(before any rebate, loading or discount)
Covers only one person
Available in All States
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading or an insurer discount. Check with your insurer for details.
Membership of this insurer is restricted to Seventh-day Adventist Church employees, Local Church Officers and their families.
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).
| Palliative care | Hospital psychiatric services | Rehabilitation |
| Assisted reproductive services | Ear, nose and throat | Male reproductive system |
| 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 | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Hernia and appendix | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Cataracts | Implantation of hearing devices | Pregnancy and birth |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Skin |
| Dental surgery | Joint reconstructions | Sleep studies |
| Diabetes management (excluding insulin pumps) | Joint replacements | Tonsils, adenoids and grommets |
| Dialysis for chronic kidney failure | Kidney and bladder | Weight loss surgery |
| Digestive system | Lung and chest |
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: No excess
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.
Theatre Fees are not covered under Basic Hospital Cover. For NSW & ACT residents only, Hospital cover includes ambulance cover for emergency (unlimited with no waiting period) and call-out fees (paid for each attendance, including emergency treatment without transport to hospital) in that state or territory only.
This health insurer does not operate a preferred provider scheme.
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
|---|---|---|---|
| General dental | 9 | $1,100 per policy (combined limit for general dental, major dental & endodontic) | Periodic oral examination - $100.00 Scale & clean - $100.00 Fluoride treatment - $100.00 |
| Major dental | 9 | Surgical tooth extraction - $270.00 Full crown veneered - $1,000.00 | |
| Endodontic | 9 | Filling of one root canal - $1,100.00 | |
| Optical | 4 | $300 per policy | Single vision lenses & frames - $300.00 Multi-focal lenses & frames - $300.00 |
| Non PBS pharmaceuticals | 2 | $400 per policy (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $100.00 |
| Physiotherapy | 2 | $500 per policy (combined limit for physiotherapy, chiropractic, exercise physiology, occupational therapy, osteopathy & speech therapy) | Initial visit - $75.00 Subsequent visit - $55.00 |
| Chiropractic | 2 | Initial visit - $45.00 Subsequent visit - $32.00 | |
| Podiatry | 2 | $250 per policy (combined limit for podiatry & orthotics (podiatric orthoses)) | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Psychology | 2 | $300 per policy | Initial visit - $110.00 Subsequent visit - $80.00 |
| Acupuncture | 2 | $300 per policy (combined limit for acupuncture, remedial massage, chinese medicine & dietetics/dietary advice) | Initial visit - $30.00 Subsequent visit - $30.00 |
| Remedial massage | 2 | Initial visit - $30.00 Subsequent visit - $30.00 | |
| Hearing aids | 12 | $600 per policy 1 service(s) every 3 years | Hearing aid - $600.00 |
| Blood glucose monitors | 12 | $55 per policy 1 service(s) every 1 year | Per monitor - $55.00 |
| Ante-natal/Post-natal classes | 2 | $300 per policy | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Chinese medicine | 2 | Combined limit - see Acupuncture | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Dietetics/dietary advice | 2 | Combined limit - see Acupuncture | Initial visit - 80% of charge Subsequent visit - 80% of charge |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $22.50 Subsequent visit - $22.50 |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $80.00 Subsequent visit - $65.00 |
| Orthotics (podiatric orthoses) | 12 | Combined limit - see Podiatry | Orthotics supply & fit - 80% of charge |
| Osteopathy | 2 | Combined limit - see Physiotherapy | Initial visit - $45.00 Subsequent visit - $32.00 |
| Speech therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $50.00 Subsequent visit - $40.00 |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $100.00 |
| Excludes Orthodontic, Audiology, Orthoptics, Home nursing. Podiatry and Orthotics does not include benefits for the purchase of shoes to accommodate orthoses or shoe modification. | |||
| Orthodontic | Other treatments - check with your insurer |
In All States this policy provides:
Emergency: Unlimited with no waiting period.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
State schemes provide ambulance services for residents of Tasmania (https://www.health.tas.gov.au/ambulance/fees_and_accounts) and Queensland (https://www.ambulance.qld.gov.au/).
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.