(before any rebate, loading or discount)
Covers two adults & dependants (3 or more people, only 2 of whom are adults)
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 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 30, 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).
| Assisted reproductive services | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Back, neck and spine | Gastrointestinal endoscopy | Pain management |
| Blood | Gynaecology | Palliative care |
| Bone, joint and muscle | Heart and vascular system | Plastic and reconstructive surgery (medically necessary) |
| Brain and nervous system | Hernia and appendix | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Breast surgery (medically necessary) | 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) | Kidney and bladder | Sleep studies |
| Digestive system | Lung and chest | Tonsils, adenoids and grommets |
| Ear, nose and throat | Male reproductive system | Hospital psychiatric services |
| Cataracts | Joint replacements | Weight loss surgery |
| Dialysis for chronic kidney failure | Pain management with device |
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 $750 per person and $1500 per policy per year.
Co-payments: No co-payments
Waiting periods:
Private and shared room accommodation in an HIF-contracted private hospital (subject to availability of private room). Shared room accommodation in a public hospital, with the exception of public hospitals in New South Wales (NSW) where private and shared room coverage is available (subject to availability of a private room).
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.
Your choice of treating doctor or specialist. Access Gap Cover for eligible services (https://www.hif.com.au/healthinsurance/useful-links/find-a-provider to learn more and find your nearest known or no gap specialist). For family policies, no excess applies to dependants under the age of 18.
HIF has partnered with a network of providers to make a selected range of services more affordable. By choosing an HIF Choice Network provider you’ll receive low or no out-of-pocket costs. See www.hif.com.au/choice-network
| Note, for items marked with an asterisk *: Optical benefit paid on frames and prescription optical items. Pharmacy benefit paid after deduction of the PBS co-payment at 100% up to $80 per script. A $20 benefit (1 per person, per calendar year) will be paid on eligible claims for flu vaccinations from a registered pharmacy only. Benefits for replacement dentures and partial dentures are not paid within three years of previous supply. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental | 2 | $1,000 per person | Periodic oral examination - $54.35 Scale & clean - $110.35 Fluoride treatment - $33.20 Surgical tooth extraction - $152.45 |
| Major dental* | 12 | $1,000 per person (combined limit for major dental & endodontic) | Full crown veneered - $799.80 |
| Endodontic | 12 | Filling of one root canal - $142.05 | |
| Orthodontic | 12 | $800 per person $2,000 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 100% of charge |
| Optical* | 2 | $275 per person | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals* | 2 | $300 per person (combined limit for non pbs pharmaceuticals & other services) | Per eligible prescription - $80.00 |
| Physiotherapy | 2 | $500 per person (combined limit for physiotherapy, exercise physiology & other services) | Initial visit - $45.00 Subsequent visit - $45.00 |
| Chiropractic | 2 | $400 per person (combined limit for chiropractic & osteopathy) | Initial visit - $32.00 Subsequent visit - $32.00 |
| Podiatry | 2 | $350 per person | Initial visit - $32.00 Subsequent visit - $32.00 |
| Psychology | 2 | $700 per person | Initial visit - $80.00 Subsequent visit - $80.00 |
| Acupuncture | 2 | $250 per person (combined limit for acupuncture, remedial massage & chinese medicine) | Initial visit - $32.00 Subsequent visit - $32.00 |
| Remedial massage | 2 | Initial visit - $32.00 Subsequent visit - $32.00 | |
| Hearing aids | 12 | $550 per person 1 appliance(s) every 3 years | Hearing aid - 100% of charge |
| Blood glucose monitors | 12 | $200 per person 1 appliance(s) every 3 years (combined limit for blood glucose monitors & other services) | Per monitor - 75% of charge |
| Chinese medicine | 2 | Combined limit - see Acupuncture | Initial visit - $32.00 Subsequent visit - $32.00 |
| Dietetics/dietary advice | 2 | $350 per person | Initial visit - $40.00 Subsequent visit - $40.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $30.00 Subsequent visit - $30.00 |
| Eye therapy (orthoptics) | 2 | $500 per person (combined limit for eye therapy (orthoptics), occupational therapy & speech therapy) | Initial visit - $40.00 Subsequent visit - $40.00 |
| Health management / Healthy lifestyle | 2 | $100 per person | Health management - 100% of charge |
| Home nursing | 2 | $450 per person | Initial visit - $75.00 Subsequent visit - $75.00 |
| Occupational therapy | 2 | Combined limit - see Eye therapy (orthoptics) | Initial visit - $40.00 Subsequent visit - $40.00 |
| Orthotics (podiatric orthoses) | 12 | $200 per person | Orthotics supply & fit - 75% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $32.00 Subsequent visit - $32.00 |
| Speech therapy | 2 | Combined limit - see Eye therapy (orthoptics) | Initial visit - $60.00 Subsequent visit - $60.00 |
| Our Complementary Therapies includes: acupuncture, myotherapy, remedial massage and traditional Chinese medicine. Treatment must be provided by a practitioner who is registered with HIF in the speciality for which the charge is raised, benefits are not payable on medicines. A 12 month waiting period applies to IVF drugs. Other items covered: Asthmatic spacers, Diabetes Education, External Prosthesis, Humidifier/ Nebuliser and a Peak Flow Meter. | |||
| Other treatments - check with your insurer |
Advanced Extras is one of our higher value Extras cover options. It includes cover for over 20 services such as Dental, Physio, Chiro, Podiatry, Complementary Therapies, Pharmacy, Psychology and more.
In Western Australia this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Non-emergency: Unlimited transport with a waiting period of 30 days.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
There's no limit to the number of emergency ambulance services you use. If you’re taken to a hospital’s emergency department for urgent treatment, we’ll cover 100% of the charge. If it’s a non-emergency ambulance service, you only make a $50 co-payment. Not covered: Inter-hospital transportation except for inter-hospital transfers relating to an emergency or new illness where approved on a case by case basis by HIF. Transportation from a hospital to your home, nursing home or other hospital. Transportation for ongoing medical treatment. Off road, sea or air ambulance (plane, helicopter or boat).
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.