(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in Victoria
Closed to new members
# 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.
Membership of this insurer is restricted to Medical and allied health professionals, their families, medical students and AMA employees.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.
| Assisted reproductive services | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Back, neck and spine | Gastrointestinal endoscopy | Pain management |
| Blood | Gynaecology | Pain management with device |
| Bone, joint and muscle | Heart and vascular system | Palliative care |
| Brain and nervous system | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Hospital psychiatric services | 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 | 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 | Weight loss surgery |
| Ear, nose and throat | 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 on admission. This is limited to a maximum of $250 per person and $500 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.
This cover is categorised as Gold as it includes cover for the full range of inpatient services eligible for Medicare benefits, meaning there are no exclusions and restrictions. Prime Choice Gold is ideal for families who are looking for comprehensive hospital cover.
This health insurer does not operate a preferred provider scheme.
| Note, for items marked with an asterisk *: Orthodontic services accrue to a lifetime limit of $3,000 at $600 per year of membership. $700 optical limit every 2 years. Individual and group physiotherapy and hydrotherapy claimable under physiotherapy. Class physiotherapy and acupuncture claimable through health management when prescribed by your medical practitioner. | |||
|---|---|---|---|
| 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 - 100% of charge Scale & clean - 100% of charge Fluoride treatment - 100% of charge Surgical tooth extraction - $195.00 |
| Major dental | 12 | $4,200 per person (combined limit for major dental, endodontic & other services - Sub-limits apply) | Full crown veneered - $900.00 |
| Endodontic | 12 | Filling of one root canal - $155.00 | |
| Orthodontic* | 12 | $3,000 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 100% of charge |
| Optical* | 2 | $700 per person | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals | 2 | $600 per person (combined limit for non pbs pharmaceuticals & vaccinations - Sub-limits apply) | Per eligible prescription - 85% of charge |
| Physiotherapy* | 2 | $700 per person (combined limit for physiotherapy, remedial massage & exercise physiology) | Initial visit - $75.00 Subsequent visit - $50.00 |
| Podiatry | 2 | $1,000 per person (combined limit for podiatry, ante-natal/post-natal classes, dietetics/dietary advice, eye therapy (orthoptics), occupational therapy, orthotics (podiatric orthoses), speech therapy & other services - Sub-limits apply) | Initial visit - $65.00 Subsequent visit - $40.00 |
| Psychology | 2 | $900 per person | Initial visit - $100.00 Subsequent visit - $100.00 |
| Acupuncture* | 2 | $250 per person up to $500 per policy (combined limit for acupuncture, health management / healthy lifestyle & other services) | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Remedial massage | 2 | Combined limit - see Physiotherapy | Initial visit - $50.00 Subsequent visit - $35.00 |
| Hearing aids | 24 | $1,600 per person 1 appliance(s) every 5 years | Hearing aid - $800.00 |
| Blood glucose monitors | 12 | $1,000 per person up to $500 per service 1 appliance(s) every 2 years (combined limit for blood glucose monitors & other services - Sub-limits apply) | Per monitor - 75% of charge |
| Audiology | 2 | 1 service(s) every 1 year | Initial visit - $60.00 Subsequent visit - $60.00 |
| Ante-natal/Post-natal classes | 2 | Combined limit - see Podiatry | Initial visit - $65.00 Subsequent visit - $35.00 |
| Dietetics/dietary advice | 2 | Combined limit - see Podiatry | Initial visit - $65.00 Subsequent visit - $40.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $35.00 Subsequent visit - $35.00 |
| Eye therapy (orthoptics) | 2 | Combined limit - see Podiatry | Initial visit - $65.00 Subsequent visit - $40.00 |
| Health management / Healthy lifestyle | 2 | Combined limit - see Acupuncture | Health management - 75% of charge |
| Home nursing | 2 | $600 per person | Initial visit - $30.00 Subsequent visit - $30.00 |
| Occupational therapy | 2 | Combined limit - see Podiatry | Initial visit - $65.00 Subsequent visit - $45.00 |
| Orthotics (podiatric orthoses) | 12 | Combined limit - see Podiatry | Orthotics supply & fit - $200.00 |
| Speech therapy | 2 | Combined limit - see Podiatry | Initial visit - $65.00 Subsequent visit - $45.00 |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - 85% of charge |
| Major dental has sub-limits and is paid at fixed benefits per item. Combined annual limit of $1,000 for podiatry, dietetics, orthoptics, occupational therapy, speech therapy and pregnancy care (sub-limits of $600 per therapy and $200 per pair for orthotics up to 2 pairs per year). Group physiotherapy and hydrotherapy $20 per session. Benefit of $800 each for one left and one right hearing aid every 5 years. Benefit for laser eye surgery to each eye every 5 years. Home nursing $30 per visit up to 6 hours, $60 per visit over 6 hours. Pharmacy benefits paid at 85% of charge above the PBS co-payment to a maximum of $70 per prescription (sub-limit applies for weight loss medications). | |||
| Chiropractic | Other treatments - check with your insurer |
Premium extras with comprehensive dental including orthodontics and high benefits and limits across therapies. 100% back for dental checkups, bitewing x-rays and fissure sealings at the provider of your choice. No sub-limits on optical benefits – use the full $700 on your choice of contact lenses or frames fitted with prescription lenses. Laser eye surgery benefit of $800 per eye once every 5 years. Premium support for mental health with a $900 limit per year. Health management includes services such as acupuncture, weight loss classes and class physiotherapy for the treatment of a specific diagnosed condition.
In Victoria this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Non-emergency: Unlimited transport with a waiting period of 1 day, or 1 day for pre-existing conditions.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
National cover for emergency and medically necessary ambulance transportation costs except where there is an entitlement to Benefits under a State Government ambulance transport scheme or any other source.
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.