(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in Victoria
# 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.
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.
| 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) | Implantation of hearing devices | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Cataracts | Insulin pumps | Rehabilitation |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Joint reconstructions | Skin |
| Dental surgery | Joint replacements | Sleep studies |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Tonsils, adenoids and grommets |
| Digestive system | Lung and chest | Hospital psychiatric services |
| Ear, nose and throat | Male reproductive system | |
| Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Assisted reproductive services | Pregnancy and birth |
| Dialysis for chronic kidney failure | 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 $750 per admission. This is limited to a maximum of $1500 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.
NSW/ACT residents -Ambulance coverage is included Australia wide. All other States residents please contact the fund for details. NOTE: This Hospital cover provides a Gap Cover Scheme minimising Out-of-Pocket expenses for Doctors services. ****Accident cover is allowed provided you are admitted to hospital (1 day waiting period).
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 | 2 | $400 per person 2 service(s) every 1 year | Periodic oral examination - $22.00 Scale & clean - $36.00 Fluoride treatment - $25.00 Surgical tooth extraction - $55.00 |
| Optical | 2 | 1 appliance(s) every 1 year | Single vision lenses & frames - $145.00 Multi-focal lenses & frames - $185.00 |
| Non PBS pharmaceuticals | 2 | $450 per person | Per eligible prescription - $50.00 |
| Physiotherapy | 2 | $600 per person (combined limit for physiotherapy, chiropractic, podiatry, psychology, acupuncture, remedial massage, dietetics/dietary advice, occupational therapy & speech therapy) | Initial visit - $36.00 Subsequent visit - $30.00 |
| Chiropractic | 2 | Initial visit - $26.00 Subsequent visit - $22.00 | |
| Podiatry | 2 | Initial visit - $25.00 Subsequent visit - $22.00 | |
| Psychology | 2 | Initial visit - $25.00 Subsequent visit - $25.00 | |
| Acupuncture | 2 | Initial visit - $25.00 Subsequent visit - $22.00 | |
| Remedial massage | 2 | Initial visit - $30.00 Subsequent visit - $20.00 | |
| Dietetics/dietary advice | 2 | Initial visit - $25.00 | |
| Occupational therapy | 2 | Initial visit - $28.00 | |
| Speech therapy | 2 | Initial visit - $36.00 | |
| Does not include treatment for: Alexander technique; Aromatherapy; Bowen therapy; Buteyko; Feldenkrais; Western herbalism; homeopathy; iridology; kinesiology; naturopathy; Pilates; reflexology; Rolfing; Shiatsu; Tai chi; Yoga | |||
| Blood glucose monitors | Hearing aids | Orthodontic |
| Endodontic | Major dental | Other treatments - check with your insurer |
Other Dental benefits included Restorations i.e. Fillings, Metallic, 3 or more adhesive, and Posterior tooth 3 or more surfaces
Pensioner Concession Card and Healthcare Card holders are entitled to free clinically necessary ambulance transport. If you are not eligible for a concession and want to be covered, you can purchase insurance from a private health insurer or take out a subscription with the state ambulance service (https://www.ambulance.vic.gov.au/membership).
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.