(before any rebate, loading or discount)
Covers only one person
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 - check with your insurer for details.
This policy does not provide benefits for travel or accommodation (outside of hospital).
| Back, neck and spine | Ear, nose and throat | Miscarriage and termination of pregnancy |
| Blood | Eye (not cataracts) | Pain management |
| Bone, joint and muscle | Gastrointestinal endoscopy | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Brain and nervous system | Gynaecology | Skin |
| Breast surgery (medically necessary) | Hernia and appendix | Tonsils, adenoids and grommets |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Implantation of hearing devices | Hospital psychiatric services |
| Dental surgery | Joint reconstructions | Palliative care |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Rehabilitation |
| Digestive system | Male reproductive system |
| Assisted reproductive services | Insulin pumps | Plastic and reconstructive surgery (medically necessary) |
| Cataracts | Joint replacements | Pregnancy and birth |
| Dialysis for chronic kidney failure | Lung and chest | Sleep studies |
| Heart and vascular system | Pain management with device | 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 $500 per admission. This is limited to a maximum of $500 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 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 | Gap Free Preventative Dental 100% Benefit Limit 2 Service Person Per Year Items Number 011-015 111-116 | Periodic oral examination - 100% of charge Scale & clean - 100% of charge Fluoride treatment - $25.00 Surgical tooth extraction - $125.00 |
| Major dental | 12 | $850 per policy | Full crown veneered - $800.00 |
| Endodontic | 2 | No annual limit | Filling of one root canal - $125.00 |
| Orthodontic | 12 | $400 per policy $2,400 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - $2,400.00 |
| Optical | 2 | $299 per policy | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals | 2 | $700 per policy (combined limit for non pbs pharmaceuticals & vaccinations - Sub-limits apply) | Per eligible prescription - $70.00 |
| Physiotherapy | 2 | $700 per policy (combined limit for physiotherapy, occupational therapy & speech therapy - Sub-limits apply) | Initial visit - $40.00 Subsequent visit - $36.00 |
| Chiropractic | 2 | $480 per policy (combined limit for chiropractic, podiatry, psychology, acupuncture, remedial massage, dietetics/dietary advice, exercise physiology & osteopathy - Sub-limits apply) | Initial visit - $26.00 Subsequent visit - $22.00 |
| Podiatry | 2 | Initial visit - $26.00 Subsequent visit - $22.00 | |
| Psychology | 2 | Initial visit - $38.00 Subsequent visit - $38.00 | |
| Acupuncture | 2 | Initial visit - $35.00 Subsequent visit - $35.00 | |
| Remedial massage | 2 | Initial visit - $40.00 Subsequent visit - $40.00 | |
| Hearing aids | 12 | $750 per policy | Hearing aid - 75% of charge |
| Blood glucose monitors | 12 | $100 per policy | Per monitor - 75% of charge |
| Ante-natal/Post-natal classes | 2 | $150 per policy | Initial visit - $15.00 Subsequent visit - $15.00 |
| Dietetics/dietary advice | 0 | Combined limit - see Chiropractic | Initial visit - $26.00 |
| Exercise physiology | 2 | Combined limit - see Chiropractic | Initial visit - $26.00 Subsequent visit - $26.00 |
| Health management / Healthy lifestyle | 2 | $100 per policy | Health management - $50.00 |
| Home nursing | 2 | $750 per Calendar Year | Initial visit - $16.00 Subsequent visit - $16.00 |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $28.00 Subsequent visit - $28.00 |
| Orthotics (podiatric orthoses) | 12 | $150 per policy | Orthotics supply & fit - 75% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $26.00 Subsequent visit - $22.00 |
| Speech therapy | 2 | Combined limit - see Physiotherapy | Initial visit - $28.00 Subsequent visit - $32.00 |
| Vaccinations | 2 | Combined limit - see Non PBS pharmaceuticals | Per service - $70.00 |
| CSIRO Total Wellbeing Diet $299 1 Per Membership Per Year | |||
| Other treatments - check with your insurer |
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.