(before any rebate, loading or discount)
Covers one adult & dependants (2 or more people, only one of whom is an adult)
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.
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 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 surgical podiatrist – 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.
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, Chemo and Rehab in the Home. Health Coaching support for self-management of chronic disease and complex health issues. Benefits directly related to a hospital admission and when medically necessary include 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. 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 2 x dental check-ups and a bonus of $100 on your Optical limit. 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 | $1,000 per person (combined limit for general dental, major dental, endodontic & orthodontic - Sub-limits apply) $1,800 lifetime limit for Orthodontic | 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 | |
| Orthodontic | 12 | Braces for upper & lower teeth, including removal plus fitting of retainer - 60% of charge | |
| Optical* | 2 | $200 per person | Single 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 |
| Vaccinations* | 2 | Per service - n/a | |
| In South Australia, get more from your cover with Health Partners providers, like 100% back on 2 dental check-ups (including x-rays) and a bonus $100 on your Optical Limit. Also get 60% back on dental and optical 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. | |||
| Acupuncture | Hearing aids | Psychology |
| Blood glucose monitors | Physiotherapy | Remedial massage |
| Chiropractic | Podiatry | Other treatments - check with your insurer |
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 Western Australia 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.