoptics) | 2 | Combined limit - see Podiatry | Initial visit - $30.00 Subsequent visit - $25.00 |
| Occupational therapy | 2 | Combined limit - see Podiatry | Initial visit - $30.00 Subsequent visit - $25.00 |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - $35.00 Subsequent visit - $30.00 |
| Speech therapy | 2 | Combined limit - see Podiatry | Initial visit - $30.00 Subsequent visit - $25.00 |
| Vaccinations* | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - n/a |
| In South Australia, get more from your cover by using Health Partners Dental and Optical practices - like 100% back on your dental check-up (including x-rays). Plus, 60% benefit on other general and major dental services, up to your limits. At Health Partners Optical, you get 100% back on your optical limit, and an unlimited 40% benefit after you’ve reached your limit. 100% back on your optical limit is also available at other recognised optical providers, sub-limit applies. At our participating physios get 100% back on a physio visit and 60% thereafter, up to your limit. Save 20% every day on full-price, non-prescription products at over 50 pharmacies across South Australia, which include participating Priceline and TerryWhite Chemmart stores. T&Cs apply. | |||
| Blood glucose monitors | Orthodontic |
| Hearing aids | Other treatments - check with your insurer |
Combined limits create flexibility for you to use your limit on what's important to you. Acupuncture and remedial massage limits also includes other natural therapies, such as Chinese herbalism, myofascial release, therapeutic massage, Swedish massage, myotherapy & nutritionist. T&Cs apply.
In South Australia this policy provides:
Emergency: Unlimited with no waiting period.
Call-out fees: will not be paid.
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.