(before any rebate, loading or discount)
Covers one adult & dependants, including non-student 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, students up to and including the age of 31 and non-students up to and including the age of 31, as well as persons with a disability who qualify as a child, student or non-student in these age ranges.
This policy exempts you from the Medicare Levy Surcharge.
This policy does not provide accident cover or benefits for travel and accommodation (outside of hospital).
| Back, neck and spine | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Blood | Gastrointestinal endoscopy | Pain management |
| Bone, joint and muscle | Gynaecology | Pain management with device |
| Brain and nervous system | Heart and vascular system | Palliative care |
| Breast surgery (medically necessary) | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Cataracts | Implantation of hearing devices | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Joint replacements | Sleep studies |
| Dialysis for chronic kidney failure | Kidney and bladder | Tonsils, adenoids and grommets |
| Digestive system | Lung and chest | Hospital psychiatric services |
| Ear, nose and throat | Male reproductive system |
| Assisted reproductive services | Pregnancy and birth | Weight 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.
Excess: You will have to pay an excess of $250 per admission. This is limited to a maximum of $250 per person per year.
Excess payments do not apply to hospital admissions for dependants.
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 to Home; includes Hospital Guide, Hospital in the Home and Rehab in the Home. Health Management Programs; Health Coaching. Benefits directly related to an admission and medically necessary: PBS approved prescriptions - 100% benefit & unlimited, Aids for recovery benefit 75% with $100 limit, non-surgically implanted medical devices and human tissue products benefit 75% with $150 limit. 12 month waiting period for insulin pumps & hearing devices. Members can also access a range of discounts, refer to the ‘Member Discount’ page at healthpartners.com.au.
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 and participating providers are in SA only. If you attend a Health Partners Dental or participating dental provider, higher benefits and 100% back on 2 x dental check-ups, 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 | No annual limit (no limit on preventative dental) | Periodic oral examination - 65% of charge Scale & clean - 65% of charge Fluoride treatment - 65% of charge Surgical tooth extraction - 65% of charge |
| Major dental* | 12 | $900 per person (combined limit for major dental & endodontic) | Full crown veneered - 65% of charge |
| Endodontic* | 12 | Filling of one root canal - 65% of charge | |
| Orthodontic | 12 | $1,500 lifetime limit (Sub-limits apply) | Braces for upper & lower teeth, including removal plus fitting of retainer - 100% of charge |
| Optical* | 2 | $250 per person (Sub-limits apply) | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals* | 2 | $300 per person (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - n/a |
| Physiotherapy* | 2 | $600 per person (combined limit for physiotherapy, chiropractic, exercise physiology & osteopathy - Sub-limits apply) | Initial visit - $40.00 Subsequent visit - $35.00 |
| Chiropractic | 2 | Initial visit - $40.00 Subsequent visit - $35.00 | |
| Podiatry | 2 | $500 per person (combined limit for podiatry, psychology, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy & speech therapy) | Initial visit - $35.00 Subsequent visit - $30.00 |
| Psychology | 2 | Initial visit - $75.00 Subsequent visit - $75.00 | |
| Acupuncture | 2 | $200 per person (combined limit for acupuncture, remedial massage & chinese medicine) | Initial visit - $30.00 Subsequent visit - $30.00 |
| Remedial massage | 2 | Initial visit - $30.00 Subsequent visit - $30.00 | |
| Hearing aids | 12 | $400 per person 1 appliance(s) every 3 years (combined limit for hearing aids, blood glucose monitors, orthotics (podiatric orthoses) & other services - Sub-limits apply) | Hearing aid - 70% of charge |
| Blood glucose monitors | 12 | Per monitor - 70% of charge | |
| Chinese medicine | 2 | Combined limit - see Acupuncture | Initial visit - $30.00 Subsequent visit - $30.00 |
| Dietetics/dietary advice | 2 | Combined limit - see Podiatry | Initial visit - $35.00 Subsequent visit - $30.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $40.00 Subsequent visit - $35.00 |
| Eye therapy (orthoptics) | 2 | Combined limit - see Podiatry | Initial visit - $35.00 Subsequent visit - $30.00 |
| Health management / Healthy lifestyle | 2 | $100 per person | Health management - 70% of charge |
| Occupational therapy | 2 | Combined limit - see Podiatry | Initial visit - $35.00 Subsequent visit - $30.00 |
| Orthotics (podiatric orthoses) | 12 | Combined limit - see Hearing aids | Orthotics supply & fit - 70% of charge |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - $40.00 Subsequent visit - $35.00 |
| Speech therapy | 2 | Combined limit - see Podiatry | Initial visit - $35.00 Subsequent visit - $30.00 |
| 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 2 x dental check-ups (including x-rays) and a mouth guard. Plus, 70% 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 70% 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. | |||
| 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 can also be used for other natural therapies, such as Chinese herbalism, myofascial release, therapeutic massage, Swedish massage, myotherapy & nutritionist. Also combined with the Hearing Aid limit is other appliances such as CPAP Machine, nebuliser & spacer devices. Sub-limits apply. Health Management limits include benefits for bowel screening, diabetes membership, weight management, post-natal lactation consultation and gym & fitness (when medically necessary). T&Cs apply.
In Northern Territory 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.